Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses

Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses


By John M. de Castro, Ph.D.


“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. Even occasional mindfulness practice can help provide a break from the stress of cancer and fill patients with a sense of calm to confront the challenges they face.” – 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 dealing with cancer. These issues extend not just to the patient but also to their partners in life. These symptoms markedly reduce the quality of life of both.


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 disturbancefear, and anxiety and depression. But cancer does not occur in isolation. It effects both the patient but also their significant others. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. But there is little research on treating the cancer patients and their spouses in mindfulness as dyads.


In today’s Research News article “A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648356/ ) Milbury and colleagues recruited adult patients undergoing treatment for metastatic non‐small cell lung cancer and their romantic partners. Couples were randomly assigned to usual care or to receive 4 one-hour sessions via videoconference of either couple-based meditation or supportive-expressive practice. Couple-based meditation incorporated meditation and couple’s emotion sharing exercises. Supportive-expressive practice involved discussion of cancer-related issues that couples share. They were measured before and after treatment and 3 months later for depression, cancer-related stress symptoms, and spiritual well-being.


Attendance was high in both groups but the couple-based meditation reported that the sessions were more beneficial than the supportive-expressive practice group. They found that in comparison to baseline and the other groups at the 3-month follow-up the couple-based meditation patients and their significant others had significantly lower depression and cancer-related stress symptoms and higher spiritual well-being.


A strength of the study is that it had an active control condition, supportive-expressive practice, that contained therapeutic elements, expectancy effects and similar attention features to the couple-based meditation practice. This reduces the possibility of confounding variable being responsible for the results and suggests that the effects were due to the nature of the therapy. Another key aspect of this study is that the therapy was delivered via videoconference which may be responsible for the high attendance rates. This form of delivery is very convenient and flexible making it more likely to be effective.


There are great psychological and emotional problems co-occurring with cancer treatment for the patient and also for the patient’s romantic partner. So, these results are interesting and important suggesting that couple-based meditation practice can help relieve the suffering. The fact that the romantic partner was included was very important as the cancer effects both members of the dyad. Treating both prevents the suffering of one from interfering with the therapy for the other.


So, dyadic mindfulness training improves the mental health of metastatic cancer patients and their spouses.


Being in this present moment, letting go, practicing non-attachment and acceptance are so helpful in dealing with uncertainty and fear. Mindfulness is something that they use for the rest of their lives for really great benefit.” – Linda Carlson


CMCS – Center for Mindfulness and Contemplative Studies


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Study Summary


Milbury, K., Li, Y., Durrani, S., Liao, Z., Tsao, A. S., Carmack, C., Cohen, L., & Bruera, E. (2020). A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial. The oncologist, 25(11), e1794–e1802. Advance online publication. https://doi.org/10.1634/theoncologist.2020-0125




Although mindfulness‐based interventions have been widely examined in patients with nonmetastatic cancer, the feasibility and efficacy of these types of programs are largely unknown for those with advanced disease. We pilot‐tested a couple‐based meditation (CBM) relative to a supportive‐expressive (SE) and a usual care (UC) arm targeting psychospiritual distress in patients with metastatic lung cancer and their spousal caregivers.

Patients and Methods

Seventy‐five patient‐caregiver dyads completed baseline self‐report measures and were then randomized to one of the three arms. Couples in the CBM and SE groups attended four 60‐minute sessions that were delivered via videoconference. All dyads were reassessed 1 and 3 months later.


A priori feasibility benchmarks were met. Although attendance was high in both groups, dyads in the CBM group indicated greater benefit of the sessions than those in the SE group (patients, CBM mean = 2.63, SE mean = 2.20, p = .003; spouses, CBM mean = 2.71, SE mean = 2.00, p = .005). Compared with the UC group, patients in the CBM group reported significantly lower depressive symptoms (p = .05; d = 0.53) and marginally reduced cancer‐related stress (p = .07; d = 0.68). Medium effect sizes in favor of the CBM compared with the SE group for depressive symptoms (d = 0.59) and cancer‐related stress (d = 0.54) were found. Spouses in the CBM group reported significantly lower depressive symptoms (p < .01; d = 0.74) compared with those in the UC group.


It seems feasible and possibly efficacious to deliver dyadic interventions via videoconference to couples coping with metastatic lung cancer. Mindfulness‐based interventions may be of value to managing psychological symptoms in the palliative care setting



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