Reduce Anxiety and Depression in Cancer Patients with Mindfulness
By John M. de Castro, Ph.D.
“Practicing mindfulness can assist with uncertainty about the future, depression, fear of recurrence and anxiety as well as mitigate physical symptoms such as fatigue, pain, and sleep disturbance.” – Erin Murphy-Wilczek
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. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.
Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness in treating anxiety in cancer patients.
In today’s Research News article “Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/) Oberoi and colleagues review, summarize, and perform a meta-analysis of the published research on the effectiveness of mindfulness in reducing anxiety in adult cancer patients. They found 28 published trials. The most common forms of mindfulness treatment were Mindfulness-Based Stress Reduction (MBSR) (13 studies) and Mindfulness-Based Cognitive Therapy (MBCT) (6 studies).
They report that the published research found that mindfulness training reduced anxiety and depression and increased quality of life over the short and medium term (up to 6 months post-treatment) with moderate effect sizes. The reduction in anxiety and depression may be responsible for the improvement in the patients’ quality of life. But 2 trials had longer term follow up measures (over 6 months) and did not find significant reductions. The fact that the effects do not appear to last beyond 6 months suggests that continued mindfulness practice or periodic booster sessions may be needed.
Fighting cancer is very stressful and amplifies negative emotions like anxiety and depression. The stress produced by these emotions can in turn interfere with the body’s ability to fight the cancer. So, treating these negative emotional states may be very important not only for the individual’s mental health but also to their physical well-being. So, mindfulness training may be important to the overall health of the cancer patient by reducing anxiety and depression.
So, reduce anxiety and depression in cancer patients with mindfulness.
“In summary, results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson
CMCS – Center for Mindfulness and Contemplative Studies
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Oberoi, S., Yang, J., Woodgate, R. L., Niraula, S., Banerji, S., Israels, S. J., Altman, G., Beattie, S., Rabbani, R., Askin, N., Gupta, A., Sung, L., Abou-Setta, A. M., & Zarychanski, R. (2020). Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis. JAMA network open, 3(8), e2012598. https://doi.org/10.1001/jamanetworkopen.2020.12598
Mindfulness-based interventions (MBIs), grounded in mindfulness, focus on purposely paying attention to experiences occurring at the present moment without judgment. MBIs are increasingly used by patients with cancer for the reduction of anxiety, but it remains unclear if MBIs reduce anxiety in patients with cancer.
To evaluate the association of MBIs with reductions in the severity of anxiety in patients with cancer.
Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and SCOPUS were conducted from database inception to May 2019 to identify relevant citations.
Randomized clinical trials (RCTs) that compared MBI with usual care, waitlist controls, or no intervention for the management of anxiety in cancer patients were included. Two reviewers conducted a blinded screening. Of 101 initially identified studies, 28 met the inclusion criteria.
Data Extraction and Synthesis
Two reviewers independently extracted the data. The Cochrane Collaboration risk-of-bias tool was used to assess the quality of RCTs, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Summary effect measures were reported as standardized mean differences (SMDs) and calculated using a random-effects model.
Main Outcomes and Measures
Our primary outcome was the measure of severity of short-term anxiety (up to 1-month postintervention); secondary outcomes were the severity of medium-term (1 to ≤6 months postintervention) and long-term (>6 to 12 months postintervention) anxiety, depression, and health-related quality of life of patients and caregivers.
This meta-analysis included 28 RCTs enrolling 3053 adults with cancer. None of the trials were conducted in children. Mindfulness was associated with significant reductions in the severity of short-term anxiety (23 trials; 2339 participants; SMD, −0.51; 95% CI, −0.70 to −0.33; I2 = 76%). The association of mindfulness with short-term anxiety did not vary by evaluated patient, intervention, or study characteristics. Mindfulness was also associated with the reduction of medium-term anxiety (9 trials; 965 participants; SMD, −0.43; 95% CI, −0.68 to −0.18; I2 = 66%). No reduction in long-term anxiety was observed (2 trials; 403 participants; SMD, −0.02; 95% CI, −0.38 to 0.34; I2 = 68%). MBIs were associated with a reduction in the severity of depression in the short term (19 trials; 1874 participants; SMD, −0.73; 95% CI; −1.00 to −0.46; I2 = 86%) and the medium term (8 trials; 891 participants; SMD, −0.85; 95% CI, −1.35 to −0.35; I2 = 91%) and improved health-related quality of life in patients in the short term (9 trials; 1108 participants; SMD, 0.51; 95% CI, 0.20 to 0.82; I2 = 82%) and the medium term (5 trials; 771 participants; SMD, 0.29; 95% CI, 0.06 to 0.52; I2 = 57%).
Conclusions and Relevance
In this study, MBIs were associated with reductions in anxiety and depression up to 6 months postintervention in adults with cancer. Future trials should explore the long-term association of mindfulness with anxiety and depression in adults with cancer and determine its efficacy in more diverse cancer populations using active controls.