Goal-Focused Emotion-Regulation Therapy (GET) in Young Adult Testicular Cancer Survivors: A Randomized Pilot Study

Overview

Journal Ann Behav Med

Publisher Oxford University Press

Specialty Social Sciences

Date 2023 Apr 20

PMID 37078969

Authors

Michael A Hoyt

Ashley Wei-Ting Wang

Raymond Carrillo Ceja

Jennifer S Cheavens

Michael A Daneshvar

Darren R Feldman

Samuel A Funt

Christian J Nelson

Affiliations

Soon will be listed here.

Abstract

Background: Young adult testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion-regulation Therapy (GET) to improve distress symptoms, emotion regulation, and goal navigation skills.

Purpose: This pilot study examined GET versus an active control intervention in young adult survivors of testicular cancer.

Methods: Seventy-five eligible survivors treated with chemotherapy were randomized to receive GET or Individual Supportive Listening (ISL). Study acceptability, engagement, and tolerability were examined, and intervention fidelity and therapeutic alliance were compared between arms. Preliminary efficacy was evaluated by effect sizes for between-group changes in primary (anxiety and depressive symptoms) and secondary (career confusion, goal navigation, and emotion regulation) outcomes from baseline to immediately and 3-month post-intervention.

Results: Among the 38 men randomized to GET, 81.1% completed all study sessions compared with 82.4% of the 37 men assigned to ISL. Fidelity to the intervention was 87% in GET. Therapeutic alliance wassignificantly higher among those receiving GET versus ISL. Participants exhibited a medium group-by-time effect size with greater reductions in depressive (d = 0.45) and anxiety (d = 0.29) symptoms for those in GET versus ISL, with a similar pattern at 3 months for depressive (d = 0.46) and anxiety (d = 0.46) symptoms.

Conclusions: GET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adults. Observed effect sizes preliminarily suggest meaningful change, though should be interpreted with caution in small samples. GET may be a developmentally-matched behavioral approach to improve psychosocial function in this cancer group.

Clinical Trial Information: Clinicaltrials.gov, NCT04150848. Registered on October 28, 2019.

Citing Articles

Young adult Latino testicular cancer survivors: a pilot study of Goal-focused Emotion regulation Therapy (GET).

Hoyt M, Campos B, Lechuga J, Fortier M, Llave K, Haydon M Support Care Cancer. 2024; 32(11):758.

PMID: 39477849 PMC: 11525392. DOI: 10.1007/s00520-024-08960-y.

Improving symptom management for survivors of young adult cancer: rationale and study protocol for a pilot randomized controlled trial.

Dorfman C, Shelby R, Stalls J, Thomas S, Arrato N, Herold B Pilot Feasibility Stud. 2024; 10(1):87.

PMID: 38851732 PMC: 11161971. DOI: 10.1186/s40814-024-01510-7.

A systematic review of health-related quality of life outcomes in psychosocial intervention trials for adolescent and young adult cancer survivors.

Murphy K, Siembida E, Lau N, Berkman A, Roth M, Salsman J Crit Rev Oncol Hematol. 2023; 188:104045.

PMID: 37269881 PMC: 10527433. DOI: 10.1016/j.critrevonc.2023.104045.

References

Payne D, Lundberg J, Brennan M, Holland J . A psychosocial intervention for patients with soft tissue sarcoma. Psychooncology. 1997; 6(1):65-71. DOI: 10.1002/(SICI)1099-1611(199703)6:1<65::AID-PON236>3.0.CO;2-2. View

Smith A, King M, Butow P, Luckett T, Grimison P, Toner G . The prevalence and correlates of supportive care needs in testicular cancer survivors: a cross-sectional study. Psychooncology. 2013; 22(11):2557-64. DOI: 10.1002/pon.3323. View

Haydon M, Stanton A, Ganz P, Bower J . Goal disturbance in early-stage breast cancer survivors. J Psychosoc Oncol. 2019; 37(4):478-493. PMC: 6529274. DOI: 10.1080/07347332.2018.1563265. View

Viechtbauer W, Smits L, Kotz D, Bude L, Spigt M, Serroyen J . A simple formula for the calculation of sample size in pilot studies. J Clin Epidemiol. 2015; 68(11):1375-9. DOI: 10.1016/j.jclinepi.2015.04.014. View

