2021-01-262021-01-262016-12-010962-93431573-2649http://dx.doi.org/10.34944/dspace/502727315118 (pubmed)http://hdl.handle.net/20.500.12613/5045© 2016, The Author(s). Objective: To examine the extent to which mindfulness skills influence psychological distress and health-related quality of life (HRQOL) in men with metastatic or castration-resistant biochemical progression of prostate cancer. Patients and methods: A cross-sectional survey of 190 men (46 % response; mean age 71 years, SD = 8.7, range 40–91 years) with advanced prostate cancer, assessed psychological and cancer-specific distress, HRQOL. Mindfulness skills were assessed as potential predictors of adjustment outcomes. Results: Overall, 39 % of men reported high psychological distress. One third had accessed psychological support previously although only 10 % were under current psychological care. One quarter had accessed a prostate cancer support group in the past six months. Higher HRQOL and lower cancer-specific and global psychological distress were related to non-judging of inner experience (p < 0.001). Higher HRQOL and lower psychological distress were related to acting with awareness (p < 0.001). Lower distress was also related to higher non-reactivity to inner experience and a lower level of observing (p < 0.05). Conclusions: Men with advanced prostate cancer are at risk of poor psychological outcomes. Psychological flexibility may be a promising target for interventions to improve adjustment outcomes in this patient group. Clinical Trial Registry: Trial Registration: ACTRN126120003068193027-3035enCC BYhttp://creativecommons.org/licenses/by/4.0/Quality of lifeAdvanced prostate cancerPsychological distressArticle2021-01-26