Mindfulness Reduces Fatigue with Breast Cancer Patients Directly and Indirectly by Improving Psychological Health
By John M. de Castro, Ph.D.
“Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro
Because of great advances in treatment, many patients today are surviving cancer. But 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, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.
Mindfulness training has been shown to help with general cancer recovery . Mindfulness practice have been shown to improve the residual symptoms in cancer survivors. So, it’s reasonable to further explore the potential benefits of mindfulness practice to relieve fatigue in patients who have survived breast cancer.
In today’s Research News article “The relation between mindfulness and the fatigue of women with breast cancer: path analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/), Ikeuchi and colleagues recruited adult women who had undergone surgery for breast cancer and 6 or more months had passed since their last cancer treatment. They completed self-report measures of fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance.
They found that the higher the levels of mindfulness the lower the levels of fatigue, anxiety, depression, pain, loneliness, and sleep disturbance and the higher the levels of anxiety, depression, pain, loneliness, and sleep disturbance the higher the levels of fatigue. They then applied path modelling to examine the relationships of the variables. They found that high levels of mindfulness were not only directly associated with low levels of fatigue but also indirectly associated by way of high mindfulness being associated with low levels of anxiety, depression, pain, loneliness, and sleep disturbance. These variables that were, in turn, associated with fatigue levels.
These results are correlational and as such caution must be exercised in inferring causation. Previous research, though, has demonstrated that mindfulness is causally related to lower levels of fatigue, anxiety, depression, pain, loneliness, and sleep. So, the present correlative results probably are due to these causal connections. Given this inference, then, the results suggest that mindfulness lowers fatigue in breast cancer patients by directly lowering fatigue and also by improving the psychological and physical health of the patients which also improves fatigue levels.
These results are important. After cancer treatment there are substantial and troubling residual physical and psychological symptoms. The findings suggest that mindfulness may be an important means to improve these symptoms and markedly improve the quality of life of patients who have been treated for breast cancer.
So, mindfulness reduces fatigue with breast cancer patients directly and indirectly by improving psychological health.
“mindfulness meditation can reduce stress and anxiety in the general population as well as in breast cancer survivors.” – Kathleen Doheny
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Ikeuchi, K., Ishiguro, H., Nakamura, Y., Izawa, T., Shinkura, N., & Nin, K. (2020). The relation between mindfulness and the fatigue of women with breast cancer: path analysis. BioPsychoSocial medicine, 14, 1. https://doi.org/10.1186/s13030-020-0175-y
Abstract
Background
Although fatigue is a common and distressing symptom in cancer survivors, the mechanism of fatigue is not fully understood. Therefore, this study aims to investigate the relation between the fatigue and mindfulness of breast cancer survivors using anxiety, depression, pain, loneliness, and sleep disturbance as mediators.
Methods
Path analysis was performed to examine direct and indirect associations between mindfulness and fatigue. Participants were breast cancer survivors who visited a breast surgery department at a university hospital in Japan for hormonal therapy or regular check-ups after treatment. The questionnaire measured cancer-related-fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance. Demographic and clinical characteristics were collected from medical records.
Results
Two-hundred and seventy-nine breast cancer survivors were registered, of which 259 answered the questionnaire. Ten respondents with incomplete questionnaire data were excluded, resulting in 249 participants for the analyses. Our final model fit the data well (goodness of fit index = .993; adjusted goodness of fit index = .966; comparative fit index = .999; root mean square error of approximation = .016). Mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance were related to fatigue, and mindfulness had the most influence on fatigue (β = − .52). Mindfulness affected fatigue not only directly but also indirectly through anxiety, depression, pain, loneliness, and sleep disturbance.
Conclusions
The study model helps to explain the process by which mindfulness affects fatigue. Our results suggest that mindfulness has both direct and indirect effects on the fatigue of breast cancer survivors and that mindfulness can be used to more effectively reduce their fatigue. It also suggests that health care professionals should be aware of factors such as anxiety, depression, pain, loneliness, and sleep disturbance in their care for fatigue of breast cancer survivors.
Trial registration
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/