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/

 

Improve the Mental Health of Breast Cancer Survivors with Mindfulness

Improve the Mental Health of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – BreastCancer,org

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

Surviving cancer, however, 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). Also, breast cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. Additionally, 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, an alteration of their body image, and psychiatric symptoms which have been found to persist even ten years after remission. So, safe and effective treatments for the symptoms in breast cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Hence, there is a need to intensively study the effectiveness of these programs to help alleviate the mental and physical sequelae of breast cancer survival.

 

In today’s Research News article “Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165667/ ), Pouy and colleagues recruited women with diagnosed breast cancer at least 6 months after diagnosis and randomly assigned them to either receive either routine care plus 4 weeks of twice a week for 1.5 hours group based mindfulness training or routine care only. The mindfulness training was based upon the Mindfulness-Based Stress Reduction (MBSR) program that includes body scan and focused meditations, yoga practice, and discussion. They were measured before the training and 2 months later for anxiety, depression, stress, physical health, mental health, social relationships, environmental health, quality of life, and life expectancy questionnaire.

 

They found that after the mindfulness training the breast cancer survivors had significantly improved quality of life and life expectancy and significantly less anxiety, depression, and stress. Hence, mindfulness training was found to be of great benefit to the patients, improving their quality of life and psychological health. These findings are similar to previous findings that mindfulness training reduces anxiety, depression, and stress and improves quality of life in cancer patients. The current study adds to the accumulating scientific evidence that mindfulness practice significantly beneficial for breast cancer survivors.

 

So, improve the mental health of breast cancer survivors with mindfulness.

 

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. Scientists caution, however that sustained benefit requires ongoing mindfulness practice.” – BCRF

 

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

 

Pouy, S., Attari Peikani, F., Nourmohammadi, H., Sanei, P., Tarjoman, A., & Borji, M. (2018). Investigating the Effect of Mindfulness-Based Training on Psychological Status and Quality of Life in Patients with Breast Cancer. Asian Pacific journal of cancer prevention : APJCP, 19(7), 1993-1998. doi:10.22034/APJCP.2018.19.7.1993

 

Abstract

Cancer poses substantial challenges to both physical and mental health of patients. On the other hand, breast cancer is one of the most common cancers among Iranian women. Therefore, the present study was conducted to investigate the effect of mindfulness-based training on psychological status and quality of life (QoL) of patients with breast cancer living in Ilam, Iran. This quasi-experimental study was performed on 66 patients diagnosed with breast cancer. The patients assigned into two groups of experimental and control. Experimental group received mindfulness-based group training through eight 90-min sessions. Sessions were conducted twice a week and were completed within 1 month. The research tools included a QoL questionnaire (WHOQOL-BREF), Schneider’s life expectancy questionnaire, and the depression anxiety stress scale (DASS-21). The questionnaires were completed before and during the interviews with the patients 2 months after intervention. Data were analyzed using SPSS (version 16) and running descriptive and analytical statistics. Before the intervention, there was no significant difference between he experimental and control groups considering QoL, life expectancy, depression, anxiety, and stress (p>0.05). However, after the intervention, the patients in the experimental group reported higher QoL and life expectancy and less severe depression, anxiety, and stress (p < 0.05). Considering the positive effect of mindfulness-based training on the psychological status and QoL of patients with breast cancer, we recommend health nurses conduct mindfulness-based training for patients receiving clinical care services.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165667/

 

Improve Cognitive Function in Breast Cancer Survivors with Mindfulness

Improve Cognitive Function in Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors.” – ScienceDaily

 

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. Cognitive impairments are a frequent side effect of cancer treatment. This has been dubbed “chemo brain.” Patients often refer to it as a mental cloudiness.

 

The patients report problems including forgetting things, trouble concentrating, trouble remembering details like names and dates, trouble multi-tasking, like answering the phone while cooking, taking longer to finish things, disorganized and slower thinking, and trouble remembering common words. These cognitive impairments generally produce problems with work and even social relationships such that patients tend to isolate themselves. They can also produce treatment problems as the patients often forget to take their medications.

 

These problems result from the fact that chemotherapy, radiation therapy and many cancer drugs directly affect the nervous system. At present, there are no known treatments for these cognitive impairment side effects of chemotherapy. Contemplative practices have been shown to affect memory and have positive effects on cancer treatment and recovery.  There is some evidence that contemplative practices may be useful for the alleviation of “chemo brain” symptoms. So, it makes sense to step back and review what is known regarding the ability of mindfulness training to improve the cancer patient’s cognitive abilities.

