Parker, P. A. et al. The effects of a presurgical stress management intervention for men with prostate cancer undergoing radical prostatectomy. J. Clin. Oncol. 27, 3169–3176 (2009).

A small study suggests that the mood and quality of life (QOL) of men with early-stage prostate cancer are improved by instruction in stress management before radical prostatectomy. “It was quite remarkable that a brief pre-surgical stress management intervention not only improved mood around the time of surgery, but also improved aspects of QOL as much as 12 months after surgery,” explains senior author Lorenzo Cohen (M. D. Anderson Cancer Center, Houston, TX, USA).

Participants were taught relaxation [and] guided imagery ... and were encouraged to discuss their concerns

Pre-surgical stress management is known to benefit women with breast cancer. The study by Cohen and colleagues—the first to examine its long-term effect on men with prostate cancer—included 159 participants randomly assigned to one of three groups.

Men in the stress management and supportive attention groups attended 2 h-long individual sessions with a clinical psychologist in the 2-week period leading up to surgery, as well as two brief 'booster sessions' immediately before and after their operation. In the former group, a cognitive-behavioral approach was taken. Participants were taught relaxation techniques, were led through a guided imagery of the day of surgery, and were encouraged to discuss their concerns and expectations. Supportive attention consisted of a semistructured assessment of psychosocial and medical history, plus free discussion. Patients assigned to standard care did not meet with a psychologist.

Men in the stress management group reported significantly less pre-surgical mood disturbance than did those who received standard care. This intervention was also associated with better physical function at 12 months. “Before we can suggest that pre-surgical stress management improves physical outcomes for all men undergoing a radical prostatectomy, we need to better understand the mechanism behind our findings, as well as understand for whom this type of intervention is the most useful,” cautions Cohen. But, in the meantime, it is reasonable to encourage cancer patients to participate in some kind of stress management program, be it mind–body or cognitive in nature. “We know that these practices are safe and that they help patients adjust to a cancer diagnosis,” he explains.