Improve Personal Growth in Cancer Survivors with Mindfulness and Spirituality

Improve Personal Growth in Cancer Survivors with Mindfulness and Spirituality

 

By John M. de Castro, Ph.D.

 

“religion and spirituality can help cancer patients find meaning in their illness and provide comfort in the face of fear.” – American Cancer Society

 

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 fatiguestress,  sleep disturbance, and anxiety and depression. In addition, religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality and mindfulness may be useful tools for the survivors of cancer to cope with their illness. Thus, there is a need to study the relationships of spirituality and mindfulness on the ability of cancer survivors to positively adjust to their situation.

 

In today’s Research News article “Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340393/), Rudaz and colleagues recruited cancer survivors and had them complete questionnaires measuring spiritual coping (using spirituality as a comfort during difficulties), spiritual mindfulness, personal growth, and positive reinterpretation (interpreting stressful events in a positive way).

 

They found that for the cancer survivors, the greater the levels of mindfulness, the greater the levels of personal growth and the greater the levels of positive reinterpretation. Hence mindfulness was associated with positive adjustments to their illness. Further they found that higher levels of spiritual coping were associated with higher levels of personal growth and higher levels of positive reinterpretation only when mindfulness was high. No relationship was present when mindfulness was low. Younger participants and those with higher levels of education had significantly higher levels of personal growth.

 

It has to be kept in mind that the study was correlational and as such no conclusions about causation can be reached. But the results suggest that spiritual mindfulness is associated with two positive characteristics in cancer survivors, personal growth and positive reinterpretation. In other words, being mindful was associated with an ability to interpret the illness in a positive way and use it as a springboard for greater personal growth. Being able to take solace in spirituality (spiritual coping) was only an effective strategy when the cancer survivors had high levels of mindfulness. Hence, mindfulness is an important characteristic on its own but also one that allows for spirituality to be associated with growth. They appear to have to work together.

 

So, improve personal growth in cancer survivors with mindfulness and spirituality.

 

“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

 

Rudaz, M., Ledermann, T., & Grzywacz, J. G. (2018). Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors. Journal of psychosocial oncology, 36(5), 609–623. doi:10.1080/07347332.2018.1464091

 

Abstract

Purpose.

This study examined the moderating role of spiritual mindfulness on the association between spiritual coping and perceived growth in individuals with and without current treatment for cancer.

Design/Sample.

Adults with a cancer history (N = 534) from the Midlife in the United States study completed a telephone interview and self-administered questionnaires.

Methods/Findings.

Moderated regression analyses, controlled for age and educational attainment, showed that mindfulness moderated the effect of spiritual coping on personal growth and on positive reinterpretation. High mindfulness amplified the effect of spiritual coping on both personal growth and positive reinterpretation. Further, this moderating effect was significantly different for adults with versus without current treatment for cancer for positive reinterpretation but not for personal growth.

Conclusions/Implications.

These findings highlight the potential amplifying effect of spiritual mindfulness on the effect of spiritual coping on perceived growth in cancer survivors.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340393/

 

Improve the Psychological Health of Cancer Patients with Psilocybin

Improve the Psychological Health of Cancer Patients with Psilocybin

 

By John M. de Castro, Ph.D.

 

“Our research has shown that, in a medically controlled setting with expert screening and preparation, psilocybin can relieve the symptoms of anxiety and depression often found in patients with a cancer diagnosis.” – Heffter Research Institute

 

Psychedelic substances have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. Psychedelics produce effects that are similar to those that are reported in spiritual awakenings. They report a loss of the personal self. They experience what they used to refer to as the self as just a part of an integrated whole. They report feeling interconnected with everything else in a sense of oneness with all things. They experience a feeling of timelessness where time seems to stop and everything is taking place in a single present moment. They experience ineffability, being unable to express in words what they are experiencing and as a result sometimes producing paradoxical statements. And they experience a positive mood, with renewed energy and enthusiasm.

 

It is easy to see why people find these experiences so pleasant and eye opening. They often report that the experiences changed them forever. Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny.

 

Psilocybin is a psychedelic substance that is found naturally in a number of varieties of mushrooms. It has been used for centuries particularly by Native Americans for their spiritual practices. When studied in the laboratory under double blind conditions, Psilocybin has been shown to “reliably occasion deeply personally meaningful and often spiritually significant experiences (e.g. mystical-type experiences).”

