Overview
This is a behavioral trial study to pilot test a stress management intervention for people with cancer who are undergoing routine cancer scans. The study will involve two pilot testing phases. Initial feasibility will be determined in an Open Trial phase, to inform any needed revisions to the intervention and/or protocol prior to a Pilot Randomized Controlled Trial phase. The Open Trial phase is an unblinded, single-site, single-arm open trial (n=10). The Pilot randomized clinical trial (RCT) phase is an unblinded, single-site, feasibility pilot randomized controlled trial (n=50).
Description
Advanced cancer patients repeatedly undergo routine scans that inform their disease status and treatment. While awaiting the results, anxiety and uncertainty are elevated, which can negatively impact quality of life. Evidence-based stress management strategies have the potential to be useful during this unique time period, but require tailoring for this population and context.
The goal of this study is to pilot test an adapted stress management program to help patients manage their anxiety while awaiting scan results. The program is a behavioral intervention that includes psychoeducation and stress management activities, delivered via a web platform to promote dissemination. In the Open Trial phase, the program will be field tested in a single-arm trial, using feedback to refine materials and procedures as needed before formal piloting. In the Pilot RCT phase, a small RCT will be conducted to test the intervention's feasibility and acceptability and to examine preliminary effects on anxiety and cancer-related intrusive thoughts.
Eligibility
Inclusion Criteria:
- Adult (ages 18 and older)
- Comfortable speaking, reading, and writing English without an interpreter
- Established diagnosis of Stage IV lung cancer (or extensive stage small cell lung cancer)
- ECOG (Eastern Cooperative Oncology Group) performance status of 0 to 2
- Receiving ongoing care from collaborating clinics with regular scans
- Initiated systemic cancer treatment for current diagnosis within the past 3 months or less
- Endorse appointment- or scan-related stress on 3-item screen (using modified items from distress thermometer, Fear of Progression scale, and Impact of Events scales)
- Willingness to use the study website
Exclusion Criteria:
- Moderate-to-severe cognitive impairment (per dementia diagnosis or cognitive screen)
- Requires an interpreter for medical visits
- Severe psychiatric illness (psychiatric hospitalization in the past year, or substance use disorder, bipolar disorder, or psychosis diagnosis)
- Currently enrolled in hospice
- Unable to complete study activities per oncology provider's judgment (e.g., due to fatigue)