Grant Number:	5R01CA206456-07 Interpret this number
Primary Investigator:	Penedo, Frank
Organization:	University Of Miami Coral Gables
Project Title:	Culturally Adapted Cognitive Behavioral Stress and Self-Management (CCBSM)
Fiscal Year:	2021

Project Summary:This 5-year study evaluates the effects of a 10-week group-based linguistically translated and culturally adapted cognitive-behavioral stress and self management (C-CBSM) intervention on symptom burden and health related quality of life (HRQOL) in Hispanic men treated for localized prostate cancer (PC). About 80% PC cases are diagnosed as early disease and have a 5- and 10-year survival rate of almost 100% and 99%, respectively. Most patients receive active treatment (~70%) leading to prolonged treatment-related side effects and dysfunction persisting well beyond primary treatment. Survival is offset by chronic side effects such as sexual and urinary dysfunction, pain and fatigue that can lead to poor psychosocial functioning, impaired intimacy and social functioning, and masculinity concerns. Hispanic PC survivors report lower physical and social functioning, poorer emotional well-being and greater sexual and urinary dysfunction, even after accounting for SES and disease severity. This sequela can lead to elevated glucocorticoid release and inflammatory cytokines that have a direct effect on these symptoms and can interfere with physiological pathways necessary for recovery of sexual and urinary functioning. We have shown that CBSM reduces symptom burden and improves HRQOL in bilingual Hispanic PC survivors. In a pilot we showed that a linguistic translation of CBSM with attention to sociocultural processes improved symptom burden and HRQOL in Spanish monolingual PC survivors. We have also shown that CBSM is associated with reduced glucocorticoid resistance and inflammatory gene expression pathways in breast cancer survivors. We propose to (a) deliver a culturally adapted C-CBSM intervention in Spanish that places greater emphasis on salient sociocultural determinants of symptom burden and HRQOL in Hispanics (e.g., fatalistic attitudes, family interdependence, perceived discrimination, machismo), (b) incorporate a neuroimmune model of symptom regulation and management, and (c) test the efficacy of C-CBSM, relative to standard non-culturally adapted CBSM, in two diverse Hispanic communities (Chicago & Miami). We will test our aims in 260 Hispanic men post-treatment for localized PC with elevated symptom burden in a 2 x 4 randomized design with condition (C- CSBM vs. CBSM) as the between groups factors, and time (baseline, post-intervention & 6- and 12-months post baseline) as the within groups factor. Our Primary Aim is to determine whether randomization to C- CBSM, relative to standard CBSM, is associated with reduced symptom burden and improved HRQOL. Our Secondary Aims evaluate whether C-CBSM leads to greater improvements in the intervention targets (e.g., stress management, psychological distress & interpersonal disruption), and physiologic adaptation (i.e., glucocorticoid receptor sensitivity & inflammatory gene expression). We will also evaluate psychosocial and physiological mechanisms as mediators of C-CBSM's effects on our primary outcomes. We will explore moderators (e.g., SES, Hispanic origin) of C-CBSM's effect and C-CBSM's effects on cardiometabolic health.




Expanded Indications for Neoadjuvant Endocrine Therapy in Early-Stage Breast Cancer During the COVID-19 Pandemic.
Authors: Khorfan R. , Vora H.P. , Namm J.P. , Solomon N.L. , Lum S.S. .
Source: Annals Of Surgical Oncology, 2024-08-12 00:00:00.0; , .
EPub date: 2024-08-12 00:00:00.0.
PMID: 39133445
Related Citations

Associations Between Perceived Discrimination, Screening Mammography, and Breast Cancer Stage at Diagnosis: A Prospective Cohort Analysis.
Authors: Hernandez A.E. , Borowsky P.A. , Lubarsky M. , Caroll C. , Choi S. , Kesmodel S. , Antoni M. , Goel N. .
Source: Annals Of Surgical Oncology, 2024-07-26 00:00:00.0; , .
EPub date: 2024-07-26 00:00:00.0.
PMID: 39060693
Related Citations