 

In today’s Research News article “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/), Griffiths and colleagues recruited patients with a potentially life threatening cancer diagnosis and high levels of anxiety and/or a mood disorder. They were randomly assigned to receive psilocybin in the lab in a living room type highly supportive environment with either a low dose in the first session and the high dose in the second 5 weeks later or in reverse order with the high dose first followed by low dose. Doses were administered double blind.

 

They were measured during the session for heart rate and respiration and ratings by attending monitors. After the drug effects subsided (7 hours after administration) they were measured for hallucinogen ratings, altered states of consciousness, mystical experiences, states of consciousness, and mysticism. They were also measured at baseline and five weeks after each session and 6 months later for anxiety, depression, mood, psychiatric symptoms, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, life coherence, and persisting effects of psilocybin. Family friends, and co-workers were also asked to rate the participant’s behavior and attitudes.

 

After the sessions no continuing adverse events were detected. During the sessions there were significant dose dependent increases in heart rate, blood pressure, joy and happiness, and visual experiences, and all ratings by the session monitors of behavior and mood. These effects all dissipated by the end of the session.

 

In comparison to baseline at all time points after psilocybin administration there were clinically significant decreases in anxiety, depression, psychiatric symptoms and significant increases in mood, quality of life, optimism, spirituality, death acceptance, death transcendence, purpose in life, and life coherence. Family friends, and co-workers also reported significant improvements in mood and behavior in the cancer patients. They also found that the greater the mystical experiences that the cancer patients had during the sessions the greater the levels of meaningfulness, spiritual significance, increased life satisfaction, meaningful existence, death acceptance, death transcendence, purpose in life, and coherence and the lower the levels of anxiety and depression.

 

The results suggest that psilocybin administration to patients with life threatening cancer diagnoses who also had high levels of anxiety and/or mood disturbance produced large and clinically significant improvements in their psychological and spiritual well-being. These benefits were observed by clinicians, session monitors, family, friend, and co-workers, and the patients themselves. These results are remarkable particularly due to the magnitude of the effects, the breadth of the benefits, their obviousness to all concerned, and the persistence of the effects, generally still large and significant 6 months after the session. This suggests that psilocybin treatment may be greatly beneficial to relieve the psychological suffering and the spiritual difficulties precipitated by cancer diagnosis.

 

So, improve the psychological health of cancer patients with psilocybin.

 

a substantial majority of people suffering cancer-related anxiety or depression found considerable relief for up to six months from a single large dose of psilocybin — the active compound in hallucinogenic “magic mushrooms.” – Vanessa McMains

 

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

 

Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., … Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology (Oxford, England), 30(12), 1181–1197. doi:10.1177/0269881116675513

 

Abstract

Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367557/

 

Treat Cancer with Mindfulness

By John M. de Castro, Ph.D.

 

“A cancer diagnosis brings an awareness of the preciousness of life,” Fine explains. “And mindfulness can help us to experience that precious life with greater clarity, balance, and gratitude, one moment at a time.” – Micki Fine

 

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. 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. In addition, cancer patients are often challenged with a wide range of residual issues including chronic pain, sleep disturbance, sexual problems, loss of appetite, and chronic fatigue. Cancer survivors are also at greater risk for developing second cancers and other health conditions.

 

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. Hence there is a need to identify safe and effective treatments for the physical, emotional, and financial hardships that can persist for years after diagnosis and treatment.

 

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. The evidence is rapidly accumulating, so it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/), Mehta and colleagues review and summarize the published research literature on the effectiveness of mindfulness practice to relieve the physical and psychological suffering of cancer patients. They identified 124 published research studies using a variety of mindfulness training programs, most of which involved either the Mindfulness-Based Stress Reduction (MBSR) program or Mindfulness-Based Cognitive Therapy (MBCT) or versions of MBSR. or MBCT that were modified for the needs of cancer patients.

 

They report that the published research finds that mindfulness training is safe, resulting in few if any negative effects and effective, producing significant improvements in cancer-related stress, depression, pain intensity, fatigue, loss of appetite and weight loss, insomnia, immune responses, and psychological responses to chemotherapy. Mindfulness training also improved the ability of caregivers for cancer patients to deal with the psychological stresses. They also report that studies indicate that mindfulness training is cost effective in treating cancer patients compared to other approaches. Hence, the research to date suggests that mindfulness training is a safe, effective, and cost effective treatment for a variety of cancer-related problems in cancer survivors and their caregivers.

