How Resilience Coaching May Help Young People With Advanced Cancer

A new resilience coaching program helped adolescents and young adults (AYA) with advanced cancer feel more hopeful and resilient, helping these individuals cope with their cancer, leading to lasting improvements in quality of life, according to study findings presented at the ASCO 2025 Annual Meeting.

Moreover, the novel resilience coaching program showed longer-term benefits to patients anxiety levels, the research noted.

The study followed AYAs with advanced cancer for 12 months. Some participated in the PRISM program (Promoting Resilience in Stress Management), while others received usual care.

After just three months, patients in the PRISM group reported greater improvements in their feelings of resilience and hope than those who did not receive coaching. While there were no major differences between the two groups at first in quality of life, anxiety, or depression, patients in the PRISM group continued to report more improvement over time. By 6 and 12 months, they had significantly better quality of life and less anxiety than the usual care group.

In addition to emotional and mental health benefits, patients who received PRISM also appeared more likely to take part in key conversations about their care.

More Information on the PRISM Intervention

Adolescents and young adults with advanced cancer often face poor quality of life, high levels of emotional distress, and limited involvement in decisions about their care. To address these challenges, researchers tested a resilience coaching program called PRISM for Advanced Cancer (PRISM-AC), according to the study. This program includes elements of advance care planning and is designed to support adolescents and young adults emotionally while encouraging more active participation in their care.

PRISM, is a skills-based, one-on-one training program for young people with cancer. The program includes four individual sessions, each lasting 30 to 60 minutes, followed by a family meeting that involves a parent, caregiver, spouse or significant other.

A pilot randomized controlled trial of PRISM showed that the program was not only feasible and acceptable but also improved key outcomes like resilience, quality of life, and psychological distress. Notably, early findings suggested the program might be especially helpful for patients with advanced cancer. Feedback from this group also helped researchers refine PRISM to better reflect their hopes, worries, and desire to find meaning in their experience, according to the research.

Trial Design

A total of 195 adolescents and young adults were enrolled and randomly assigned to either usual care (96 patients) or the PRISM-AC program (99 patients) between April 2019 and January 2024 during this research. Additionally, participants had a mean age of 16.5 years, and most identified as White (63%), non-Hispanic (59%), and were publicly insured (53%). Researchers evaluated whether the PRISM-AC program could improve outcomes for AYAs facing the unique emotional and medical stressors that come with an advanced cancer diagnosis.

Moreover, patients were eligible to enroll onto the trial if they were between the ages of 12 and 24 and had been diagnosed with advanced cancer, including progressive, recurrent or refractory disease, or any diagnosis with an estimated overall survival of less than 50%, determined at least two weeks prior to enrollment. Participants needed to be able to speak English and read either English or Spanish, and they had to be cognitively able to take part in interviews.

Patients were excluded if they or, in the case of minors under age 18, their parents declined participation.

Reference

1. “Promoting Resilience in Stress Management (PRISM): A randomized controlled trial of a psychosocial intervention for adolescents and young adults with advanced cancer,” by Abb R. Rosenberg, et al., Journal of Clinical Oncology.

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