Improve Cognition after Cancer Recovery with Mindfulness
By John M. de Castro, Ph.D.
“Mindfulness meditation practices enable cancer survivors to better manage cancer-related cognitive impairment. MBSR provides a creative solution for survivors whose social and occupational functioning may have been negatively impacted by cognitive difficulties.” – Shelly Johns
Cognitive impairments are a frequent side effect of cancer treatment. This has been dubbed “chemo brain.” Patients often refer to it as a mental cloudiness. The patients report problems including forgetting things, trouble concentrating, trouble remembering details like names and dates, trouble multi-tasking, like answering the phone while cooking, taking longer to finish things, disorganized and slower thinking, and trouble remembering common words. These cognitive impairments generally produce problems with work and even social relationships such that patients tend to isolate themselves. They can also produce treatment problems as the patients often forget to take their medications.
These problems result from the fact that chemotherapy, radiation therapy and many cancer drugs directly affect the nervous system. At present, there are no known treatments for these cognitive impairment side effects of chemotherapy. Contemplative practices have been shown to affect memory and have positive effects on cancer treatment and recovery. There is some evidence that contemplative practices may be useful for the alleviation of “chemo brain” symptoms. So, it makes sense to further study the ability of mindfulness training to improve the cancer patient’s cognitive abilities.
In today’s Research News article “Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cognitive impairment.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864185/, Johns and colleagues recruited breast cancer and colorectal cancer survivors with moderate fatigue and randomly assigned them to receive either an 8-week, once a week for 2 hours, fatigue education and support or a program of Mindfulness-Based Stress Reduction (MBSR) with home practice. MBSR contains meditation, yoga, and body scan practices. The participants were measured before and after the 8-week treatment period and 6 months later for attentional function, mindfulness, and cognitive executive function with the Stroop Test.
They found that compared to baseline and the fatigue education group, the participants in the MBSR program demonstrated significant improvement in attentional function, including greater effective attentional actions and fewer attentional lapses. Further mediational analysis revealed that MBSR acted by increasing the ability to act with awareness which in turn increased attentional function. In addition, the MBSR group had significantly fewer errors on the Stroop Test indicating better cognitive function. Importantly, the benefits of the MBSR program were not only significant at the end of training but also 6 months later.
These are interesting and potentially important results. The “Chemo Brain” resulting from cancer treatments produces significant degradation in the patient’s cognitive abilities. The results suggest that a Mindfulness-Based Stress Reduction (MBSR) program can significantly produce lasting improvements in these degraded attentional abilities and thinking. MBSR appears to work, at least in part, by increasing the patient’s ability to act with awareness, thereby decreasing distractions and intrusions of off-topic thoughts. Cancer patients have suffered terribly from their disease and the treatments for the disease. It is heartening that a mindfulness practice can be so beneficial in relieving at least residual symptoms of “Chemo Brain.”
So, improve cognition after cancer recovery with mindfulness.
“Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors” – CancerCommons
CMCS – Center for Mindfulness and Contemplative Studies
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Johns, S. A., Von Ah, D., Brown, L. F., Beck-Coon, K., Talib, T. L., Alyea, J. M., … Giesler, R. B. (2016). Randomized controlled pilot trial of mindfulness-based stress reduction for breast and colorectal cancer survivors: effects on cancer-related cognitive impairment. Journal of Cancer Survivorship : Research and Practice, 10(3), 437–448. http://doi.org/10.1007/s11764-015-0494-3
Cancer-related cognitive impairment (CRCI) is a common, fatigue-related symptom that disrupts cancer survivors’ quality of life. Few interventions for CRCI exist. As part of a randomized pilot study targeting cancer-related fatigue, the effects of mindfulness-based stress reduction (MBSR) on survivors’ cognitive outcomes were investigated.
Breast and colorectal cancer survivors (n=71) with moderate-to-severe fatigue were randomized to MBSR (n=35) or a fatigue education and support (ES; n=36) condition. The Attentional Function Index (AFI) and the Stroop test were used to assess survivors’ cognitive function at baseline (T1), after the 8-week intervention period (T2), and 6 months later (T3) using intent-to-treat analysis. Mediation analyses were performed to explore mechanisms of intervention effects on cognitive functioning.
MBSR participants reported significantly greater improvement on the AFI total score compared to ES participants at T2 (d=0.83, p=0.001) and T3 (d=0.55, p=0.021). MBSR also significantly outperformed ES on most AFI subscales, although both groups improved over time. MBSR produced greater Stroop accuracy rates relative to ES at T2 (r=0.340, p=0.005) and T3 (r=0.280, p=0.030), with improved accuracy over time only for the MBSR group. There were no significant differences in Stroop reaction time between groups. Improvements in mindfulness mediated the effect of group (e.g., MBSR vs. ES) on AFI total score at T2 and T3.
Additional randomized trials with more comprehensive cognitive measures are warranted to definitively assess the efficacy of MBSR for CRCI.