 

So, treat cancer with mindfulness.

 

“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

 

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

 

Study Summary

 

Mehta, R., Sharma, K., Potters, L., Wernicke, A. G., & Parashar, B. (2019). Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques. Cureus, 11(5), e4629. doi:10.7759/cureus.4629

 

Abstract

Mindfulness is being used increasingly in various aspects of cancer management. Benefits of mindfulness practices are being observed to manage the adverse effects of treatment, symptoms from cancer progression, and the cost-effectiveness compared to conventional contemporary management strategies. In this review article, we present clinical trial data showing the benefits of mindfulness in various aspects of cancer management as well as techniques that have been commonly used in this practice.

Conclusions

Mindfulness-based practices are being increasingly utilized in various aspects of cancer management. It has shown utility in multiple prospective trials and continues to be explored. Most of the evidence of the benefit of mindfulness in cancer is to reduce toxicity and stress. There is a need for more prospective trials exploring its use in reducing cancer incidence or preventing its recurrence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6623989/

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

 

Therapeutic Alliance is Important for Success in Treating Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

Compared with [treatment as usual], MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.” – Felix Compen

 

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 depressionMindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. So, it would make sense to study the effectiveness of MBCT and the characteristics of the therapy the psychological distress of cancer patients.

 

In today’s Research News article “Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/ ), Bisseling and colleagues recruited cancer patients who were high in anxiety and depression and randomly assigned them to receive Mindfulness-Based Cognitive Therapy (MBCT) delivered either face-to-face in groups or online or to continue receiving treatment as usual. MBCT was delivered in 8 weekly 2.5 hour sessions along with audio guided home practice. They were measured before and after treatment for psychological distress, group cohesion, therapeutic alliance, and therapist competence.

 

Only the data from patients who had completed therapy were included in the analysis. They found that following treatment there was a significant decrease in anxiety and depression (psychological distress). They also found that the higher the levels of therapeutic alliance the greater the reduction in psychological distress. This was not true for either the group cohesion or the therapist competence.

 

Therapeutic alliance consists of “how closely client and therapist agree on and are mutually engaged in the goals of treatment; how closely client and therapist agree on how to reach the treatment goals; and the degree of mutual trust, acceptance, and confidence between client and therapist.” So, the results suggest that this relationship between patient and therapist is an important factor in the effectiveness of mindfulness treatment to improve the psychological distress of cancer patients. It is not how good the therapist is, but how well they create a mutual agreement regarding the therapy that is important for the effectiveness of the therapy.

 

This agreement may signal a buy-in by the patient to the efficacy of the therapy. This, in turn, can drive a positive expectation for therapeutic success both from the patient and the therapist. It has been demonstrated that the beliefs of the patient and the therapist have powerful effects on the outcome. So, it is possible that the therapeutic alliance is simply a measure of the power of those expectations and, in turn, the effectiveness of the program.

 

Mindfulness-based cognitive therapy (MBCT) and individual Internet-based MBCT (eMBCT) had comparable efficacy in improving psychological distress among patients with cancer.” – James Nam

 

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

 

Bisseling, E. M., Schellekens, M., Spinhoven, P., Compen, F. R., Speckens, A., & van der Lee, M. L. (2019). Therapeutic alliance-not therapist competence or group cohesion-contributes to reduction of psychological distress in group-based mindfulness-based cognitive therapy for cancer patients. Clinical psychology & psychotherapy, 26(3), 309–318. doi:10.1002/cpp.2352

 

Abstract

Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.

Key Practitioner Message

  • Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care and has been increasingly applied in oncology to reduce psychological distress.
  • Therapeutic alliance predicts reduction in psychological distress after MBCT for cancer patients, whereas group cohesion and therapist competence did not.
  • Therapist competence did not appear to be a precondition for a good therapeutic alliance and high group cohesion.
  • Contrary to expectation, we found competence to be negatively related to group cohesion.
  • Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT for cancer patients.
  • The current findings should be taken into account in the training of MBCT therapists.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680267/

 

Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

Improve the Psychological and Physical Health of Myeloproliferative Neoplasm Patients with a Smartphone Mindfulness App

 

By John M. de Castro, Ph.D.

