16 October 2020

By Dr Natalie Heynsbergh (Deakin University), Prof Trish Livingston (Deakin University) and Dr Jacqueline Schmitt (PCFA)

Receiving a diagnosis of prostate cancer is a major life stress for most men and their loved ones. Suddenly, the things that matter most seem threatened and it is very normal to experience a wide range of feelings and emotions.

Sometimes you may feel more distressed than at other times. Your feelings might be more intense while waiting for test results, making treatment decisions or just before commencing treatment. Side effects from treatment may also cause stress and upset. After treatment, you may worry about the cancer returning.

Today, there are over 220,000 men living after a diagnosis of prostate cancer. For most men the long-term outlook is very good - relative to the general population and considering other causes of death, 95% of men with prostate cancer will survive at least five years after diagnosis and 91% of men with prostate cancer will survive 10 years or more.

To help improve the lives of men living with prostate cancer, there is a need for more evidence-based strategies to help them manage the challenges of living with the disease. There is growing evidence that mindfulness is one strategy that can be used to reduce symptoms of anxiety and depression associated with prostate cancer.

What is mindfulness and how can it improve prostate cancer outcomes

Mindfulness is a technique you can learn to help you to pay attention to your present experience in a nonjudgmental, curious and accepting way. It is something you can do as you go about your everyday activities, but it can be improved and made more effective with the right training. For example, you can practice mindfulness listening to recordings guiding your thoughts.

Mindfulness training involves learning about what mindfulness is, how it works and how to practise it. Skills that are learnt during training can then be practised during everyday experiences. For example, noticing the smell and taste of food when eating and paying attention to your experience while eating.

In one research study, men living with prostate cancer described many benefits from mindfulness practise including a reduction in symptoms of anxiety and depression and worries associated with cancer returning. Men have also been highly satisfied with becoming more aware of their thoughts as well as finding ways to manage unhelpful or intrusive thoughts.

The effects of participating in mindfulness can extend far beyond the duration of mindfulness programs. A study led by Professor Victorson of men on Active Surveillance for prostate cancer found that an eight-week mindfulness program resulted in a significant improvement in anxiety for up to 6 months, a decrease in uncertainty for as long as 12 months and an increase in positive changes after a traumatic event for up to 12 months. In particular, men reported an improvement in being able to relate to others and an increase in personal strength

Some improvements men reported after mindfulness training included:

  • Increased emotional regulation - “The reduction in stress has enabled me to establish a clearer and more honest relationship to my thoughts” and "I step back and observe and then adjust. I experience my feelings. Don’t always act on them
  • Increase self-awareness - “I’ve become more aware and relaxed—able to deal with stress better. The breathing exercises have really helped” and I’ve become more aware of my thoughts and feelings and am able to react to situations in a more positive way”
  • Greater patience and tolerance – I have more tolerance for people’s quirksandI have become more patient and tolerant of myself 
  • Positive health behaviour change  I now meditate more and try to keep a clear head and quit worrying a lot about what I can’t change” 
  • Living more in the moment - “I am living more so in the present moment with less anxiety, gratitude, intimacy w/ spouse andI am more mindful, more in the moment 
  • Greater appreciation  I have more appreciation for people’s goodness” and I am thankful for every day 
  • Relationship improvement I am more relaxed, not as confrontational and I listen to others points of view”, “I’m nicer to my wife and tell her more I love her and I think before acting. If I’m upset, I’ll address it sooner rather than later. I’ll tell my wife more what I am thinking or feeling 

What is online mindfulness?

Mindfulness can be taught in several ways including face-to-sessions, in individual or groups sessions or online. Traditionally mindfulness was taught in face-to-face sessions and could provide additional benefits such as creating a sense of peer support among men. With the development of technology there has been the opportunity to adapt face-to-face sessions to online platforms.  

Emerging online mindfulness courses suggest that it is possible to provide tailored programs for people living with cancer to address their unique experiences and concerns. Across different cancer types tailored online mindfulness programs have been shown to improve people’s wellbeing such as reducing cancer related fatigue, improving mental health outcomes and quality of life and reducing worries associated with cancer returning.  

As well as improving the wellbeing of people living with cancer, online programs provide additional benefits including being able to participate regardless of geographical location, having the privacy to complete sessions independently and the flexibility to complete sessions and training at a convenient time. With increasing numbers of men living with prostate cancer, online mindfulness courses provide the opportunity for more men to seek and receive support, at any stage of the cancer experience from diagnosis to treatment and survivorship.

Online mindfulness for men with prostate cancer – how can you help?

Research studies are assessing how mindfulness can help men living with prostate cancer. Participating in studies such as these provides men with the opportunity to influence the development of resources that specifically address the concerns and needs of men with prostate cancer. MindOnLine is an online mindfulness program for cancer that is being developed and tested by a team of Australian researchers. If you would like to take part in this study click here for more information.