Objective: As the global population ages, cancer incidence among older adults is rising, with cases projected to reach nearly 20 million by 2040. This growing burden presents unique psychological challenges, as older adults face both cancer and age-related losses. Few psychotherapies specifically address the intersection of aging and cancer. Cancer and Aging: Reflections for Elders (CARE) is a novel, telephone-delivered intervention designed to alleviate distress in older cancer patients. CARE integrates developmental theories of aging, Folkman’s meaning-based coping model, and qualitative research with older adults. This presentation will review the CARE intervention, share pilot data, and provide updates from an ongoing Phase III randomized controlled trial (RCT).
Sample/Procedures: Eligible patients were ≥70 years old, ≥6 months post-diagnosis with lung, prostate, breast, lymphoma, or gynecological cancer, receiving active treatment or within six months post-treatment, and experiencing elevated distress. Participants were randomized to either the CARE intervention or a supportive psychotherapy control condition. Both groups were matched for time and attention, completing five psychotherapy sessions over seven weeks. Assessments were conducted at baseline, post-intervention, and four months post-intervention. Primary outcomes included depression and anxiety; secondary outcomes included demoralization, coping, loneliness, and spiritual well-being.
Results: The ongoing Phase III RCT has enrolled 320 participants (CARE n=160; supportive psychotherapy control n=160). Pilot study results (n=59; CARE n=30; supportive psychotherapy controls, n=29) showed that CARE participants reported lower depression (d=0.58, p=0.01), lower anxiety (d=0.41, p=0.10), and greater meaning (d=0.48, p=0.04) compared to controls.
Conclusion and Clinical Implications: CARE is a novel, manualized psychotherapy tailored to the developmental and psychological needs of older adults with cancer. Delivered via telephone, it holds promise as an accessible and effective first-line treatment for depression and anxiety in this growing patient population.