Changes in perceived cognitive functioning following a codesigned online group cognitive rehabilitation for prostate cancer survivors on androgen deprivation therapy: Series of single-case experimental designs

Limited treatments exist for prostate cancer survivors (PCS) experiencing cancer-related cognitive impairment (CRCI). We aimed to investigate the feasibility, acceptability, and potential efficacy of an online group cognitive rehabilitation intervention for PCS on androgen deprivation therapy (ADT) experiencing CRCI. Eight adult, English-speaking PCS receiving ADT with perceived cognitive changes participated in a weekly, 2-hour, four-session intervention - "Promoting Cognitive Wellbeing in Prostate Cancer Survivors (ProCog)." A mixed methods approach was adopted using nonconcurrent, multiple baseline single-case experimental designs. Perceived cognitive functioning was measured weekly using the FACT-Cog Perceived Cognitive Impairments scale (PCI18). Brief objective cognitive testing, goal attainment scaling, and measures of depression, generalized anxiety, fatigue and self-efficacy were administered at four time-points. Feasibility and acceptability were assessed through attendance, homework adherence, and feedback. Most participants had locally advanced prostate cancer, were retired and lived in regional areas (mean age = 69 years). Most participants (5/8) demonstrated significant improvements in PCI18 despite no consistent changes on cognitive testing. All participants made progress towards goal attainment post-intervention. Clinically significant improvements were seen in levels of anxiety, depression, and fatigue, though changes in self-efficacy were variable. Session attendance and homework completion were at ≥97%. Larger-scaled studies are required to support ProCog's benefits.Trial registration: Prospectively registered on anzctr.org.au identifier: ACTRN12623000946617.