A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN)

ObjectiveHot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self-help cognitive behavioural therapy (CBT) intervention on HFNS problem-rating (primary outcome), HFNS frequency, mood and health-related quality of life (secondary outcomes) in patients undergoing ADT. MethodsPatients reporting treatment-induced HFNS were randomly assigned to CBT (n=33) or treatment as usual (TAU) (n=35), stratified for cancer type. The CBT intervention included a booklet, CD plus telephone contact during a 4-week period. Validated self-report questionnaires were completed at baseline, 6weeks and 32weeks after randomisation. The primary outcome was HFNS problem rating (perceived burden of HFNS) at 6weeks after randomisation. Potential moderators and mediators were examined. Data analysis was conducted on a modified intention-to-treat basis. ResultsCompared with TAU, CBT significantly reduced HFNS problem rating (adjusted mean difference: -1.33, 95% CI -2.07 to -0.58; p=0.001) and HFNS frequency (-12.12, 95% CI -22.39 to -1.84; p=0.02) at 6weeks. Improvements were maintained at 32weeks, but group differences did not reach significance. There were significant reductions in negative HFNS Beliefs and Behaviours following CBT, but not in mood or quality of life. ConclusionsGuided self-help CBT appears to be a safe and effective brief treatment for men who have problematic HFNS following prostate cancer treatments. Further research might test the efficacy of the intervention in a multicentre trial. (c) 2015 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.