Presurgical Stress Management Techniques Increase Immune Response, Decrease Mood Disturbance in Prostate Cancer Patients

By training men with prostate cancer scheduled for prostatectomy on stress management techniques, nurses can help them raise their immune outcome and lower their mood disturbance. These outcomes, identified in a randomized study, build on the previous discovery that stress management techniques can improve quality of life 1 year postsurgery.

 

For the study, 159 men were assigned to one of three groups: (1) two sessions of stress management training; (2) two sessions of supportive attention; or (3) standard care. Stress management training included the opportunity to discuss their concerns regarding the surgery and learning diaphragmatic breathing, guided imagery, and coping skills. Supportive attention consisted of the discussion opportunity and a semistructured medical interview.

 

Blood samples, collected 1 month before and 48 hours after surgery, provided immune function data. Mood was assessed using the Profile of Mood States, 1 month and 1 week before as well as the morning of surgery.

 

At 48 hours postsurgery, men in the stress management group had higher levels of natural killer cells function (P = .04) and circulating proinflammatory cytokines (interleukin [IL]-12p70, P = .02; IL-1beta, P = .02; tumor necrosis factor-alpha, P = .05) than those in the supportive care group. Comparing the stress management group with the standard care group, higher levels of natural killer cells (P = .02) and IL-1beta (P =.05) were observed.

 

Men who underwent stress management training had lower Profile of Mood States scores than those who received supportive attention (P = .006). No differences were seen between the supportive care and standard care groups. Although psychologically beneficial, mood improvement did not confer immune outcomes.

 

The complete findings are published online in the January 21 edition of Psychosomatic Medicine.