 

“Even with an app, mindfulness takes practice. Like playing an instrument or a sport, the more you practice, the better you get and the more you get out of it. . . Whatever you try, mindfulness training is considered very safe, and has a good chance of increasing your happiness and peacefulness, and reducing your depression, anxiety, and stress.” – James Cartreine

 

Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, depression, pain, and sleep disturbance, reduced physical, social, and cognitive functioning resulting in a reduced quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many patients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, Apps for smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these Apps in relieving the psychological and physical symptoms of cancer and improving their quality of life.

 

In today’s Research News article “Smartphone-Based Meditation for c: Feasibility Study to Inform Future Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/), Huberty and colleagues recruited Myeloproliferative Neoplasm Patients and randomly assigned them to either to receive 4 weeks of mindfulness training including 10 minutes of meditation per day via a smartphone app (“Calm”) followed by mindfulness training via another smartphone app (“10% Happier App”), the 2 apps in reverse order, education about Myeloproliferative Neoplasm followed by “10% Happier App”, or education followed by “Calm” app. They were measured before and after training and for Myeloproliferative Neoplasm symptoms, fatigue, anxiety, depression, pain, sleep disturbance, sexual function, health, and quality of life.

 

They found that the participants used the “Calm” App to a significantly greater extent and enjoyed it more than the “10% Happier” App. But following mindfulness training with both apps there were significant improvements. For the “10% Happier” App after training there were significant increases in health, and mental health and decreases in fatigue, anxiety, depression, and sleep disturbance. For the “Calm” App after training there were significant increases in health, and decreases in Myeloproliferative Neoplasm symptoms, fatigue, depression, vaginal discomfort, and sleep disturbance.

 

This was a relatively small pilot study that demonstrated the feasibility and efficacy of mindfulness training smartphone apps for the treatment of Myeloproliferative Neoplasm patients. It would appear that the “Calm” App is the preferred app. But both were effective in producing benefits. The improvements were significant and helpful in relieving the suffering of the patients. This is important as the use of smartphone apps makes it easier, more convenient, and more cost effective to provide mindfulness training to a wide swath of Myeloproliferative Neoplasm patients thus maximizing the utilization of mindfulness training for the improvement of the symptoms of patients with Myeloproliferative Neoplasm.

 

So, improve the psychological and physical health of myeloproliferative neoplasm patients with a smartphone mindfulness app.

 

“So how can this practice of mindfulness help people with cancer? . . . Routinely, we see large and meaningful improvements in mood, stress levels, depression, anger, worry, and rumination. We also see people having an increased sense of meaning and purpose in life, better sleep, and more energy, as well as displaying biological changes like a healthier pattern of stress hormones and less inflammation in the immune system.” – Linda 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

 

Jennifer Huberty, Ryan Eckert, Linda Larkey, Jonathan Kurka, Sue A Rodríguez De Jesús, Wonsuk Yoo, Ruben Mesa. Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials. JMIR Form Res. 2019 Apr-Jun; 3(2): e12662. Published online 2019 Apr 29. doi: 10.2196/12662

 

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms.

Objective

The aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group.

Methods

Patients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden.

Results

A total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happierapp averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety (P<.001 d=−0.43), depression (P=.02; d=−0.38), sleep disturbance (P=.01; d=−0.40), total symptom burden (P=.13; d=−0.27), and fatigue (P=.06; d=−0.30), and moderate effects on physical health (P<.001; d=0.52). Calm app participants saw small effects on anxiety (P=.29; d=−0.22), depression (P=.09; d=−0.29), sleep disturbance (P=.002; d=−0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=−0.27), and fatigue (P=.13; d=−0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77).

Conclusions

Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658299/

Improve Sleep and Relieve Fatigue in Cancer Survivors with Yoga

Improve Sleep and Relieve Fatigue in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

We recommend that doctors prescribe this low-risk, low-cost treatment to all cancer patients with cancer-related fatigue. We would like them to prescribe gentle hatha yoga but they need to refer to appropriate yoga instructors who have experience of working with cancer patients.” – Po-Ju Lin

 

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 . Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. So, it’s reasonable to further explore the potential benefits of yoga practice to improve sleep and relieve fatigue in patients who have survived cancer.

 

In today’s Research News article “Influence of Yoga on Cancer-Related Fatigue and on Mediational Relationships Between Changes in Sleep and Cancer-Related Fatigue: A Nationwide, Multicenter Randomized Controlled Trial of Yoga in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552348/), Lin and colleagues recruited patients who had survived a variety of different cancers, and who had completed primary care and who had sleep disturbance, from centers all over the U.S. They were randomly assigned them to receive standard care plus yoga training or standard care alone. Yoga training occurred for 75 minutes, twice a week, for 4 weeks and consisted of breathing exercises, physical alignment postures, and mindfulness exercises. They were measured before and after treatment for cancer related fatigue, including general, physical, emotional, mental, and vigor domains, and sleep, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, sleep medication use, and daytime dysfunction.

 

They found that in comparison to baseline and the treatment-as-usual group, the participants who received yoga training had significant improvements in all domains of fatigue with moderate effect sizes. The yoga group also had significant improvements in sleep, including increases in overall sleep quality and subjective sleep quality and decreases in daytime dysfunction. Finally, they found, employing path analysis, that yoga training improved fatigue directly and indirectly by improving sleep that in turn improved sleep.

 

These are potentially important findings. Fatigue and sleep disturbance are difficult residual problems. There is a need to have long-term follow-up of these patients to determine whether yoga practice produces sustained relief of sleep disturbance and fatigue. Nevertheless, the findings show that at least on the short-term, yoga practice can address these symptoms and as a result improve the well-being and quality of life of cancer survivors. In addition, practicing yoga has been shown to produce widespread benefits for the physical and psychological health of practitioners. So, yoga practice would seem to be an excellent additional treatment for patients who have survived cancer.

 

So, improve sleep and relieve fatigue in cancer survivors with yoga.

 

“Two randomized controlled trials in breast cancer patients (one in patients undergoing radiation and one in breast cancer survivors) showed yoga practice significantly improved fatigue.” – Carrie Newsom

 

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

 

Lin, P. J., Kleckner, I. R., Loh, K. P., Inglis, J. E., Peppone, L. J., Janelsins, M. C., … Mustian, K. M. (2019). Influence of Yoga on Cancer-Related Fatigue and on Mediational Relationships Between Changes in Sleep and Cancer-Related Fatigue: A Nationwide, Multicenter Randomized Controlled Trial of Yoga in Cancer Survivors. Integrative cancer therapies, 18, 1534735419855134. doi:10.1177/1534735419855134

 

Abstract

Background: Cancer-related fatigue (CRF) often co-occurs with sleep disturbance and is one of the most pervasive toxicities resulting from cancer and its treatment. We and other investigators have previously reported that yoga therapy can improve sleep quality in cancer patients and survivors. No nationwide multicenter phase III randomized controlled trial (RCT) has investigated whether yoga therapy improves CRF or whether improvements in sleep mediate the effect of yoga on CRF. We examined the effect of a standardized, 4-week, yoga therapy program (Yoga for Cancer Survivors [YOCAS]) on CRF and whether YOCAS-induced changes in sleep mediated changes in CRF among survivors. Study Design and Methods: Four hundred ten cancer survivors were recruited to a nationwide multicenter phase III RCT comparing the effect of YOCAS to standard survivorship care on CRF and examining the mediating effects of changes in sleep, stemming from yoga, on changes in CRF. CRF was assessed by the Multidimensional Fatigue Symptom Inventory. Sleep was assessed via the Pittsburgh Sleep Quality Index. Between- and within-group intervention effects on CRF were assessed by analysis of covariance and 2-tailed t test, respectively. Path analysis was used to evaluate mediation. Results: YOCAS participants demonstrated significantly greater improvements in CRF compared with participants in standard survivorship care at post-intervention (P < .01). Improvements in overall sleep quality and reductions in daytime dysfunction (eg, excessive napping) resulting from yoga significantly mediated the effect of yoga on CRF (22% and 37%, respectively, both P < .01). Conclusions: YOCAS is effective for treating CRF among cancer survivors; 22% to 37% of the improvements in CRF from yoga therapy result from improvements in sleep quality and daytime dysfunction. Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552348/

 

 

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/