Intervention targets for newly diagnosed prostate cancer patients experiencing significant emotional distress

By most estimates, about a third of men diagnosed with prostate cancer develop clinically significant emotional distress. Early identification and intervention has been recommended for these men, given evidence that many will continue to experience elevated distress even several years post-treatment. To effectively screen and support survivors, we need to understand which factors are associated with distress in newly diagnosed patients, a topic that has received little attention. We investigated the extent to which beliefs, social resources, personality, and clinical and demographic characteristics were associated with distress assessed with the emotional distress thermometer in 1254 men newly diagnosed with localized prostate cancer (pre-treatment). Factors amenable to psycho-education intervention (lower confidence in cancer control, decision-making self-efficacy, and lower masculine self-esteem; ps<.01) were associated with higher distress, as were personality factors (lower optimism, and lower resilience; ps<.05). Clinical and demographic factors also predicted higher distress (higher Gleason score, younger age, black vs. white race, and higher perceived social status; ps<.05). The same predictors, with the exception of optimism and decision-making self-efficacy, were risk factors for clinically significant distress (≥5 on distress thermometer). Potential intervention targets include improving provider communication about prostate cancer prognosis, providing decision-making support to increase decision-making self-efficacy, and referral to brief cognitive behavioral interventions to help patients reframe and adjust to the health threat. Furthermore, as strategies are developed to reduce emotional distress in prostate cancer patients, early screening may become a useful tool for identifying and allocating resources to those at risk for poor adjustment in survivorship.