Journal of Behavioral Medicine, Vol. 28, No. 3, June 2005 ( C  2005) DOI: 10.1007/s10865-005-4664-z Coping with Prostate Cancer: A Meta-Analytic Review Scott C. Roesch, 1,3 Linda Adams, 2 Amanda Hines, 2 Alan Palmores, 2 Pearlin Vyas, 2 Cindy Tran, 2 Shannon Pekin, 2 and Allison A. Vaughn 1 Accepted for pubilcation: August 23, 2004 The present meta-analytic review assessed the relations between coping categories and indices of adjustment in men with prostate cancer. Relevant methodological and statistical information was extracted from 33 target studies (n = 3,133 men with prostate cancer). Men with prostate cancer who used approach, problem-focused, and emotion-focused coping were healthier both psychologically and physically, although the effect sizes for problem-focused coping and emotion-focused coping were more modest. For approach coping these effect sizes were particularly strong for measures of self-esteem, positive affect, depression, and anxiety. Conversely, men with prostate cancer who used avoidance coping experienced heightened negative psychological adjustment and physical health, and particularly for measures of positive mood and physical functioning. The findings of this study suggest that active approaches to coping with prostate cancer are beneficial psychologically, physically, and are positively associated with a return to pre-cancer activities. KEY WORDS: coping; cancer; adjustment; meta-analysis. According to the American Cancer Society (2003) prostate cancer is now the leading cancer di- agnosed in males and is the second leading cause of mortality in males. Moreover, 1 out of 10 men is expected to develop prostate cancer during his life- time, with this fraction increasing over time. Inter- estingly, however, survival rates are fairly promis- ing. For example, less than 20% of these men are expected to die from the disease and 93% will survive for at least 5 years post-diagnosis, making quality of life issues extremely important for this group. Both the diagnosis and treatment for prostate cancer are extremely invasive, and this illness en- genders feelings of depression and anxiety not only for the individual diagnosed with prostate cancer but for his family as well. In addition, physical out- comes can include incontinence and impotence. For 1 San Diego State University. 2 Calfornia State Polytechnic University, Pomona. 3 To whom correspondence should be addressed at Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4611; e-mail to scroesch@sciences.sdsu.edu this reason, the identification of psychosocial fac- tors that lead to both positive and negative psy- chological (and physical) outcomes is warranted, and is empirically under-represented relative to other major cancer types (Sestini and Pakenham, 2000). The diagnosis of cancer can trigger a sequence of life-altering decisions that can induce stress (e.g., fi- nancial concerns, role changes) and increase personal vulnerability. The stage and the type of treatment that the cancer patient finds himself in, further com- plicates stressful feelings. Psychological research has confirmed that diagnosis of cancer leads to feelings of uncertainty, a loss of personal control, and a feeling of powerlessness (Davison and Degner, 1997). The consequences of cancer and its treatment, however, can produce sequelae varying from inconsequential to severely debilitating. Cognitive and social pro- cesses may account for these inconsistent findings; that is, coping strategies or general perceptions of the illness may predict which individuals with prostate cancer have better or worse psychological and phys- ical adjustment (quality of life) during the course of cancer management. 281 0160-7715/05/0600-0281/0 C  2005 Springer Science+Business Media, Inc.