 

In today’s Research News article “Mindfulness-based interventions and cognitive function among breast cancer survivors: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260900/ ), Cifu and colleagues review and summarize the published research studies on the effectiveness of mindfulness training for the cognitive deficits present after recovery from breast cancer. They identified 6 studies; 5 of which were randomized controlled studies and 4 of which used the Mindfulness-Based Stress Reduction (MBSR) program.

 

They found mixed results from the studies but the majority found that mindfulness training produced significant improvements in the cognitive abilities of the patients. The 2 studies that reported follow-up data demonstrated that the improvements were sustained 2 and 6 months after the end of the program. These mixed findings suggest that mindfulness training may be useful in treating the problems with thinking, memory, and attention that result from treatment for breast cancer, but more research is needed to reach firm conclusions.

 

It is not known what the mechanism might be by which mindfulness training relieves these cognitive impairments. But it has been previously demonstrated that mindfulness training improves cognition in healthy and aging populations by changing the brain, particularly the frontal cortical regions. It is possible that this is the same phenomenon only with breast cancer survivors.

 

So, improve cognitive function in breast cancer survivors with mindfulness.

 

“Mindfulness-based stress reduction (MBSR) may improve cognitive function in breast and colorectal cancer survivors.” Neurology Advisor

 

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

 

Cifu, G., Power, M. C., Shomstein, S., & Arem, H. (2018). Mindfulness-based interventions and cognitive function among breast cancer survivors: a systematic review. BMC cancer, 18(1), 1163. doi:10.1186/s12885-018-5065-3

 

Abstract

Background

Breast cancer survivors have an elevated risk of cognitive impairment compared to age-matched women without cancer. Causes of this impairment are complex, including both treatment and psychological factors. Mindfulness-based interventions, which have been shown to improve cognitive function in the general population, may be one approach to mitigate cognitive impairment in this survivor population. Our objective was to conduct a systematic literature review of studies on the effect of mindfulness-based interventions on cognition among breast cancer survivors.

Methods

We conducted searches of three electronic databases (Scopus, PubMed and Cochrane Database of Systematic Reviews) in September 2017 for studies pertaining mindfulness and cognitive function among breast cancer survivors. Abstracts were manually searched by two reviewers and additional articles were identified through reference lists.

Results

A total of 226 articles were identified through our systematic search and six met inclusion criteria for this review. The reviewed studies lacked consistency in terms of the cognition domains studied (e.g. executive function, recent memory, etc) and in the measures used to assess cognition. Of the included studies, two found no association between mindfulness interventions and cognitive function, two found improvement that was not sustained at the follow-up, and another two found sustained improvement at 2- or 6-months.

Conclusions

Mindfulness-based interventions have shown some evidence for improving cognition among breast cancer survivors, but further research using validated and comprehensive cognitive assessments is needed. More research is also needed related to the timing, duration and content of mindfulness interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260900/

 

Improve Breast Cancer Symptoms with Mindfulness

Improve Breast Cancer Symptoms 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. 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. One particularly effective mindfulness training program is Mindfulness-Based Stress Reduction (MBSR). 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. 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 “Mindfulness-Based Stress Reduction on breast cancer symptoms: 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/PMC6282865/ ), Castanhel and Liberali review, summarize and perform a meta-analysis of the published research studies on the effectiveness of Mindfulness-Based Stress Reduction (MBSR) training for the symptoms of breast cancer patients. They identified 7 published research studies that included a total of 532 women.

 

They report that the literature finds that Mindfulness-Based Stress Reduction (MBSR) training produces a decrease in fatigue in the breast cancer patients. This is significant as fatigue affects all facet of the patient’s life. Additionally, there is no drug treatments which successfully treat fatigue in these patients. This makes MBSR treatment particularly valuable to be included along with the usual treatments.

 

Mindfulness practices, in general have been shown to be effective in relieving fatigue. One of the components of MBSR treatment, yoga practice, has been previously been shown to also relieve fatigue in breast cancer patients. It is possible that this is the critical component of MBSR practice. But it will require further research to determine exactly which components or combinations of components are essential for the relief of fatigue.

 

So, improve breast cancer symptoms with mindfulness.

