Improve Eating Behavior in Obese Cancer Survivors with Mindfulness

Improve Eating Behavior in Obese Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindful eating helps you distinguish between emotional and physical hunger. It also increases your awareness of food-related triggers and gives you the freedom to choose your response to them.” – Adda Bjarnadottir

 

Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment, to emotional states, and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food. External eating is non-homeostatic eating in response to the environmental stimuli that surround us, including the sight and smell of food or the sight of food related cause such as the time of day or a fast food restaurant ad or sign.

 

Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake. Indeed, high levels of mindfulness are associated with lower levels of obesity and mindfulness training has been shown to reduce binge eating, emotional eating, and external eating.

 

A mindfulness training technique that was developed to treat addictions called Mindfulness-Oriented Recovery Enhancement (MORE) involves 10 weekly sessions of 2 hours and includes mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. Participants are also encouraged to practice at home for 15 minutes per day. It is not known if MORE is effective in changing eating behavior in obese women cancer survivors.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement Restructures Reward Processing and Promotes Interoceptive Awareness in Overweight Cancer Survivors: Mechanistic Results From a Stage 1 Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552347/), Thomas and colleagues recruited obese (BMI >30) women who had a cancer diagnosis either current or in remission. They were randomly assigned to receive a 10-week, 1.5-hour session, once per week, of either a standard exercise and nutrition program or the Mindfulness-Oriented Recovery Enhancement (MORE) program. The participants were measured before and after the program for body composition, eating behaviors, interoceptive awareness, savoring the moment, and attention bias toward food. In addition, they were measured for muscular electrical responses to food and non-food pictures to assess responsiveness to cues.

They found that in comparison to baseline and the exercise and nutrition program Mindfulness-Oriented Recovery Enhancement (MORE) produced significantly greater increases in smiling to natural reward cues, and interoceptive awareness including increases in noticing body sensations, attention regulation, self-regulation, and body listening, and significant decreases in attentional responsiveness to food cues and external eating. Using a path analysis, they found that MORE had its effects on attentional responsiveness to food cues directly and also indirectly by its positive effects on attention bias toward natural reward cues that, in turn, negatively affected their responsiveness to food cues. Finally, these decreases in attentional responsiveness to food cues were related to decreases in the participants’ waist to hip ratio.

 

These results are interesting and suggest that Mindfulness-Oriented Recovery Enhancement (MORE) may reduce inappropriate responsiveness to food in obese women with cancer by increasing their awareness of their internal state (interoceptive awareness) and their responsiveness to natural reward cues. Hence, the training makes the women more sensitive to their actual internal state which makes them more responsive to real hunger and satiety and less responsive to non-homeostatic eating signals. In addition, it appears to allow them to receive more reward from non-food related natural stimuli and thereby reduce their need to receive reward through eating. Thus, MORE appears to improve obese women’s ability to better regulate their eating behavior.

 

So, improve eating behavior in obese cancer survivors with mindfulness.

 

“Mindfulness practice helps individuals develop skills for self-regulation by improving awareness of emotional and sensory cues, which are also important in altering one’s relationship with food.” –  Sunil Daniel

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Thomas, E. A., Mijangos, J. L., Hansen, P. A., White, S., Walker, D., Reimers, C., … Garland, E. L. (2019). Mindfulness-Oriented Recovery Enhancement Restructures Reward Processing and Promotes Interoceptive Awareness in Overweight Cancer Survivors: Mechanistic Results From a Stage 1 Randomized Controlled Trial. Integrative cancer therapies, 18, 1534735419855138. doi:10.1177/1534735419855138

 

Abstract

Introduction: The primary aims of this Stage I pilot randomized controlled trial were to establish the feasibility of integrating exercise and nutrition counseling with Mindfulness-Oriented Recovery Enhancement (MORE), a novel intervention that unites training in mindfulness, reappraisal, and savoring skills to target mechanisms underpinning appetitive dysregulation a pathogenic process that contributes to obesity among cancer survivors; to identify potential therapeutic mechanisms of the MORE intervention; and to obtain effect sizes to power a subsequent Stage II trial. Methods: Female overweight and obese cancer survivors (N = 51; mean age = 57.92 ± 10.04; 88% breast cancer history; 96% white) were randomized to one of two 10-week study treatment conditions: (a) exercise and nutrition counseling or (b) exercise and nutrition counseling plus the MORE intervention. Trial feasibility was assessed via recruitment and retention metrics. Measures of therapeutic mechanisms included self-reported interoceptive awareness, maladaptive eating behaviors, and savoring, as well as natural reward responsiveness and food attentional bias, which were evaluated as psychophysiological mechanisms. Results: Feasibility was demonstrated by 82% of participants who initiated MORE receiving a full dose of the intervention. Linear mixed models revealed that the addition of MORE led to significantly greater increases in indices of interoceptive awareness, savoring, and natural reward responsiveness, and, significantly greater decreases in external eating behaviors and food attentional bias—the latter of which was significantly associated with decreases in waist-to-hip ratio. Path analysis demonstrated that the effect of MORE on reducing food attentional bias was mediated by increased zygomatic electromyographic activation during attention to natural rewards. Conclusions and Implications: MORE may target appetitive dysregulatory mechanisms implicated in obesity by promoting interoceptive awareness and restructuring reward responsiveness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552347/

 

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

 

By John M. de Castro, Ph.D.

