Prostate cancer grows very slowly, and because the disease typically attacks older men, some patients may never even need treatment for their cancer. In these cases, an approach known as “active surveillance” is often used to monitor the cancer closely. Usually this approach includes a doctor visit with a prostate-specific antigen blood test and digital rectal exam about every 6 months. Prostate biopsies may be done every year as well. If your test results change, your doctor would then talk to you about treatment options.
Needless to say, living under the prostate cancer Sword of Damocles is unnerving. The anxiety and uncertainty that men who choose active surveillance experience when diagnosed with prostate cancer causes one in four to receive definitive therapies within one to three years, even when there is no sign of tumor progression. However, men with prostate cancer who are under close active surveillance reported significantly greater resilience and less anxiety over time after receiving an intervention of mindfulness meditation, according to a recently pilot study from Northwestern University.
Mindfulness meditation is a well-known contemplative awareness practice dating back some 2,500 years. It is a form of meditation designed to develop the skill of paying attention to our inner and outer experiences with acceptance, patience and compassion.
Health psychologist David Victorson, the principal investigator of the study and an associate professor of medical social sciences at Northwestern University Feinberg School of Medicine, researches the emotional stress of active surveillance and how mindfulness training helps alleviate the anxiety.
"It's very understandable that some men will feel concerned with the knowledge that they indeed have prostate cancer but are asked to NOT do anything to remove it,” Victorson said. "For many men this can create a great deal of inner turmoil. This turmoil can build up over time and eventually lead to men seeking surgical intervention when it may not ultimately be necessary.“
Victorson and his Northwestern team now are partnering with other academic medical institutions to conduct a five-year multi-site controlled trial where men and their spouses will be randomized to eight weeks of intensive mindfulness meditation training or an eight-week control group.
“I believe we have an opportunity to investigate and equip men with additional tools above and beyond surgical intervention that can help them manage cancer-related uncertainty intolerance," Victorson said.