Improve Mental and Physical Health of Breast Cancer Survivors with Mindfulness
By John M. de Castro, Ph.D.
“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – Breastcancer.org
About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.
Surviving cancer, however, carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” (National Cancer Survivors Day). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.
Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress, sleep disturbance, and anxiety and depression. Yoga practice has also been shown to be helpful with the residual symptoms and the psychological and physical ability to deal with cancer treatment. The Mindfulness-Based Stress Reduction (MBSR) program includes meditation, body scan, and yoga. So, it would likely be of great benefit for women with breast cancer during and after treatment.
In today’s Research News article “Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012660/ ), Lengacher and colleagues recruited women with Stage 0 to III breast cancer who had been diagnosed within the last 2 years. They were randomly assigned to receive usual care or usual care plus a 6-week, 2-hour, once a week program of Mindfulness-Based Stress Reduction (MBSR). The MBSR group was encouraged to practice at home for 15 to 45 minutes daily. They were measured before and after treatment and 6-weeks later for pain, fatigue, quality of life, anxiety, depression, perceived stress, concerns about recurrence, and clinical history of cancer diagnosis and treatment. Participation rates were high with 91% of the original participants completing the program.
They found that MBSR participation produced significant symptom improvements that were generally maintained for the following 6 weeks. The MBSR group had significantly greater reductions in anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference. They also found that the women who had the greatest levels of stress at the beginning of the training benefited the most from it, with significantly greater reductions in fear of recurrence and fatigue.
MBSR has been shown in other healthy and ill groups to reduce anxiety, fatigue, and stress. So, it is good to see that MBSR is effective for this highly compromised and stressed group. The trial did not have an active control condition, leaving open the possibility of bias. Future research should include and active control, perhaps exercise. Regardless, the results are very encouraging and suggest that Mindfulness-Based Stress Reduction (MBSR) may be an excellent additional treatment for women with breast cancer improving their mental and physical health.
So, improve mental and physical health of breast cancer survivors with Mindfulness.
“The most widely researched meditation program is called Mindfulness-Based Stress Reduction or MBSR. It combines a variety of techniques, including body scan, sitting meditation, and gentle and mindful yoga. Studies of MBSR in women with breast cancer show that the practice can have a strong positive impact on mental health and lower levels of hormones that cause stress.” – LBBC.org
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Lengacher, C. A., Reich, R. R., Paterson, C. L., Ramesar, S., Park, J. Y., Alinat, C., … Kip, K. E. (2016). Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial. Journal of Clinical Oncology, 34(24), 2827–2834. http://doi.org/10.1200/JCO.2015.65.7874
Abstract
Purpose
The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe.
Patients and Methods
A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects.
Results
Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC).
Conclusion
The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes.