The role of mindfulness in distress and quality of life for men with advanced prostate cancer.
To examine the extent to which mindfulness skills influence psychological distress and health-related quality of life (HRQOL) in men with metastatic or castration-resistant biochemical progression of prostate cancer.



A cross-sectional survey of 190 men (46 % response; mean age 71 years, SD = 8.7, range 40-91 years) with advanced prostate cancer, assessed psychological and cancer-specific distress, HRQOL. Mindfulness skills were assessed as potential predictors of adjustment outcomes.



Overall, 39 % of men reported high psychological distress. One third had accessed psychological support previously although only 10 % were under current psychological care. One quarter had accessed a prostate cancer support group in the past six months. Higher HRQOL and lower cancer-specific and global psychological distress were related to non-judging of inner experience (p < 0.001). Higher HRQOL and lower psychological distress were related to acting with awareness (p < 0.001). Lower distress was also related to higher non-reactivity to inner experience and a lower level of observing (p < 0.05).



Men with advanced prostate cancer are at risk of poor psychological outcomes. Psychological flexibility may be a promising target for interventions to improve adjustment outcomes in this patient group.



Trial Registration: ACTRN12612000306819.
Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia. suzanne.chambers@griffith.edu.au.|Cancer Council Queensland, Brisbane, Australia. suzanne.chambers@griffith.edu.au.|Prostate Cancer Foundation of Australia, Sydney, Australia. suzanne.chambers@griffith.edu.au.|University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Australia. suzanne.chambers@griffith.edu.au.|Health and Wellness Institute, Edith Cowan University, Perth, Australia. suzanne.chambers@griffith.edu.au.|Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia. suzanne.chambers@griffith.edu.au.
Suzanne K
0000-0003-2369-6111
SK
Chambers
Mind Potential, Sydney, Australia.
Elizabeth
E
Foley
Cancer Council Queensland, Brisbane, Australia.|Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.
Samantha
S
Clutton
Cancer Council Queensland, Brisbane, Australia.|Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.
Robert
R
McDowall
Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|School of Psychology, Griffith University, Brisbane, Australia.
Stefano
S
Occhipinti
Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Central Coast Cancer Centre, Gosford, Australia.
Martin
M
Berry
Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia.|National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia.
Martin R
MR
Stockler
Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA.
Stephen J
SJ
Lepore
Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Department of Surgery, Faculty of Medicine, Monash University, Melbourne, Australia.|Department of Urology, Monash Health, Melbourne, Australia.
Mark
M
Frydenberg
University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Australia.|Health and Wellness Institute, Edith Cowan University, Perth, Australia.|Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia.
Robert A
RA
Gardiner
Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Monash University, Melbourne, Australia.|Eastern Health, Melbourne, Australia.
Ian D
ID
Davis
Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia.|Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Sydney, Australia.|Cancer Council NSW, Sydney, Australia.
David P
DP
Smith
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D011471:Prostatic Neoplasms / Q000523:psychology*; D012657:Self-Help Groups; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000523:psychology*
Advanced prostate cancer; Psychological distress; Quality of life