{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:04:05Z","timestamp":1788969845829,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009128","name":"DH | NIHR | Research for Patient Benefit Programme","doi-asserted-by":"publisher","award":["NIHR201542"],"award-info":[{"award-number":["NIHR201542"]}],"id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Br J Cancer"],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Androgen deprivation therapy (ADT) causes hot flushes and night sweats (HFNS) and is associated with sleep disturbance, anxiety, low mood and cognitive impairment. We tested self-help cognitive behavioural therapy (CBT), when guided by prostate cancer nurse specialist teams, for mitigation of the long-term impact of HFNS, and associated symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prostate cancer patients receiving ADT, with a HFNS Problem Rating Scale \u22652, were randomised (1:1) to treatment as usual (TAU) or CBT\u2009+\u2009TAU, stratified by centre and treatment intent. CBT was a 4-week self-help intervention with pre- and post-intervention group workshops guided by trained prostate cancer nurse specialists. Primary endpoint: 6-month HFNS Problem Rating Scale. Secondary endpoints included HFNS frequency, ADT compliance and rating scales for HFNS beliefs and behaviours, quality of life, anxiety, depression and sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      162 patients were randomised. 6 month mean HFNS Problem Rating Scale score was not significantly different between the TAU and CBT\u2009+\u2009TAU groups (mean 4.08 vs 4.04, 95% confidence interval (CI) for difference: \u22120.89, 0.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.97), although was improved at 6 weeks (mean 4.47 vs 3.79, 95% CI: \u22121.26, -0.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), when depression, anxiety scores and ADT compliance also favoured CBT\u2009+\u2009TAU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The addition of CBT in prostate cancer patients receiving ADT improved short-term HFNS severity, in addition to improved anxiety and depression scores, but these were not maintained at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>ISRCTN58720120.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41416-026-03375-4","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:49:09Z","timestamp":1774313349000},"page":"1413-1419","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Self-help cognitive behavioural therapy for hot flushes and night sweats during androgen deprivation therapy for prostate cancer: the MANCAN2 randomized controlled trial"],"prefix":"10.1038","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3521-9064","authenticated-orcid":false,"given":"Simon J.","family":"Crabb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alannah","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenia","family":"Stefanopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Fleure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9579-8021","authenticated-orcid":false,"given":"Gareth O.","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherish","family":"Boxall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Wilding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Nearchou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-4917","authenticated-orcid":false,"given":"Sean","family":"Ewings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Nuttall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zina","family":"Eminton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Tilt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Whitby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Siu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ridley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynsey","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Nobes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Preece","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Bacon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Chamberlain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Fenlon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,24]]},"reference":[{"key":"3375_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74:229\u201363.","journal-title":"CA Cancer J Clin"},{"key":"3375_CR2","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1001\/jama.2025.0228","volume":"333","author":"R Raychaudhuri","year":"2025","unstructured":"Raychaudhuri R, Lin DW, Montgomery RB. Prostate Cancer: A Review. JAMA. 2025;333:1433\u201346.","journal-title":"JAMA"},{"key":"3375_CR3","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/j.jaccao.2021.09.014","volume":"3","author":"V Narayan","year":"2021","unstructured":"Narayan V, Ross AE, Parikh RB, Nohria A, Morgans AK. How to treat prostate cancer with androgen deprivation and minimize cardiovascular risk. A therapeutic tightrope. JACC CardioOncol. 2021;3:737\u201341.","journal-title":"JACC CardioOncol"},{"key":"3375_CR4","first-page":"E107","volume":"46","author":"Y Qan\u2019ir","year":"2019","unstructured":"Qan\u2019ir Y, DeDeaux D, Godley PA, Mayer DK, Song L. Management of androgen deprivation therapy-associated hot flashes in men with prostate cancer. Oncol Nurs Forum. 2019;46:E107\u2013E18.","journal-title":"Oncol Nurs Forum"},{"key":"3375_CR5","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1001\/jama.294.2.238","volume":"294","author":"N Sharifi","year":"2005","unstructured":"Sharifi N, Gulley JL, Dahut WL. Androgen deprivation therapy for prostate cancer. JAMA. 2005;294:238\u201344.","journal-title":"JAMA"},{"key":"3375_CR6","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1177\/1557988306298802","volume":"2","author":"CA Engstrom","year":"2008","unstructured":"Engstrom CA. Hot flashes in prostate cancer: state of the science. Am J Mens Health. 2008;2:122\u201332.","journal-title":"Am J Mens Health"},{"key":"3375_CR7","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1002\/pon.3794","volume":"24","author":"E Stefanopoulou","year":"2015","unstructured":"Stefanopoulou E, Yousaf O, Grunfeld EA, Hunter MS. A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN). Psychooncology. 2015;24:1159\u201366.","journal-title":"Psychooncology"},{"key":"3375_CR8","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1002\/pon.5432","volume":"29","author":"D Fenlon","year":"2020","unstructured":"Fenlon D, Maishman T, Day L, Nuttall J, May C, Ellis M, et al. Effectiveness of nurse-led group CBT for hot flushes and night sweats in women with breast cancer: Results of the MENOS4 randomised controlled trial. Psychooncology. 