Familism, family cohesion, and health-related quality of life in Hispanic prostate cancer survivors.
Authors: Pedreira P.B. , Fleszar-Pavlović S.E. , Walsh E.A. , Noriega Esquives B. , Moreno P.I. , Perdomo D. , Heller A.S. , Antoni M.H. , Penedo F.J. .
Source: Journal Of Behavioral Medicine, 2024-03-01 00:00:00.0; , .
EPub date: 2024-03-01 00:00:00.0.
PMID: 38429598
Related Citations

Impact of Neighborhood Disadvantage on Tumor Biology and Breast Cancer Survival.
Authors: Goel N. , Hernandez A. , Kwon D. , Antoni M.H. , Cole S. .
Source: Annals Of Surgery, 2024-02-01 00:00:00.0; 279(2), p. 346-352.
EPub date: 2023-08-28 00:00:00.0.
PMID: 37638386
Related Citations

Effects of neighborhood disadvantage on cortisol and interviewer-rated anxiety symptoms in breast cancer patients initiating treatment.
Authors: Goel N. , Hernandez A.E. , Ream M. , Clarke E.S. , Blomberg B.B. , Cole S. , Antoni M.H. .
Source: Breast Cancer Research And Treatment, 2023-08-10 00:00:00.0; , .
EPub date: 2023-08-10 00:00:00.0.
PMID: 37561280
Related Citations

Stress Management Interventions to Facilitate Psychological and Physiological Adaptation and Optimal Health Outcomes in Cancer Patients and Survivors.
Authors: Antoni M.H. , Moreno P.I. , Penedo F.J. .
Source: Annual Review Of Psychology, 2023-01-18 00:00:00.0; 74, p. 423-455.
EPub date: 2022-08-12 00:00:00.0.
PMID: 35961041
Related Citations

Spiritual well-being, distress and quality of life in Hispanic women diagnosed with cancer undergoing treatment with chemotherapy.
Authors: Barata A. , Hoogland A.I. , Small B.J. , Acevedo K.I. , Antoni M.H. , Gonzalez B.D. , Jacobsen P.B. , Lechner S.C. , Tyson D.M. , Meade C.D. , et al. .
Source: Psycho-oncology, 2022-09-19 00:00:00.0; , .
EPub date: 2022-09-19 00:00:00.0.
PMID: 36121699
Related Citations

Biobehavioral Pathways and Cancer Progression: Insights for Improving Well-Being and Cancer Outcomes.
Authors: Chang A. , Sloan E.K. , Antoni M.H. , Knight J.M. , Telles R. , Lutgendorf S.K. .
Source: Integrative Cancer Therapies, 2022 Jan-Dec; 21, p. 15347354221096081.
PMID: 35579197
Related Citations

Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors.
Authors: Kronenfeld J.P. , Graves K.D. , Penedo F.J. , Yanez B. .
Source: The Oncologist, 2021 Jun; 26(6), p. 443-452.
EPub date: 2021-03-10 00:00:00.0.
PMID: 33594785
Related Citations

Association between real-world experiential diversity and positive affect relates to hippocampal-striatal functional connectivity.
Authors: Heller A.S. , Shi T.C. , Ezie C.E.C. , Reneau T.R. , Baez L.M. , Gibbons C.J. , Hartley C.A. .
Source: Nature Neuroscience, 2020-05-18 00:00:00.0; , .
EPub date: 2020-05-18 00:00:00.0.
PMID: 32424287
Related Citations

Study design and protocol for a culturally adapted cognitive behavioral stress and self-management intervention for localized prostate cancer: The Encuentros de Salud study.
Authors: Penedo F.J. , Antoni M.H. , Moreno P.I. , Traeger L. , Perdomo D. , Dahn J. , Miller G.E. , Cole S. , Orjuela J. , Pizarro E. , et al. .
Source: Contemporary Clinical Trials, 2018 Aug; 71, p. 173-180.
EPub date: 2018-07-09 00:00:00.0.
PMID: 29909057
Related Citations