Behavioral intervention may improve psychological distress after testicular cancer

Goal-focused Emotion regulation Therapy (GET) was shown to be a feasible and acceptable intervention for improving emotional and psychological outcomes in young adult Latino patients following treatment for testicular cancer, according to data published in Supportive Care in Cancer.¹

The authors suggest that further research is warranted.

“GET strives to empower survivors to reconnect with meaningful life goals by fostering self-regulation through navigating goals and teaching emotion-regulating coping skills. Because GET is designed for young adults and involves goal navigation in a manner consistent with personal values, GET may feel more consonant with the experiences of Latino survivors,” explained lead author Michael A. Hoyt, PhD, in a news release on the findings.² Hoyt is the chair and professor of population health and disease prevention at Wen Public Health as well as the director of the Institute for Interdisciplinary Salivary Bioscience Research at the University of California, Irvine.

In total, the pilot study included 35 men aged 18 to 39 who underwent treatment with chemotherapy for testicular cancer. Of those included in the study, 54% initiated intervention sessions, and 94.7% of those patients completed all study procedures.

Participants who took part in the intervention rated the helpfulness of skills, number of interventions, and length of interventions in the moderate to high range. Patients were also likely to recommend the intervention to a friend with testicular cancer.

Findings also showed significant reductions in both anxiety (F(2,33), 5.67: P = .008; partial η2 = 0.26; observed power, 0.83) and depressive symptoms (F(2,33), 14.95; P < .001; partial η2 = 0.30; power, 1.00) following the intervention, which were maintained at 3 month follow-up.

Similarly, improvements in both goal navigation capacity (F[2,33] = 14.69; P < .001; partial η2 = 0.47; power = 1.00) and goal blockage (F[2,33] = 8.39; P = .001; partial η2 = 0.34; power = 0.95) were noted after the intervention and at 3 months post-intervention.

Post-intervention improvements were also seen in both hope metrics—agency (F[2,33] = 10.28; P < .001; partial η2 = 0.38; power = 0.98) and pathway mapping (F[2,33] = 10.41; P < .001; partial η2 = 0.39; power = 0.98)—as well as both emotion regulation metrics—greater use of cognitive reappraisal (F[2,33] = 8.26; P = .001; partial η2 = 0.33; power = 0.95) and lessened use of expressive suppressive (F[2,33] = 8.26; P = .019; partial η2 = 0.21; power = 0.72).

The investigators then assessed the influence of simpatía, which according to the news release is, “a Latino cultural value emphasizing positivity, harmony, and avoidance of conflict” as well as “acculturative stress, which arises from navigating a marginalized identity in a predominantly non-Hispanic society.”²

Patients who scored higher for simpatía-related positivity and warmthdemonstrated greater reductions in depressive symptoms post-intervention, but not at 3 months. However, higher scores for acculturative stress were significantly associated with anxiety post-intervention and at 3 months, as well as depressive symptoms at 3 months.

In relation to the specific aspects of GET, simpatía was significantly associated with less goal blockage (β^ = − 0.50; P = .002), less use of expressive suppression (β^ = − 0.48; P = .005), and greater skill in pathway mapping (β^ = 0.38; P = .026). Conversely, acculturative stress was significantly associated with diminished goal navigation capacity (β^ = − 0.43; P = .013), greater goal blockage (β = 0.60; P < .001), and lower skill in pathway mapping (β^ = − 0.50; P = .003).

Based on these findings, the authors suggest that further research is warranted. They note that a randomized-controlled study would help to establish the efficacy of GET in this population by comparing outcomes to standard care or to a time and attention-supportive intervention.

“Our findings offer a blueprint for more culturally responsive and inclusive survivorship care tailored to one of the fastest-growing groups of testicular cancer survivors,” Hoyt concluded in the news release.² “Future research should measure additional cultural influences and values as potential intervention effects, and we hope our study encourages the inclusion of simpatía and acculturative stress in that consideration.”

References

1. Hoyt MA, Campos B, Lechuga JG, et al. Young adult Latino testicular cancer survivors: a pilot study of Goal-focused Emotion regulation Therapy (GET). Support Care Cancer. 2024;32(11):758. doi:10.1007/s00520-024-08960-y

2. Psychological therapy offers new hope for young Latino testicular cancer survivors. News release. University of California, Irvine. November 22, 2024. Accessed November 25, 2024. https://www.newswise.com/articles/psychological-therapy-offers-new-hope-for-young-latino-testicular-cancer-survivors