2020;29:1514\u201323.","journal-title":"Psychooncology"},{"key":"3375_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07325-w","volume":"24","author":"S Crabb","year":"2023","unstructured":"Crabb S, Morgan A, Hunter MS, Stefanopoulou E, Griffiths G, Richardson A, et al. A multicentre randomised controlled trial of a guided self-help cognitive behavioural therapy to MANage the impact of hot flushes and night sweats in patients with prostate CANcer undergoing androgen deprivation therapy (MANCAN2). Trials. 2023;24:450.","journal-title":"Trials"},{"key":"3375_CR10","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1093\/jnci\/85.5.365","volume":"85","author":"NK Aaronson","year":"1993","unstructured":"Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365\u201376.","journal-title":"J Natl Cancer Inst"},{"key":"3375_CR11","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","volume":"28","author":"DJ Buysse","year":"1989","unstructured":"Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193\u2013213.","journal-title":"Psychiatry Res"},{"key":"3375_CR12","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.maturitas.2014.09.014","volume":"79","author":"MS Hunter","year":"2014","unstructured":"Hunter MS, Sharpley CF, Stefanopoulou E, Yousaf O, Bitsika V, Christie DR. The Hot Flush Beliefs and Behaviour Scale for Men (HFBBS-Men) undergoing treatment for prostate cancer. Maturitas. 2014;79:464\u201370.","journal-title":"Maturitas"},{"key":"3375_CR13","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606\u201313.","journal-title":"J Gen Intern Med"},{"key":"3375_CR14","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1192\/bjp.180.5.461","volume":"180","author":"JC Mundt","year":"2002","unstructured":"Mundt JC, Marks IM, Shear MK, Greist JH. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002;180:461\u20134.","journal-title":"Br J Psychiatry"},{"key":"3375_CR15","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092\u20137.","journal-title":"Arch Intern Med"},{"key":"3375_CR16","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1097\/gme.0b013e3181591db7","volume":"15","author":"JS Carpenter","year":"2008","unstructured":"Carpenter JS, Rand KL. Modeling the hot flash experience in breast cancer survivors. Menopause. 2008;15:469\u201375.","journal-title":"Menopause"},{"key":"3375_CR17","doi-asserted-by":"publisher","first-page":"171","DOI":"10.3109\/13697131003717070","volume":"14","author":"KL Rand","year":"2011","unstructured":"Rand KL, Otte JL, Flockhart D, Hayes D, Storniolo AM, Stearns V, et al. Modeling hot flushes and quality of life in breast cancer survivors. Climacteric. 2011;14:171\u201380.","journal-title":"Climacteric"},{"key":"3375_CR18","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1080\/13697137.2019.1580258","volume":"22","author":"MS Hunter","year":"2019","unstructured":"Hunter MS, Nuttall J, Fenlon D. A comparison of three outcome measures of the impact of vasomotor symptoms on women\u2019s lives. Climacteric. 2019;22:419\u201323.","journal-title":"Climacteric"},{"key":"3375_CR19","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.maturitas.2009.10.017","volume":"65","author":"J Frisk","year":"2010","unstructured":"Frisk J. Managing hot flushes in men after prostate cancer\u2014a systematic review. Maturitas. 2010;65:15\u201322.","journal-title":"Maturitas"},{"key":"3375_CR20","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/S1470-2045(09)70338-9","volume":"11","author":"J Irani","year":"2010","unstructured":"Irani J, Salomon L, Oba R, Bouchard P, Mottet N. Efficacy of venlafaxine, medroxyprogesterone acetate, and cyproterone acetate for the treatment of vasomotor hot flushes in men taking gonadotropin-releasing hormone analogues for prostate cancer: a double-blind, randomised trial. Lancet Oncol. 2010;11:147\u201354.","journal-title":"Lancet Oncol"},{"key":"3375_CR21","first-page":"1183","volume":"29","author":"S Tran","year":"2021","unstructured":"Tran S, Hickey M, Saunders C, Ramage L, Cohen PA. Nonpharmacological therapies for the management of menopausal vasomotor symptoms in breast cancer survivors. Support Care Cancer. 2021;29:1183\u201393.","journal-title":"Support Care Cancer"},{"key":"3375_CR22","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1097\/gme.0b013e31823fe835","volume":"19","author":"B Ayers","year":"2012","unstructured":"Ayers B, Smith M, Hellier J, Mann E, Hunter MS. Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause. 2012;19:749\u201359.","journal-title":"Menopause"},{"key":"3375_CR23","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1038\/s41391-021-00342-3","volume":"24","author":"R Mundle","year":"2021","unstructured":"Mundle R, Afenya E, Agarwal N. The effectiveness of psychological intervention for depression, anxiety, and distress in prostate cancer: a systematic review of literature. Prostate Cancer Prostatic Dis. 2021;24:674\u201387.","journal-title":"Prostate Cancer Prostatic Dis"}],"container-title":["British Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41416-026-03375-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41416-026-03375-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41416-026-03375-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:28:55Z","timestamp":1777530535000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41416-026-03375-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,24]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,5,20]]}},"alternative-id":["3375"],"URL":"https:\/\/doi.org\/10.1038\/s41416-026-03375-4","relation":{},"ISSN":["0007-0920","1532-1827"],"issn-type":[{"value":"0007-0920","type":"print"},{"value":"1532-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,24]]},"assertion":[{"value":"23 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"SJC: personal fees for speaking and\/or advisory work from Amgen, Amphista Therapeutics, Astellas, AstraZeneca, Bayer, Bristol-Myers Squibb, Duality Bio, Ipsen, Janssen, Merck, MSD, Novartis, Pfizer and Roche. Research funding support from Astex Pharmaceuticals, AstraZeneca, Clovis Oncology, Veracyte and Roche. Support for scientific meeting attendance from Bayer, BMS, Janssen, Merck and Novartis. GOG: research funding support from Janssen-Cilag, AstraZeneca, Novartis, Astex, Roche, Heartflow, Celldex, BMS, BioNTech, MSD, IntraOp, Synairgen, NHS England, Unitaid, Imugene, and GSK. Consultancy fees from AstraZeneca, AbbVie and RS Oncology. The rest of the authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines and approved by West Midlands-South Birmingham Research Ethics Committee (21\/WM\/0259). All participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}