 

“Exercise can increase blood flow to the hands and feet and may offer temporary relief from pain. People should discuss the exercises that are best for them with their doctor. Low-impact activities, such as swimming, low-impact aerobics, or yoga, are the safest options.” – Zawn Villines

 

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, surviving cancer carries with it a number of problems. Painful Chemotherapy-induced peripheral neuropathy is a frequent side effect of cancer treatment. This Neuropathy is characterized by damage to the nervous system resulting from chemotherapy. Between 30-100% of patients can experience this neuropathy.  It can affect patients motor abilities including walking, and balance. But it can also affect driving, relationships, work, writing, exercise, sleep and sexual activity.

 

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, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to help relieve chronic pain and be beneficial for cancer patients.  So, it makes sense to examine the ability of yoga practice to help relieve the symptoms of chemotherapy-induced peripheral neuropathy.

 

In today’s Research News article “Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/), Galantino and colleagues recruited cancer survivors who had completed all treatments but who had some degree of peripheral neuropathy. They participated in a 90 minute, twice a week for 8-weeks, Hatha yoga program including postures, breathwork, and meditation. They were also asked to practice at home. They were measured before and after treatment for motor functions, balance, lower extremity flexibility, pain, neurotoxicity, perceived stress, sleep quality, spiritual efficacy, fear of falling, vibration sense, and salivary cortisol. The participants were asked to record their reflections on their yoga practice in a diary.

 

They found that at the completion of the yoga training the patients had significantly improved mobility, flexibility, balance, risk of falling, perceived pain, pain interference with life activities, sensory systems, muscular weakness, foot vibration sensitivity, and perceived stress. They did not find any adverse effects of the yoga practice on the patients. Qualitative analysis of the patient diaries revealed that the patients noted improvements in enhanced sensations in the extremities, that the yoga practice helped them in managing their symptoms, that the improvement in physical function allowed return to work and re-engagement in hobbies, greater ability to relax, and enjoyment of the social aspects of the yoga practice.

 

It should be noted that this was a small pilot study and there wasn’t a control condition so the results need to be interpreted with caution. But the results are very encouraging and suggest that a large randomized controlled trial is justified and needed to verify the efficacy of the yoga program. But prior to the program there was no improvement over time, so participation in the program likely produced the benefits. The benefits obtained in this study are significant and important contributing to the daily functions, mental and physical health of the patients.

 

Chemotherapy-induced peripheral neuropathy is painful, persistent, disruptive, and debilitating. The degree of improvement seen in the patients after yoga practice markedly improved their symptoms and greatly reduced their suffering. Importantly, after yoga practice the symptoms of peripheral neuropathy were greatly reduced allowing the patients to better function and to enjoy their lives.

 

So, improve mobility and quality of life in patients with chemotherapy-induced peripheral neuropathy with yoga.

 

“They may also benefit from exercise programs such as water exercise, a strength & balance class, Tai Chi, and yoga.  Although patients survived their cancer, giving them their quality of life back should be a priority for those that are suffering from CIPN.” – Pam McMillan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (). Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integrative cancer therapies, 18, 1534735419850627. doi:10.1177/1534735419850627

 

Abstract

Objective. Chemotherapy-induced peripheral neuropathy (CIPN) syndrome causes significant pain as an adverse effect of treatment, with few nonpharmacological interventions tested. A somatic yoga and meditation (SYM) intervention on functional outcomes and quality of life (QOL) was investigated. Design and methods. Individuals diagnosed with CIPN were enrolled in an open-label, single-arm, mixed-methods feasibility trial. Participants and Setting. In an outpatient rehabilitation center, ten participants with median age 64.4 years (47-81) attended 61% of the sessions with no adverse events. Intervention. SYM twice a week for 8 weeks for 1.5 hours, with home program and journaling. Main outcome measures. Primary functional outcomes included Sit and Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers included salivary cortisol (stress) and bioesthesiometer (vibration). Results: Quantitative findings. Significant improvements were found in flexibility (SR; P = .006); balance (FR; P = .001) and fall risk (TUG; P = .004). PNQ improved significantly (P = .003) with other measures improving non-significantly. Qualitative findings. Five themes emerged: (1) vacillation of CIPN pain perception over time; (2) transferability of skills to daily activities; (3) improvement in physical function; (4) perceived relaxation as an effect of SYM; and (5) group engagement provided a social context for not feeling isolated with CIPN. Conclusion. Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer survivors with CIPN, with a fully powered randomized controlled trial indicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/

 

Improve Cancer-Related Symptoms in Cancer Survivors with Tai Chi

Improve Cancer-Related Symptoms in Cancer Survivors with Tai Chi

 

By John M. de Castro, Ph.D.

 

In terms of the evidence that’s out there and the scientific literature, practices such as tai chi have been found to help improve patients’ quality of life. There are some studies showing that these types of mind-body practices can also have an impact on physiological functioning, improving aspects of immune function and decreasing stress hormones.” – Lorenzo Cohen

 

Receiving a diagnosis of cancer has a huge impact on most people. 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. 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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. They are very gentle and safe practices. The research is accumulating. So, it makes sense to take a step back and summarize what has been found in regard to Tai Chi practice for the treatment of cancer survivors.

 

In today’s Research News article “Tai Chi and Qigong for cancer-related symptoms and quality of life: 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/PMC5958892/), Wayne and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Tai Chi practice in relieving cancer-related symptoms in cancer survivors. They identified 22 published research studies that included a total of 1571 cancer survivors. 15 of the studies were randomized controlled trials investigating survivors of a variety of cancers including breast, prostate lymphoma, lung, and multiple cancers.

 

They report that in general the research studies demonstrated a significant reduction in fatigue, sleep difficulty, depression , and quality of life resulting from Tai Chi practice. No significant improvements in pain were observed. No adverse events were reported. Hence, the research suggests that Tai Chi practice is a safe and effective treatment for cancer-related symptoms in cancer survivors. Tai Chi practice appears to benefit the mental and physical health of the survivors.

 

The results of the published research strongly suggests that Tai Chi  practice should be routinely prescribed for survivors of cancer. Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to improve the well-being of cancer survivors.

 

So, improve cancer-related symptoms in cancer survivors with Tai Chi.

 

“Tai chi does not treat the cancer itself. Research suggests that tai chi can help lower blood pressure, reduce stress, ease pain and stiffness and improve sleep. Small studies have shown that regular tai chi may help with depression and improve self-esteem. These studies have also suggested that regular practice of tai chi can improve quality of life.” – Canadian Cancer Society

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wayne, P. M., Lee, M. S., Novakowski, J., Osypiuk, K., Ligibel, J., Carlson, L. E., & Song, R. (2017). Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of cancer survivorship : research and practice, 12(2), 256–267. doi:10.1007/s11764-017-0665-5

 

Abstract

Purpose

Summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors.

Methods

A systematic search in 4 electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and quality of life (QOL) in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges’ g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed.

Results

Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n=7), prostate (n=2), lymphoma (n=1), lung (n=1), or combined (n=4) cancers. RCT comparison groups included active intervention (n=7), usual care (n=5), or both (n=3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue [ES=−0.53, p<.001], sleep difficulty [ES=−0.49, p=.018], depression [ES=−0.27, p=.001], and overall QOL [ES=0.33, p=.004]; a statistically non-significant trend was observed for pain [ES=−0.38, p=.136]. Random effects models were used for meta-analysis based on Q-test and I-squared criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results.

Conclusions

Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958892/

 

Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

Improve Symptoms and Quality of Life in Breast Cancer Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

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 alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that is also an exercise that has been shown to be beneficial for cancer patients. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/), Cramer and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice as a treatment for patients recovering from breast cancer. They identified 24 published research studies, 17 of which compared yoga practice to no-treatment, while 4 compared it to a psychoeducation program while 3 compared it to another exercise.

 

They found that the published research reports that in comparison to no-treatment yoga practice significantly improves health related quality of life and reduces fatigue and disturbance of sleep in women recovering from breast cancer. When compared to psychoeducation programs (4 studies), yoga practice had additional significant reductions of anxiety and depression. But, when compared to other exercise programs (3 studies), no significant effects were reported.

 

These results are interesting and suggest that yoga practice is a safe and effective treatment for women recovering from breast cancer, improving their quality of life and physical and mental well-being. The fact that these benefits were not significantly different from other forms of exercise suggests that the it’s the exercise provided by yoga that is the important aspect of the practice producing the benefits. Regardless, it is clear that yoga practice is quite helpful for the well-being of women recovering from breast cancer.

 

So, improve symptoms and quality of life in breast cancer patients with yoga.

 

“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 E. Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cramer, H., Lauche, R., Klose, P., Lange, S., Langhorst, J., & Dobos, G. J. (2017). Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. The Cochrane database of systematic reviews, 1(1), CD010802. doi:10.1002/14651858.CD010802.pub2

 

Abstract

Background

Breast cancer is the cancer most frequently diagnosed in women worldwide. Even though survival rates are continually increasing, breast cancer is often associated with long‐term psychological distress, chronic pain, fatigue and impaired quality of life. Yoga comprises advice for an ethical lifestyle, spiritual practice, physical activity, breathing exercises and meditation. It is a complementary therapy that is commonly recommended for breast cancer‐related impairments and has been shown to improve physical and mental health in people with different cancer types.

Objectives

To assess effects of yoga on health‐related quality of life, mental health and cancer‐related symptoms among women with a diagnosis of breast cancer who are receiving active treatment or have completed treatment.

Search methods

We searched the Cochrane Breast Cancer Specialised Register, MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), Indexing of Indian Medical Journals (IndMED), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal and Clinicaltrials.gov on 29 January 2016. We also searched reference lists of identified relevant trials or reviews, as well as conference proceedings of the International Congress on Complementary Medicine Research (ICCMR), the European Congress for Integrative Medicine (ECIM) and the American Society of Clinical Oncology (ASCO). We applied no language restrictions.

Selection criteria

Randomised controlled trials were eligible when they (1) compared yoga interventions versus no therapy or versus any other active therapy in women with a diagnosis of non‐metastatic or metastatic breast cancer, and (2) assessed at least one of the primary outcomes on patient‐reported instruments, including health‐related quality of life, depression, anxiety, fatigue or sleep disturbances.

Data collection and analysis

Two review authors independently collected data on methods and results. We expressed outcomes as standardised mean differences (SMDs) with 95% confidence intervals (CIs) and conducted random‐effects model meta‐analyses. We assessed potential risk of publication bias through visual analysis of funnel plot symmetry and heterogeneity between studies by using the Chi2 test and the I2 statistic. We conducted subgroup analyses for current treatment status, time since diagnosis, stage of cancer and type of yoga intervention.

Main results

We included 24 studies with a total of 2166 participants, 23 of which provided data for meta‐analysis. Thirteen studies had low risk of selection bias, five studies reported adequate blinding of outcome assessment and 15 studies had low risk of attrition bias.

Seventeen studies that compared yoga versus no therapy provided moderate‐quality evidence showing that yoga improved health‐related quality of life (pooled SMD 0.22, 95% CI 0.04 to 0.40; 10 studies, 675 participants), reduced fatigue (pooled SMD ‐0.48, 95% CI ‐0.75 to ‐0.20; 11 studies, 883 participants) and reduced sleep disturbances in the short term (pooled SMD ‐0.25, 95% CI ‐0.40 to ‐0.09; six studies, 657 participants). The funnel plot for health‐related quality of life was asymmetrical, favouring no therapy, and the funnel plot for fatigue was roughly symmetrical. This hints at overall low risk of publication bias. Yoga did not appear to reduce depression (pooled SMD ‐0.13, 95% CI ‐0.31 to 0.05; seven studies, 496 participants; low‐quality evidence) or anxiety (pooled SMD ‐0.53, 95% CI ‐1.10 to 0.04; six studies, 346 participants; very low‐quality evidence) in the short term and had no medium‐term effects on health‐related quality of life (pooled SMD 0.10, 95% CI ‐0.23 to 0.42; two studies, 146 participants; low‐quality evidence) or fatigue (pooled SMD ‐0.04, 95% CI ‐0.36 to 0.29; two studies, 146 participants; low‐quality evidence). Investigators reported no serious adverse events.

Four studies that compared yoga versus psychosocial/educational interventions provided moderate‐quality evidence indicating that yoga can reduce depression (pooled SMD ‐2.29, 95% CI ‐3.97 to ‐0.61; four studies, 226 participants), anxiety (pooled SMD ‐2.21, 95% CI ‐3.90 to ‐0.52; three studies, 195 participants) and fatigue (pooled SMD ‐0.90, 95% CI ‐1.31 to ‐0.50; two studies, 106 participants) in the short term. Very low‐quality evidence showed no short‐term effects on health‐related quality of life (pooled SMD 0.81, 95% CI ‐0.50 to 2.12; two studies, 153 participants) or sleep disturbances (pooled SMD ‐0.21, 95% CI ‐0.76 to 0.34; two studies, 119 participants). No trial adequately reported safety‐related data.

Three studies that compared yoga versus exercise presented very low‐quality evidence showing no short‐term effects on health‐related quality of life (pooled SMD ‐0.04, 95% CI ‐0.30 to 0.23; three studies, 233 participants) or fatigue (pooled SMD ‐0.21, 95% CI ‐0.66 to 0.25; three studies, 233 participants); no trial provided safety‐related data.

Authors’ conclusions

Moderate‐quality evidence supports the recommendation of yoga as a supportive intervention for improving health‐related quality of life and reducing fatigue and sleep disturbances when compared with no therapy, as well as for reducing depression, anxiety and fatigue, when compared with psychosocial/educational interventions. Very low‐quality evidence suggests that yoga might be as effective as other exercise interventions and might be used as an alternative to other exercise programmes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465041/

 

Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“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 E. 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. 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. Pain, anxiety, depression, fatigue and insomnia and reduced quality of life are common symptoms in the aftermath of surviving cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. The research is accumulating. So, it is useful to take a step back and look at what has been learned.

 

In today’s Research News article “A Systematic Review: Mindfulness Intervention for Cancer-Related Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/), Ngamkham and colleagues review and summarize the high quality published research literature on the application of mindfulness training for the treatment of cancer related pain. They found 6 randomized controlled clinical trials (RCTs). These studies used Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Breathing Meditation, or Mindful Awareness Practice (MAP) programs as treatments.

 

They found that the published research reports that mindfulness training produces a significant reduction in cancer related pain that was still present 6-months after the training. The research also found significant reductions in anxiety and depression and significant increases in the patient’s quality of life. Hence, mindfulness training was found to be a safe and effective treatment for patients suffering with cancer related pain.

 

It is not known exactly how mindfulness training produces these benefits. It has been shown, however, that in healthy individuals, mindfulness training also produces reductions in pain, anxiety, and depression. It is thought that one way mindfulness training reduces is by reducing worry and rumination which is thought to amplify pain. Mindfulness training has also been shown to improve emotion regulation and reduce response to stress that may also contribute to pain reduction. Regardless mindfulness training should be recommended for cancer patients to reduce pain and improve their well-being.

 

So, improve pain, mental health and quality of life in cancer patients with mindfulness.

 

“Fear. Uncertainty about the future. Some of the most difficult elements of the cancer experience are well-suited for mindfulness.” – Lu Hanessian

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A Systematic Review: Mindfulness Intervention for Cancer-Related Pain. Asia-Pacific journal of oncology nursing, 6(2), 161–169. doi:10.4103/apjon.apjon_67_18

 

Abstract

Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/

 

Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

 

By John M. de Castro, Ph.D.

 

“In studies of women with breast cancer, yoga has been shown to reduce fatigue and improve quality of sleep, physical vitality, and overall quality of life.” – BreastCancer.org

 

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 alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients. But yoga practice is both a mindfulness practice and an exercise. It is unclear whether the benefits of yoga practice for cancer patients is due to its mindfulness or exercise components or both. The research has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory 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/PMC6388460/ ), El-Hashimi and Gorey review, summarize and perform a meta-analysis of the effectiveness of yoga for improving the quality of life in survivors of breast cancer. They found and report on 8 randomized controlled trials that included a comparison to another exercise program.

 

They report that the research demonstrated that exercise practices including yoga produce significant improvements in quality of life for the breast cancer patients that are still present as much as a year later. But yoga practice was not significantly better than other exercise programs in improving the quality of life. It would appear that the fact that yoga practice is an exercise and not its mindfulness aspect is critical for the improvement in the quality of life of breast cancer patients.

 

So, improve quality of life in breast cancer survivors with exercise or yoga.

 

“Yoga, meditation, and breathing practices allow women with breast cancer to explore their emotions, foster mindful empathy, and cope with fatigue and tightness,” – Sierra Campbell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

El-Hashimi, D., & Gorey, K. M. (2019). Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory Meta-Analysis of Randomized Controlled Trials. Journal of evidence-based integrative medicine, 24, 2515690X19828325.

 

Abstract

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater effectiveness: d = 0.14, P = .10. However, at longer term follow-up, no statistically or practically significant between-group difference was observed. This meta-analysis preliminarily demonstrated that yoga is probably as effective as other exercise modalities in improving the QoL of women with breast cancer. Both interventions were associated with clinically significant improvements in QoL. Nearly all of the yoga intervention programs, however, were very poorly resourced. Larger and better controlled trials of well-endowed yoga programs are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388460/

 

Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

 

By John M. de Castro, Ph.D.

 

“Sleep disturbance is a common problem for women with breast cancer, and can have a variety of causes, from stress and depression related to the treatment or diagnosis, to a side effect of some of the drugs and anti-nausea medications used in chemotherapy regimens. Yoga not only produced benefits in the short term, it also produced benefits in sleep quality three months and six months after treatment.” – Paul Raeburn

 

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. Fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients.  In today’s Research News article “Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/ ), Chaoul and colleagues examine the ability of yoga practice to improve sleep in breast cancer patients.

 

They recruited patients with Stage 1 to 3 breast cancer scheduled to undergo chemotherapy. They were randomly assigned to usual care or to either receive a Tibetan Yoga Program or a stretching program. Participants met for 4, 75 to 90-minute, sessions during chemotherapy and 3 booster sessions over the next 6 months. The participants were also encouraged to practice at home. The Tibetan Yoga Program consisted of “1) mindfulness and focused attention through guided meditation with breathing and visualization; 2) an alternate nostril breathing practice and a breath retention exercise; 3) Tsa Lung movements; and 4) closing with a brief compassion-based meditation.” The participants were measured before and after the programs and 3, 6, and 12 months later for sleep quality, fatigue, and actigraph measured sleep patterns.

 

They found that all groups improved in sleep quality and fatigue over the 12-month measurement period. But the Tibetan Yoga group had significantly less daily sleep disturbances and fewer minutes awake before sleep onset. Hence, participation in the Tibetan Yoga Program had modest benefits for the quality of sleep for the patients. The Tibetan Yoga Program contains a number of different components including meditation, postures, and breathing exercises. It is impossible to determine in the current study which components or which combinations of components were necessary and sufficient for the benefits.

 

These results are encouraging but not clinically significant as the effects were very modest. But,

it should be kept in mind that yoga and meditation programs have been shown to improve a number of other impacts of breast cancer diagnosis and survival. So, the total impact of participation in yoga for breast cancer patients may be much greater than implied by the current results.

 

So, improve sleep in breast cancer patients undergoing chemotherapy with yoga.

 

“it is encouraging to see that the women who practiced yoga outside of class had improved sleep outcomes over time. Previous research has established that yoga effectively reduces sleep disturbances for cancer patients, but have not included active control groups or long-term follow-up.” – Lorenzo Cohen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chaoul, A., Milbury, K., Spelman, A., Basen-Engquist, K., Hall, M. H., Wei, Q., Shih, Y. T., Arun, B., Valero, V., Perkins, G. H., Babiera, G. V., Wangyal, T., Engle, R., Harrison, C. A., Li, Y., … Cohen, L. (2017). Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer, 124(1), 36-45.

 

Abstract

BACKGROUND

This randomized trial examined the effects of a Tibetan yoga program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and fatigue in women with breast cancer undergoing chemotherapy.

METHODS

Women with stage I–III breast cancer undergoing chemotherapy were randomized to TYP (n=74), STP (n=68), or UC (n=85) groups. Participants in the TYP and STP groups participated in 4 sessions during chemotherapy, followed by three booster sessions over the subsequent 6 months, and encouraged to practice at home. Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index) fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline, 1-week post-treatment, and 3, 6 and 12 months.

RESULTS

There were no group differences in total sleep disturbances or fatigue levels over time. However, patients in TYP reported fewer daily disturbances 1-week post-treatment than STP (difference=−0.43, 95% CI: −0.82, −0.04, P=0.03) and UC (difference=−0.41, 95.5% CI: −0.77, −0.05, P=0.02). Group differences at the other time points were maintained for TYP versus STP. Actigraphy data revealed greater minutes awake after sleep onset for STP 1-week post treatment versus TYP (difference=15.36, 95% CI: 7.25,23.48, P=0.0003) and UC (difference=14.48, 95% CI: 7.09,21.87, P=0.0002). Patients in TYP who practiced at least two times a week during follow-up reported better PSQI and actigraphy outcomes at 3 and 6 months post-treatment than those who did not and better than those in UC.

CONCLUSIONS

Participating in TYP during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time for those who practiced TYP at least two times a week.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/

 

Increase Positive Feelings About Caregiving for Cancer Patients with Mindfulness

Increase Positive Feelings About Caregiving for Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“caregivers of cancer patients face under-recognized health challenges. “Studies have suggested that caregivers are more depressed than patients themselves. There is also a reciprocal relationship between caregivers and patients, so improving quality of life for caregivers could improve patient outcomes.” – Sarah Stanley

 

There is a tremendous demand for caregiving in the U.S. It is estimated that over 65 million (29% of the adult population) provides care to someone who is mentally or physically ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost to the caregiver. It exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Family members are an increasingly important source of caregiving. But it comes with a cost to the caregiver. Mindfulness training has been shown to be beneficial for both the caregiver and the patients. So, mindfulness training may be helpful in decreasing the psychological difficulty of caring for a patient with cancer.

 

In today’s Research News article “Mindful Learning Improves Positive Feelings of Cancer Patients’ Family Caregivers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352041/ ), Geng and colleagues recruited caregivers for cancer patients and randomly assigned them to receive either 4, 30-minute, mindfulness training sessions or mindlessness training. The mindfulness training involved “innovation classification” in which they were asked to “think and write four answers from different perspectives to a picture-related question.” The mindlessness condition involved writing answers to the same pictures but from only one perspective. They were measured before and after training for mindfulness, caregiver reactions, and positive aspects of caregiving.

 

They found in comparison to baseline and the mindlessness group, that after training the mindfulness group had significantly higher mindfulness and positive feelings toward caregiving. In addition, the higher the levels of mindfulness, the greater the positive feelings toward caregiving.

 

These results suggest that a simple form of mindfulness training can improve caregiver’s mindfulness and feeling about caregiving for cancer patients. It remains for future research to demonstrate if these benefits are lasting and can result in improved care for the patients and less stress and burnout for the caregivers.

 

So, increase positive feelings about caregiving for cancer patients with mindfulness.

 

“We are set up for short-term stress, but caregiving is long-term stress. Mindfulness is basically coming back into the present moment, so it works to inhibit the stress response. Most of us run around listening to our thoughts, and this is particularly true of caregivers, who are driven by the to-do list. They are never at rest.” – Joan Griffiths Vega

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Geng, L., Wang, J., Cheng, L., Zhang, B., & Shen, H. (2019). Mindful Learning Improves Positive Feelings of Cancer Patients’ Family Caregivers. International journal of environmental research and public health, 16(2), 248. doi:10.3390/ijerph16020248

 

Abstract

Positive feelings are an important health dimension for family caregivers of cancer patients. The aim of this study was to investigate whether Langerian mindfulness is a valid proactive method to increase the positive feelings of family caregivers for cancer patients. Participants were randomly assigned to either a mindfulness group or a mindlessness group and completed the Caregiver Reaction Assessment (CRA) as a measure of caregivers’ feelings before the intervention. Subsequently, both groups were given four sessions of mindfulness training using “innovation classification”. Finally, participants completed the Langer Mindfulness Scale (LMS) and the Positive Aspects of Caregiving (PAC) scale as post-intervention measures. The results revealed that participants in the mindfulness and mindlessness groups differed significantly in LMS and PAC scores, with the mindfulness group having higher levels of positive feelings than those in the mindlessness group. The results also indicated that mindfulness level significantly predicted positive feelings of caregivers. Thus mindful interventions may play a meaningful role in promoting family caregivers’ spirituality and faith, improving the willingness of sharing their thoughts, beliefs, and grief, which could be useful for increasing the positive feelings of caregivers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352041/

 

Improve the Psychological Health of Thyroid Cancer Patients with Mindfulness

Improve the Psychological Health of Thyroid 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. When a person gets diagnosed, there’s fear and uncertainty about the future. There’s the loss of routine and predictability. There’s the physical aspect, the treatment or surgery, pain, insomnia, which almost everybody gets, and the post-treatment fatigue. A lot of people find the hardest time is from active treatment to survivorship or post-treatment period where all of a sudden, it’s time to get back to one’s life, but what’s the new normal? For many people, it’s a catalyst or transition period. They look at their life and wonder what’s important. What are my values? What does an authentic life look like? What brings me meaning and purpose?” – 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. 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. In the case of Thyroid cancer that number is over 95%. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia and reduced quality of life are common symptoms in the aftermath of surviving cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. In today’s Research News article “Mindfulness-based stress reduction in patients with differentiated thyroid cancer receiving radioactive iodine therapy: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324610/ ), Liu and colleagues recruited patients with Thyroid cancer who were receiving radioactive iodine treatment and randomly assigned them to either a usual care control condition or to receive a Mindfulness-Based Stress Reduction (MBSR) treatment. The MBSR program consists of 8 weekly 2-hour group sessions involving meditation, yoga, body scan, and discussion. The patients are also encouraged to perform daily practice for 15-45 minutes. They were measured before and after treatment and 3 months later for cancer specific quality of life, depression, and anxiety.

 

They found that in comparison to baseline and the treatment as usual control group, the patients who participated in MBSR treatment had significantly improved overall cancer specific quality of life, including emotional function and fatigue, and they reported significantly lower levels of anxiety and depression. Importantly, these improvements were still present and significant 3 months after the conclusion of treatment.

 

These are impressive results that suggest that mindfulness training produces significant and lasting benefits for the psychological well-being of Thyroid cancer patients. These patients have a lot to deal with in fighting their disease. The improvements in psychological well-being are important producing relief of one aspect of cancer so that the patient can better focus on the physical side. These results add Thyroid cancer patients to the growing list of cancer patients helped by mindfulness training.

 

So, improve the psychological health of thyroid cancer patients with mindfulness.

 

“MBSR can help to relieve particular symptoms and improve quality of life for people with cancer. It might, improve mood, improve concentration, reduce depression and anxiety, reduce symptoms and side effects, such as feeling sick (nausea), boost the immune system. . . There is no evidence that meditation can help to prevent, treat or cure cancer, or any other disease.” – Cancer Research UK

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu, T., Zhang, W., Xiao, S., Xu, L., Wen, Q., Bai, L., Ma, Q., … Ji, B. (2019). Mindfulness-based stress reduction in patients with differentiated thyroid cancer receiving radioactive iodine therapy: a randomized controlled trial. Cancer management and research, 11, 467-474. doi:10.2147/CMAR.S183299

 

Abstract

Objective

The aim of this study was to evaluate the efficacy of mindfulness-based stress reduction (MBSR) on health-related quality of life (QoL), depression, and anxiety in patients with differentiated thyroid cancer (DTC) receiving radioactive iodine therapy (RIT).

Patients and methods

A randomized controlled trial of MBSR with 120 DTC patients was performed. They were randomly assigned into the MBSR intervention group and usual care (UC) group. An 8-week MBSR program was administered to the MBSR group starting 8 weeks before RIT. Health-related QoL, depression, and anxiety were measured immediately before the start of MBSR (T1), immediately after RIT hospitalization was concluded (1 week after concluding the last MBSR session, T2), and 3 months after RIT hospitalization (T3), using the QoL Questionnaire Core 30 Items (QLQ-C30), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS).

Results

Fifty-three patients in the UC group and 49 patients in the MBSR group completed the study and were analyzed. Both the UC and MBSR groups reported low QoL and high SDS and SAS scores immediately after RIT hospitalization. Patients randomly assigned to the MBSR group showed significantly greater improvements in emotional function (P=0.012, d=–0.03 for T2 and d=1.17 for T3), fatigue (P=0.037, d=1.00 for T2 and d=–0.69 for T3), global QoL (P=0.015, d=1.61 for T2 and d=1.56 for T3), depression (P=0.027, d=–1.19 for T2 and d=–0.83 for T3), and anxiety (P=0.043, d=–1.00 for T2 and d=–0.86 for T3).

Conclusion

An 8-week MBSR program significantly improved a wide range of scales in health-related QoL and mitigated depression and anxiety among DTC patients receiving RIT.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324610/

 

Sleep and Fatigue is not Improved in Prostate Cancer Patients Undergoing Radiotherapy with Qigong/Tai Chi Exercise

Sleep and Fatigue is not Improved in Prostate Cancer Patients Undergoing Radiotherapy with Qigong/Tai Chi Exercise

 

By John M. de Castro, Ph.D.

 

“While most studies to date fail to show that qigong has a direct effect on cancer, several studies have found this practice to have a positive impact on the well-being and quality of life for people living with cancer.” – Lynne Eldridge

 

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.

 

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. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression.. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. Qigong is a very gentle and safe practice. So, it makes sense to further study its utility for cancer patients.

 

In today’s Research News article “Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378667/ ), McQuade and colleagues recruited prostate cancer patients undergoing radiotherapy and randomly assigned them to one of three conditions; Qigong/Tai Chi; light exercise; or wait-list control. The Qigong/Tai Chi and light exercise training occurred three times per week for 40 minutes during radiotherapy treatment. Light exercise consisted of stretching and light resistance exercise matched to the exertion level of the Qigong/Tai Chi exercise. They were measured before, during, and after treatment and 1 and 3 months later for sleep disturbance, fatigue, and health-related quality of life.

 

They found that midway through treatment the Qigong/Tai Chi group slept better than the other groups but these differences were not maintained at the end of treatment or on follow-up. There were no significant effects or treatment on fatigue or quality of life. In some ways these results are disappointing and suggest that Qigong/Tai Chi is not effective in helping prostate cancer patients during radiotherapy.

 

Radiotherapy, however, produces considerable side effects including hot flashes and urinary symptoms that are highly predictive of sleep disturbance, fatigue, and quality of life. In addition, Qigong/Tai Chi exercise has been shown to improve quality of life, reduce fatigue in other cancer patients after treatment. It will require future research to determine if Qigong/Tai Chi exercise conducted after radiotherapy is completed may be beneficial for these patients.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

McQuade, J. L., Prinsloo, S., Chang, D. Z., Spelman, A., Wei, Q., Basen-Engquist, K., Harrison, C., Zhang, Z., Kuban, D., Lee, A., … Cohen, L. (2016). Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial. Psycho-oncology, 26(11), 1936-1943.

 

Abstract

Objectives

Sleep disturbances and fatigue are common in prostate cancer patients undergoing radiotherapy. Prior research suggests mind-body techniques may improve these outcomes. We conducted a randomized-controlled trial of qigong/tai chi (QGTC) in men with prostate cancer undergoing radiotherapy.

Methods

Men with prostate cancer starting definitive radiation were randomized to one of three groups: (1) QGTC; (2) light exercise (LE); or (3) wait list control (WLC). Sleep disturbances (PSQI) and fatigue (BFI) were assessed at baseline, mid-radiotherapy (T2), during the last week of radiotherapy (T3) and at 1 (T4) and 3 months (T5) after the end of radiotherapy. Patients in the QGTC and LE groups attended three 40-minute classes per week throughout radiotherapy.

Results

Ninety patients were randomized to the three groups (QGTC=26; LE=26; WLC=24). QGTC group reported longer sleep duration at mid-XRT (QGTC=7.01 hours; LE=6.42; WL=6.50; p=0.05) but this difference did not persist over time. There were no group differences in other domains of sleep or fatigue. Exploratory analyses conducted to examine the effect of health-related QOL (EPIC and AUA score) on sleep and fatigue showed significant correlations across multiple domains.

Conclusions

QGTC during radiation for prostate cancer resulted in superior sleep duration midway through radiation, but this effect was not durable and there were no differences in other domains of sleep or fatigue. Exploratory analysis demonstrated that both sleep and fatigue were highly correlated with prostate cancer related physical symptoms. Future mind-body intervention studies should incorporate multi-modal therapy focused on improving physical symptoms in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378667/