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Pre-op stress management aids healing from prostate cancer surgery

Kathleen Blanchard's picture
Stress management

Stress management techniques are found to boost immunity and improve mood for men undergoing prostate cancer surgery, leading to better outcomes. Researchers at the The University of Texas MD Anderson Cancer Center found men undergoing radical prostatectomy who practice stress management techniques heal and recover more quickly.

Lower stress levels boost immune function and promotes physical and psychological healing.

Previous studies have shown men who practice stress management techniques after prostate cancer surgery had improved quality of life and mood one year later.

For the new study, researchers included 159 men scheduled to undergo prostate cancer surgery, randomized into three groups - stress management (SM), supportive attention (SA) and standard care (SC).

The group given stress management before prostate surgery met with a psychologist one to two weeks before surgery and were instructed on guided imagery, breathing techniques and led through mental imagery to prepare for surgery. They also received a stress management guide and audiotapes to practice on their own. They again met with a psychologist briefly before surgery and two days after for reinforcement.

The supportive attention group met twice with a psychologist to discuss one to two weeks before surgery to discuss medical and psychological history during an interview. They were given support and empathy and an opportunity to discuss concerns before surgery and again 48 hours after prostate surgery.

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The standard care group did not meet with a psychologist and received routine medical care.

Blood samples were collected a month before surgery and again 48 hours after. The researchers measured mood about a month before surgery, one week before the procedure, after the interventions, and the morning of the surgery.

The findings revealed men in the stress management group had higher levels of immune fighting cytokine IL-1b than men in the standard care group. They also had lower mood disturbances before prostate cancer surgery that was not associated with improved immune function.

Lorenzo Cohen, Ph.D., the study's senior author and professor in MD Anderson's Departments of General Oncology and Behavioral Science. "Both the physical and psychological stress of surgery can be harmful to the immune system. Even brief pre-surgery sessions of stress management positively impact on the recovery process, both in terms of psychological and immunological outcomes," he said.

The researchers explain stress can delay healing, raising cytokine levels that can also lower immunity. Stress management before prostate cancer surgery can be beneficial Cohen says.

"We're looking at targeting future research to people who might benefit the most, in particular those who are the most distressed and have the lowest level of social support," Cohen said. "This will help provide the most benefit and effective use of health care system's limited resources." The researchers plan to study stress management outcomes in more diverse populations. The men in the current study were primarily non-Hispanic, highly educated, married and mostly white.

The findings from the study shows managing stress is important, especially before surgery. Men undergoing prostate cancer surgery were found to have improved mood, better immune function and speedier recovery from learning deep breathing, guided imagery and from interaction with a psychologist before and after surgery.

Psychosom Med 2011, doi:10.1097/PSY.0b013e31820a1c26
"Presurgical Stress Management Improves Postoperative Immune Function in Men With Prostate Cancer Undergoing Radical Prostatectomy"