Improve Cognition in Breast Cancer Patients with Meditation
By John M. de Castro, Ph.D.
“Between diagnosis, treatment, recovery and ongoing treatment, living with cancer is a stressful roller-coaster set on repeat. Meditation is a very useful and powerful tool that can help you get in touch with your thoughts and emotions, cultivate compassion and find strength to keep going -maybe even to thrive.” -Jasmin Fiore Dodge
Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. 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 “Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083855/ ), Milbury and colleagues recruited women who had breast cancer and had completed chemotherapy at least 6 months ago. They were randomly assigned to receive either Tibetan Sound Meditation or were assigned to a wait-list control condition. Tibetan Sound Meditation was practiced in twice weekly, 1-hour sessions, for 6 weeks. It included focused meditation, mindfulness development, breathing exercises, and cognitive tasks. The participants were measured before training and one month after the completion of the program for cognitive performance, perceived cognitive function, depression, sleep disturbance, fatigue, health related quality of life, and spiritual well-being.
They found that after training the women receiving meditation training had significant albeit small improvements in cognitive function including verbal memory, short-term memory, processing speed and significant decreases in perceived cognitive function. Hence the women following meditation treatment had improve objective and subjective cognitive abilities. In addition, the treated women had significantly higher levels of overall mental health and spiritual well-being and lower levels of depression.
This was a relatively small pilot study, so it was surprising and encouraging to discover significant improvements. Tibetan Sound Meditation is a complex practice consisting of a number of different practices. It would be interesting to begin to determine which components or combination of components were responsible for the benefits. It would also be interesting to compare the effectiveness of Tibetan Sound Meditation to other forms of meditation practice such as open monitoring meditation or loving kindness meditation.
It should be noted that the control condition received no activities other than treatment as usual. So, the results may have been affected by participant and experimenter bias and expectancy effects. It would be better in future studies to use an active control condition such as light exercise of health education. Nevertheless, the results suggest that training in Tibetan Sound Meditation improves the thinking ability and spiritual and mental health of women who completed chemotherapy for breast cancer.
So, improve cognition in breast cancer patients with meditation.
“Enduring treatment is not only unpleasant, but time-consuming and expensive. Meditation is one method that can be extremely beneficial throughout the healing process. Like many illnesses, breast cancer can be worsened by stress. Meditation can help you reduce stress levels throughout the day.” – Laura Sage
CMCS – Center for Mindfulness and Contemplative Studies
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Milbury, K., Chaoul, A., Biegler, K., Wangyal, T., Spelman, A., Meyers, C. A., … Cohen, L. (2013). Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial. Psycho-Oncology, 22(10), 2354–2363. http://doi.org/10.1002/pon.3296
Although chemotherapy-induced cognitive impairment is common among breast cancer patients, evidence for effective interventions addressing cognitive deficits is limited. This randomized controlled trial examined the feasibility and preliminary efficacy of a Tibetan Sound Meditation (TSM) program to improve cognitive function and quality of life in breast cancer patients.
Forty-seven breast cancer patients (mean age 56.3 years), who were staged I–III at diagnosis, 6–60 months post-chemotherapy, and reported cognitive impairment at study entry were recruited. Participants were randomized to either two weekly TSM sessions for 6 weeks or a wait list control group. Neuropsychological assessments were completed at baseline and 1 month post-treatment. Self-report measures of cognitive function (Functional Assessment of Cancer Therapy (FACT)-Cog), quality of life (SF-36), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sleep disturbance (Pittsburgh Sleep Quality Index), fatigue (Brief Fatigue Inventory), and spirituality (FACT-Sp) were completed at baseline, the end of treatment, and 1 month later.
Relative to the control group, women in the TSM group performed better on the verbal memory test (Rey Auditory Verbal Learning Test trial 1) (p = 0.06) and the short-term memory and processing speed task (Digit Symbol) (p = 0.09) and reported improved cognitive function (p = 0.06), cognitive abilities (p = 0.08), mental health (p = 0.04), and spirituality (p = 0.05) at the end of treatment but not 1 month later.
This randomized controlled trial revealed that TSM program appears to be a feasible and acceptable intervention and may be associated with short-term improvements in objective and subjective cognitive function as well as mental health and spirituality in breast cancer patients.