 

“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.” — 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

 

Castanhel, F. D., & Liberali, R. (2018). Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis. Einstein (Sao Paulo, Brazil), 16(4), eRW4383. doi:10.31744/einstein_journal/2018RW4383

 

ABSTRACT

Mindfulness-Based Stress Reduction practices increase the capacity for concentration and attention, and these practices are particularly effective for people with breast cancer. To analyze the effects of the application of Mindfulness-Based Stress Reduction on breast cancer symptoms. Systematic review and meta-analysis were carried out. To find suitable studies, the PubMed/ MEDLINE database was searched using the keywords “breast cancer” and “Mindfulness-Based Stress Reduction”. Studies included were published between 2013 and 2017, written in English and showed methodological quality through the PEDro scale (score greater than 3). They also presented empirical evidence, had an experimental study design (randomized or non-randomized), and had full text available. For the meta-analysis, we used a random-effects model, with standardized mean differences and 95% confidence intervals. Seven studies were included, one non-randomized and containing only an intervention group of Mindfulness-Based Stress Reduction, and six randomized including samples of two or three groups. The non-randomized study showed 6 points on the PEDro scale, the randomized studies of two groups 6 to 7 points and studies with three groups showed 7 points. In the meta-analysis of the two randomized studies, the results, although not significant, revealed a moderate effect for Mindfulness-Based Stress Reduction on the outcome of fatigue, with a mean difference of −0.42 (95%CI −0.92- −0.07; p=0.09). Mindfulness-Based Stress Reduction seems to be a promising alternative for treatment of this disease’s symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282865/

 

Improve Physical and Psychological Well-Being in Head and Neck Cancer Survivors with Yoga

Improve Physical and Psychological Well-Being in Head and Neck Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“Many people living with cancer find a sense of peace participating in yoga, an ancient practice combining breathing, relaxation and meditation exercises. Those that practice yoga may find their quality of life improve and gain a renewed sense of belonging.” – CancerCare

 

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 stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients. Patients recovering from surgery for head and neck cancer often face substantial musculoskeletal impairments especially in the jaw, neck, shoulders, and chest. Yoga practice, then may be especially helpful for these patients as it combines the benefits of a mindfulness practice with those of a gentle exercise.

 

In today’s Research News article “Feasibility and Preliminary Efficacy of Tailored Yoga in Survivors of Head and Neck Cancer: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142084/ ), Adair and colleagues recruited adult survivors of head and neck cancer who were at least 3 months post-treatment. They were randomly assigned to either be on a wait list or receive Hatha yoga training, including breathing exercises, meditation, relaxation, and poses adapted to the needs of the patient. Yoga practice occurred for 90 minutes for 8 weeks 3 times per week for the first 4 weeks and 2 times a week for the second 4 weeks. They were also encouraged to practice at home. They were measured before, during, and after treatment for range of motion, posture, head and neck symptoms, pain, anxiety, depression, and quality of life. They also completed a questionnaire regarding the feasibility and acceptability of the yoga practice.

 

They found that there were no adverse events and there was very high compliance with both the guided and home practice sessions and the participants found the practice to be highly satisfactory. Hence, the technique appears to be feasible for a larger study. But, they still were able to document efficacy. They found in comparison to baseline and the wait-list group that there were significant improvements in range of motion, especially in the shoulder region, and decreases in both anxiety and pain.

 

This was a pilot study that was designed to simply determine feasibility for a larger trial. But, it was still able to demonstrate that the tailored yoga practice produced significant improvements in the physical and psychological well-being of the survivors of head and neck cancer. Hence, tailored yoga practice may well be a safe and effective treatment reducing the suffering and improving the lives of head and neck cancer patients.

 

So, improve physical and psychological well-being in head and neck cancer survivors with yoga.

 

“Yoga for cancer patients—what better way to manage anxiety, gain strength, increase flexibility, and create feelings of well-being. A growing body of research points to the potential of yoga for supporting cancer patients, both during and after treatment.” – Tari Prinster

 

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

 

Adair, M., Murphy, B., Yarlagadda, S., Deng, J., Dietrich, M. S., & Ridner, S. H. (2018). Feasibility and Preliminary Efficacy of Tailored Yoga in Survivors of Head and Neck Cancer: A Pilot Study. Integrative cancer therapies, 17(3), 774-784.

 

Purpose: Treatment for head and neck cancer (HNC) results in long-term toxicities and increased physical and psychosocial survivor burden. There are a limited number of treatments for these late effects. Yoga postures, breath work, relaxation, and meditation, may improve these late effects. The purpose of this study was to examine the feasibility of a tailored yoga program in HNC survivors and obtain preliminary efficacy data. Methods: This was a randomized wait-list control study of yoga-naive HNC survivors who were >3 months post–cancer treatment. Baseline data were collected. Participants were randomized to either an 8-week hatha yoga intervention group or a wait-list group. Feasibility and efficacy data were collected. At 4 and 8 weeks, patients underwent a repeat assessment of health. Wait-list control group participants were offered the yoga program after data collection. Descriptive statistics evaluated feasibility. Mixed effects general linear models were used to generate estimates of the efficacy outcomes. Results: Seventy-three individuals were screened and 40 were eligible. All eligible individuals consented and enrolled. Five of the intervention group discontinued early and none in the wait-list control group. Feasibility was affirmed as participants were recruited and retained in the study, there were no adverse events, fidelity to protocol was demonstrated, and satisfaction rates were high. Efficacy measures indicated potential benefit for shoulder range of motion (d = 0.57-0.86, P < .05), pain (d = 0.67-0.90, P ≤ .005), and anxiety (d = 0.59, P = .015). Conclusion: A tailored hatha yoga program is feasible and potentially efficacious for HNC survivors. Preliminary data supports further investigation of yoga in this population is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142084/

