Prostate cancer is the most common male cancer in developed countries (excluding non-melanoma skin cancer). In 2007, 19,403 Australian men were diagnosed with prostate cancer . Approximately 10-15% of men with prostate cancer have locally advanced or metastatic prostate cancer at diagnosis  and a further 20-40% of men with localised cancer at diagnosis experience recurrence or progression after treatment . Men with advanced prostate cancer face additional physical and psychological challenges compared to men with localised disease. The iatrogenic effects of hormonal ablation, the main treatment for advanced disease, include mood disturbance, cognitive impairment, fatigue, and sexual dysfunction . By comparison to men with localised prostate cancer, men with advanced disease report higher levels of psychological distress and poorer quality of life (QoL) [5, 6]; and have an increased risk of suicide [7, 8]. Hence research into psychological intervention to maximise psychological adjustment is crucial for these men.
To date, no psychological intervention research specifically targeting men with advanced prostate cancer has been reported . In this study we propose using the cognitive behavioural approach of Mindfulness-Based Cognitive Therapy (MBCT) as relevant to this patient group. Mindfulness involves open awareness of current experience and the intention to observe habits of reacting to difficulties as they arise. Over time, this practice leads the person to gain the ability to be less reactive to difficult experiences and approach equanimity regarding the content of the illness experience, including negative emotions and thoughts. MBCT specifically targets the cognitive processes associated with depression by encouraging participants to disengage from reactive and ruminative states of mind, such as those that are commonly reported by cancer patients [10, 11]. Qualitative studies of cancer patients who have taken part in mindfulness courses have identified positive changes in acceptance, self-control, personal growth, shared experience and self-regulation as outcomes of mindfulness practice [12, 13]. In a pilot study of group MBCT conducted with 19 men with advanced prostate cancer, men reported significant changes in both general psychological and cancer-specific distress . Qualitative data revealed that acceptance of and learning from other group members were key aspects of the group context that contributed to acceptance of progressive disease. Thus, in the context of MBCT the group setting appears important as a contributor to acceptance of cancer through peer learning and modelling.
Accordingly, in this trial we apply a tele-based MBCT group intervention to decrease anxiety and depression and cancer-specific distress in men with advanced prostate cancer.