Background: The Distress Thermometer (DT) has been used in psycho-oncology research across the globe and has been recommended as a clinical tool to be used routinely in cancer settings to detect clinically significant distress. We sought to characterize the translation and validation of the DT in cancer patients in different countries and cultures and summarize how the translated versions function to detect clinically significant distress.Methods: An electronic mail survey was sent to the members of the International Psychosocial Oncology Society Federation of Psycho-Oncology Societies and electronic searches of English language databases were conducted to identify translations of the DT and studies designed to validate these translations.Results: Our efforts yielded a total of 21 non-English translations of the DT; 18 of these were validated in studies designed for that purpose. A variety of instruments were used in receiver operating characteristic curve analysis to derive an optimal cut-off score indicative of clinically significant distress. Cut-off scores varied by language, country, and clinical setting and to sample characteristics. In the majority of studies, a score of 4 maximized sensitivity and specificity relative to an established criterion.Conclusions: These findings provide a broad, international perspective on the current state of psychosocial screening using the DT. Findings also demonstrate widespread awareness of the need for psychological and social support of persons diagnosed with and treated for cancer.

Purpose Prior research examining the impact of androgen deprivation therapy (ADT) for prostate cancer on cognitive performance has found inconsistent relationships. The purpose of this study was to systematically review the existing literature and determine the effect of ADT on performance across seven cognitive domains using meta-analysis. Methods A search of PubMed Medline, PsycINFO, Cochrane Library, and Web of Knowledge/Science databases yielded 157 unique abstracts reviewed by independent pairs of raters. Fourteen studies with a total of 417 patients treated with ADT were included in the meta-analysis. Objective neuropsychological tests were categorized into seven cognitive domains: attention/working memory, executive functioning, language, verbal memory, visual memory, visuomotor ability, and visuospatial ability. Results Separate effect sizes were calculated for each cognitive domain using pairwise comparisons of patients who received ADT with 1) prostate cancer patient controls, 2) non-cancer controls, or 3) ADT patients’ own pre-ADT baselines. Patients treated with ADT performed worse than controls or their own baseline on visuomotor tasks (g=−0.67, p=.008; n=193). The magnitude of the deficits was larger in studies with a shorter time to follow-up (p=.04). No significant effect sizes were observed for the other six cognitive domains (p=.08=–.98). Conclusions Prostate cancer patients who received ADT performed significantly worse on visuomotor tasks compared to non-cancer control groups. These findings are consistent with the known effects of testosterone on cognitive functioning in healthy men. Knowledge of the cognitive effects of ADT may help patients and providers better understand the impact of ADT on quality of life.

Background The utility of psychosocial interventions in reducing symptom burden and improving health-related quality of life (HRQOL) for men with localized prostate cancer has been demonstrated. However, studies have yet to demonstrate the efficacy of interventions in advanced prostate cancer (APC). This study examined the feasibility, acceptability and preliminary efficacy of a technology-assisted 10-week group-based psychosocial intervention for diverse men with APC. Methods Participants were 74 men (mean age = 68.84 years, 57% Non-Hispanic White and 40.5% Black) who were randomized to a cognitive behavioral stress management treatment (CBSM) or health promotion (HP) attention control condition. Participants were assessed at baseline, weekly throughout the 10-week program, and 6 months post-baseline. Outcomes were assessed using the Patient-Reported Outcomes Measurement Information System along with established measures of HRQOL, CBSM intervention targets (e.g., relaxation skills), and patient-reported acceptability. Results Feasibility was demonstrated through good retention rates (> 85%), acceptable average attendance rates (> 70%), and acceptability was demonstrated through very favorable weekly session evaluations (mean score 4/5) and exit surveys (mean score 3.6/4). Men randomized to the CBSM condition reported significant reductions (p < .05) in depressive symptoms and improvements in relaxation self-efficacy (p < .05) at the 6-month follow up. CBSM participants reported trends for improvement in distress and functional well-being (ps < .08) relative to those in the HP condition. Effect sizes ranged from medium (0.54) to large (1.87) and in some instances were clinically meaningful. Conclusions Technology-based CBSM interventions among diverse men with APC may be feasible, acceptable, and efficacious.

These study findings support the use of the CBM in predicting which cancer survivors experience greater FCR and indicates that CBM-driven interventions may prove beneficial for reducing distressing FCR.