Counseling for Chinese Patients with Advanced Cancer

Adaptation of Individual Meaning-Centered Psychotherapy for Chinese Immigrant Cancer

This study is testing a new counseling approach to help Chinese patients with advanced cancer find meaning and purpose in their lives, using telehealth sessions in Mandarin or English.

Quick facts

• Study type: Observational
• Enrollment: 93 (estimated)
• Ages: 21 Years to 80 Years
• Sex: All
• Sponsor: Memorial Sloan Kettering Cancer Center (other)
• Locations: 9 sites (Basking Ridge, New Jersey and 8 other locations)
• Trial ID: NCT02112188 on ClinicalTrials.gov

What this trial studies

This study aims to adapt Individual Meaning Centered Psychotherapy (IMCP) to better serve Chinese patients with advanced cancer. It involves formative research through in-depth interviews with Chinese immigrants to understand their specific needs and cultural context. The adapted intervention will be delivered via telehealth in Mandarin or English, focusing on helping patients find meaning and purpose despite their illness. The study will be conducted in phases, starting with formative research, followed by adaptation, and culminating in a proof-of-concept pilot trial.

Who should consider this trial

Good fit: Ideal candidates include Chinese immigrants aged 18 and older with Stage III or IV cancer who are Mandarin-speaking and reside in New York or New Jersey.

Not a fit: Patients who are not of Chinese descent or those with early-stage cancer may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could enhance the emotional well-being and coping mechanisms of Chinese cancer patients.

How similar studies have performed: Other studies have shown success with culturally tailored counseling approaches, indicating potential for this adaptation.

Eligibility criteria

Inclusion Criteria:

Phases 1 and 2:

Interview Inclusion Criteria (per self-report):

* Non-US born;
* Of Chinese descent;
* Age 21 years through 80 years;
* Language spoken: Mandarin and/or English
* Diagnosis of Stage IV cancer (any type).

Phase 3:

* Stage III or IV cancer (per self-report or on the MSKCC EMR). If traditional staging does not apply (i.e. for leukemia), we can allow patient deemed by provider to have poor prognosis/roughly equivalent to Stage III or IV to be referred.
* Age 18 or older
* Of Chinese descent
* Mandarin-speaking
* Have an estimated life expectancy of at least 6 months (per self-report or on the MSKCC EMR)
* Resides in New York State or New Jersey

Phase 4:

* Stage III or IV cancer (per self-report or on the MSKCC EMR). If traditional staging does not apply (i.e. for leukemia), we can allow patient deemed by provider to have poor prognosis/roughly equivalent to Stage III or IV to be referred.
* Age 18 or older
* Of Chinese descent
* Mandarin-speaking
* Have an estimated life expectancy of at least 6 months (per referring physician assessment or on the MSKCC EMR)
* Resides in New York State or New Jersey

Exclusion Criteria:

Phases 1 and 2:

* Presence of cognitive impairment disorder (e.g., delirium or dementia) sufficient to preclude meaningful informed consent and/or data collection. The Chinese version of the Mini Mental State Examination (MMSE) (46) will be used as a cognitive screening tool. Patients with MMSE scores below 20 will be excluded. For English speaking patients we will use the English version of the MMSE.
* Has a household member who has already participated (or agreed to participate).

Phase 3:

* Previous participation in Phases 1 or 2 of the study
* Unable/unwilling to use or no access to a telehealth platform (i.e., telephone or videoconference)
* For participants who express interest in RSMI, unable/unwilling to use Zoom videoconferencing platform
* Unable or unwilling to commit to up to 16 weeks to complete 6-session intervention and follow-up assessments
* Major psychiatric illness or cognitive impairment that in the judgment of study investigators or study staff would preclude study participation
* Patients diagnosed with primary brain tumors (per self-report or on the MSKCC EMR), as they may have difficulty completing the intervention and answering questionnaires
* Undergoing hematopoietic stem cell transplantation (HSCT) (per self-report or on the MSKCC EMR)
* Currently in psychotherapeutic treatment (patients being treated with psychotropic medications will not be excluded, as long as they are not in psychotherapy; per self report)

Phase 4:

* Previous participation in Phases 1, 2, or 3 of the study
* Unable/unwilling to use or no access to the Zoom videoconferencing platform (required for RSMI)
* Unable or unwilling to commit to up to 16 weeks to complete 6-session intervention and follow-up assessments
* Major psychiatric illness or cognitive impairment that in the judgment of study investigators or study staff would preclude study participation
* Patients diagnosed with primary brain tumors (per self-report or on the MSKCC EMR), as they may have difficulty completing the intervention and answering questionnaires
* Undergoing hematopoietic stem cell transplantation (HSCT) (per self-report or on the MSKCC EMR)
* Currently in psychotherapeutic treatment (patients being treated with psychotropic medications will not be excluded, as long as they are not in psychotherapy; per self report)

Where this trial is running

Basking Ridge, New Jersey and 8 other locations

• Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities) — Basking Ridge, New Jersey, United States (RECRUITING)
• Memorial Sloan Kettering Monmouth (Limited Protocol Activities) — Middletown, New Jersey, United States (RECRUITING)
• Memorial Sloan Kettering Bergen (Limited Protocol Activities) — Montvale, New Jersey, United States (RECRUITING)
• Memorial Sloan Kettering Cancer Center Suffolk- Commack (Limited Protocol Activities) — Commack, New York, United States (RECRUITING)
• City College of New York (Data Collection AND Data Analysis) — New York, New York, United States (RECRUITING)
• MSK at Ralph Lauren (Limited Protocol Activities) — New York, New York, United States (RECRUITING)
• Memorial Sloan Kettering Cancer Center — New York, New York, United States (RECRUITING)
• Memorial Sloan Kettering Nassau (Limited Protocol Activities) — Uniondale, New York, United States (RECRUITING)
• Memorial Sloan Kettering Westchester (Limited Protocol Activities) — West Harrison, New York, United States (RECRUITING)

Study contacts

• Principal investigator: Florence Lui, PhD — Memorial Sloan Kettering Cancer Center
• Study coordinator: Florence Lui, PhD

Conditions: Advanced Cancer