Facilitating Treatment Decision Making, Adjustment, and Coping in Men Newly Diagnosed with Prostate Cancer. Addendum

This study evaluated the efficacy of a patient-spouse centered cognitive-affective counseling session (CARE: cognitive-affective reactions and expectations), to facilitate treatment decision-making for localized prostate cancer (PrCa). Methods: CARE identified treatment-related values and goals and focused on improving knowledge about treatment options. A time and attention matched General Health Information (GHI) session provided nutrition information. Couples (N=300) were enrolled after diagnosis with PrCa, but before a definite treatment decision was made. Data were assessed separately for patients and spouses at baseline, at 6-months, and at 12 months post intervention. Results: Both sessions were well accepted among participants. The goal of CARE to facilitate treatment decision making was best achieved for spouses and among those patient/partners who chose a non-invasive treatment option. Partners were more distressed about the treatment decision compared to patients, especially in the CARE condition and when considering invasive procedures. We interpret this result as an indication that participants in CARE processed the relevant information and that momentarily higher levels of distress were the cost of such processing. At 6-mo this effect disappears, underscoring its temporal nature. Conclusions: The results demonstrate the usefulness of integrating a brief counseling session into the decision-making process, and that increases in perceived difficulty of decision-making are short-term.
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