Improve the Physical and Psychological Health of Cancer Patients with Mindfulness
By John M. de Castro, Ph.D.
“It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson
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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.
Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress, sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.
In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.
The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.
It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.
So, improve the physical and psychological health of cancer patients with mindfulness.
“patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline
CMCS – Center for Mindfulness and Contemplative Studies
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Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214
Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.
Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.
Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.
MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.