. Distress management. Clinical practice guidelines. J Natl Compr Canc Netw. 2009; 1(3):344-74. DOI: 10.6004/jnccn.2003.0031. View

Vehling S, Mehnert A, Hartmann M, Oing C, Bokemeyer C, Oechsle K . Anxiety and depression in long-term testicular germ cell tumor survivors. Gen Hosp Psychiatry. 2015; 38:21-5. DOI: 10.1016/j.genhosppsych.2015.09.001. View

Hoyt M, Nelson C, Darabos K, Marin-Chollom A, Stanton A . Mechanisms of navigating goals after testicular cancer: meaning and emotion regulation. Psychooncology. 2016; 26(6):747-754. PMC: 4970952. DOI: 10.1002/pon.4068. View

Chien F, Schwartz S, Johnson R . Increase in testicular germ cell tumor incidence among Hispanic adolescents and young adults in the United States. Cancer. 2014; 120(17):2728-34. PMC: 4454545. DOI: 10.1002/cncr.28684. View

Hoyt M, Wang A, Breen E, Nelson C . A Randomized Controlled Trial of Goal-Focused Emotion-Regulation Therapy for Young Adult Survivors of Testicular Cancer: Effects on Salivary and Inflammatory Stress Markers. Am J Mens Health. 2021; 15(5):15579883211044557. PMC: 8436315. DOI: 10.1177/15579883211044557. View

10.

Chovanec M, Lauritsen J, Bandak M, Oing C, Kier G, Kreiberg M . Late adverse effects and quality of life in survivors of testicular germ cell tumour. Nat Rev Urol. 2021; 18(4):227-245. DOI: 10.1038/s41585-021-00440-w. View

11.

Arnett J . Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000; 55(5):469-80. View

12.

Dahl A, Mykletun A, Fossa S . Quality of life in survivors of testicular cancer. Urol Oncol. 2005; 23(3):193-200. DOI: 10.1016/j.urolonc.2005.03.004. View

13.

Chovanec M, Abu Zaid M, Hanna N, El-Kouri N, Einhorn L, Albany C . Long-term toxicity of cisplatin in germ-cell tumor survivors. Ann Oncol. 2017; 28(11):2670-2679. PMC: 6246726. DOI: 10.1093/annonc/mdx360. View

14.

Hoyt M, Nelson C . Goal-focused Emotion-Regulation Therapy for young adult survivors of testicular cancer: Feasibility of a behavioral intervention. Contemp Clin Trials Commun. 2020; 19:100648. PMC: 7473872. DOI: 10.1016/j.conctc.2020.100648. View

15.

Jonker-Pool G, Hoekstra H, van Imhoff G, Sonneveld D, Sleijfer D, van Driel M . Male sexuality after cancer treatment--needs for information and support: testicular cancer compared to malignant lymphoma. Patient Educ Couns. 2004; 52(2):143-50. DOI: 10.1016/s0738-3991(03)00025-9. View

16.

Bumbasirevic U, Bojanic N, Pekmezovic T, Janjic A, Janicic A, Milojevic B . Health-related quality of life, depression, and sexual function in testicular cancer survivors in a developing country: a Serbian experience. Support Care Cancer. 2012; 21(3):757-63. DOI: 10.1007/s00520-012-1577-6. View

17.

Thompson E, Stanton A, Bower J . Situational and dispositional goal adjustment in the context of metastatic cancer. J Pers. 2012; 81(5):441-51. DOI: 10.1111/jopy.12025. View

18.

Wiechno P, Demkow T, Kubiak K, Sadowska M, Kaminska J . The quality of life and hormonal disturbances in testicular cancer survivors in Cisplatin era. Eur Urol. 2007; 52(5):1448-54. DOI: 10.1016/j.eururo.2007.05.012. View

19.

Kistin C, Silverstein M . Pilot Studies: A Critical but Potentially Misused Component of Interventional Research. JAMA. 2015; 314(15):1561-2. PMC: 4917389. DOI: 10.1001/jama.2015.10962. View

20.

Galdas P, Darwin Z, Kidd L, Blickem C, McPherson K, Hunt K . The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies. BMC Public Health. 2014; 14:1230. PMC: 4295235. DOI: 10.1186/1471-2458-14-1230. View