{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:49:36Z","timestamp":1791985776842,"version":"4.4.0"},"reference-count":58,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"23","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2018,8,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Individuals with advanced cancer experience substantial distress in response to disease burden and impending mortality. Managing Cancer And Living Meaningfully (CALM) is a novel, brief, manualized psychotherapeutic intervention intended to treat and prevent depression and end-of-life distress in patients with advanced cancer. We conducted a randomized controlled trial to compare CALM with usual care (UC) in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with advanced cancer were recruited from outpatient oncology clinics at a comprehensive cancer center into an unblinded randomized controlled trial. Permuted block randomization stratified by Patient Health Questionnaire-9 depression score allocated participants to CALM plus UC or to UC alone. Assessments of depressive symptoms (primary outcome), death-related distress, and other secondary outcomes were conducted at baseline, 3 months (primary end point), and 6 months (trial end point). Analyses were by intention to treat. Analysis of covariance was used to test for outcome differences between groups at follow-up, controlling for baseline. Mixed-model results are reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (n = 305) were recruited between February 3, 2012, and March 4, 2016, and randomly assigned to CALM (n = 151) or UC (n = 154). CALM participants reported less-severe depressive symptoms than UC participants at 3 months (\u0394 = 1.09; P = .04; Cohen\u2019s d = 0.23; 95% CI, 0.04 to 2.13) and at 6 months (\u0394 = 1.29; P = .02; d = 0.29; 95% CI, 0.24 to 2.35). Significant findings for greater end-of-life preparation at 6 months also favored CALM versus UC. No adverse effects were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings suggest that CALM is an effective intervention that provides a systematic approach to alleviating depressive symptoms in patients with advanced cancer and addresses the predictable challenges these patients face.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2017.77.1097","type":"journal-article","created":{"date-parts":[[2018,6,29]],"date-time":"2018-06-29T16:00:43Z","timestamp":1530288043000},"page":"2422-2432","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":303,"title":["Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer"],"prefix":"10.1200","volume":"36","author":[{"given":"Gary","family":"Rodin","sequence":"first","affiliation":[{"name":"All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Lo","sequence":"additional","affiliation":[{"name":"All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Rydall","sequence":"additional","affiliation":[{"name":"All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Shnall","sequence":"additional","affiliation":[{"name":"All authors: Princess Margaret Cancer Centre; Gary Rodin, Christopher Lo, Rinat Nissim, Madeline Li, Camilla Zimmermann, and Sarah Hales, University of Toronto; 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