HSR21-064: The Effectiveness of Psychological Intervention on Reducing Distress in Patients With Prostate Cancer: A Literature Meta-Analysis

Authors: Rhea Mundle BS1, Evans Afenya PhD2, and Neeraj Agarwal MD3
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  • 1 University of Illinois at Urbana Champaign, Urbana, IL
  • | 2 Elmhurst University, Elmhurst, IL
  • | 3 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT

Background: The diagnosis, symptoms, and treatment side-effects of prostate cancer place a psychological burden on patients. Aside from general distress (GD), prostate cancer (PCa) patients experience cancer-specific distress (CSD), thus needing regular screening and psychological support. In the present analysis, we assessed the effectiveness of Psychosocial/Psychoeducational interventions in PCa patients. Methods: A systematic literature search was conducted in PubMed from reports in the last 20 years (2000-2020). After filtering for randomized clinical trials, the search results (n=274) were further refined using exclusion criteria for non-psychological interventions, e.g. physical activity, exercise, yoga, etc. With distress as inclusion criterion, 13 studies were identified: 12 on patients and 6 on spouses/care giver. A % change in the mean score reported for GD or CSD from pre- to post-intervention was calculated in each study and used for analysis. Non-parametric Mann-Whitney test for difference in medians between study groups was used to determine statistical significance at p≤0.05. Results: In all studies, the Psychosocial or Psychoeducation intervention was led by an expert (psychologists, oncology nurse, or physician). The primary assessment tools used for GD were the Hospital Anxiety and Depression Scale (HADS) or Depression, Anxiety and Stress Scale-21 (DASS-21). CDS was consistently measured by the Impact of Event Scale-Revised (IES-R). Active psychological intervention effectively reduced both GD and CSD in patients compared to care as usual: median change- GD- 24.4% improvement vs 4.7% worsening, p=0.0019; CSD- 37.6% improvement vs 3.6% worsening, p=0.0782, respectively. Intervention showed better improvement in CSD than in GD (p=0.0454). When analyzing intervention type, we found better results with cognitive techniques than educational intervention. In spouses/care givers, the % change with intervention for GD or CSD compared to care as usual or between GD and CSD with intervention did not attain significance. Conclusions: Our meta-analysis, based on randomized clinical studies, confirms that psychological intervention, especially cognitive methods, could reduce general and cancer-specific distress in PCa patients. A timely psychological intervention should be regularly considered in management of PCa patients.

Corresponding Author: Rhea Mundle, BS
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