 

Improve Quality of Life in Cancer Patients with Mindfulness

Improve 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. Insomnia is a common occurrence 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 stress,  sleep disturbance, and anxiety and depression. But, most research is with western populations and there are very few that study the effectiveness of mindfulness training with Asian populations.

 

In today’s Research News article “Effects of a Mindfulness Meditation Program on Quality of Life in Cancer Outpatients: An Exploratory Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041936/ ), Chang and colleagues recruited Taiwanese outpatient cancer patients and separated them into a usual care group and a mindfulness meditation group. Mindfulness meditation was taught in once a month for 3 months 2.5-hour sessions focusing on sitting insight meditation. The participants were expected to practice at home daily. They were measured before and after training and 3 month later for quality of life, including subscales for physical health, psychological health, social relationships, and environment.

 

They found that the mindfulness meditation group had significant improvements in their quality of life including all 4 subscales while the usual care group did not. These improvements in quality of life were sustained 3 months later. These results are similar to previously reported improvements in quality of life in cancer patients produced by mindfulness training. But, these findings extend these to include oriental populations. Hence mindfulness training appears to be a safe and effective treatment to improve the well-being and relieve the suffering of patients from all over the world with various forms of cancer.

 

So, improve quality of life in cancer patients with Mindfulness.

 

“mindfulness-based meditation can help ease the stress, anxiety, fear, and depression that often come along with a breast cancer diagnosis and treatment.” – BreastCancer,org

 

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

Chang, Y.-Y., Wang, L.-Y., Liu, C.-Y., Chien, T.-J., Chen, I.-J., & Hsu, C.-H. (2018). The Effects of a Mindfulness Meditation Program on Quality of Life in Cancer Outpatients: An Exploratory Study. Integrative Cancer Therapies, 17(2), 363–370. http://doi.org/10.1177/1534735417693359

 

Abstract

Objective. Numerous studies have investigated the efficacy of mindfulness meditation (MM) in managing quality of life (QoL) in cancer populations, yet only a few have studied the Asian population. The aim of this exploratory study is to evaluate the effect of a MM program on the QoL outcomes in Taiwanese cancer outpatients. Methods. Patients with various cancer diagnoses were enrolled and assigned to the MM group and usual care (UC) group. The meditation intervention consisted of 3 sessions held monthly. The outcomes of the whole intervention were measured using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Results. A total of 35 participants in the MM group and 34 in the UC group completed the study. The results showed that the postintervention scores were significantly higher than the preintervention scores in the MM group. In the UC group, there was no significant difference between preintervention and postintervention scores, except for the lower environment domain scores. There was no significant difference between the follow-up scores and postintervention scores in the MM group, indicating that improvement can be maintained for 3 months after completing the MM course. Conclusions. The present study provides preliminary outcomes of the effects on the QoL in Taiwanese cancer patients. The results suggest that MM may serve as an effective mind–body intervention for cancer patients to improve their QoL, and the benefits can persist over a 3-month follow-up period. This occurred in a diverse cancer population with various cancer diagnoses, strengthening the possibility of general use.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041936/

 

Improve Chronic Conditions with Mindfulness Taught over the Internet

Improve Chronic Conditions with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“It’s important for people living with health conditions to recognize what they are feeling, instead of trying to push painful thoughts and emotions away, which can actually amplify them. For those living with serious medical conditions, mindfulness can help them accept and respond to difficult feelings, including fear, loneliness and sadness. By bringing mindfulness to emotions (and the thoughts that may underlie them), we can begin to see them more clearly and recognize that they are temporary.” – Shauna Shapiro

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients 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. This makes delivery to individuals in remote locations nearly impossible.

 

As an alternative, applications over the internet and on smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, eliminating the need to go repeatedly to specific locations, and being available to patients in remote areas. But, the question arises as to the level of compliance with the training and the effectiveness of these internet applications in inducing mindfulness and improving physical and psychological health in chronically ill patients.

 

In today’s Research News article “Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107686/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/  ), Russell and colleagues review and summarize the published research literature on the effectiveness of internet based mindfulness training programs for the treatment of patients with chronic diseases. They identified 10 randomized controlled studies that contained a control group where mindfulness training was performed over the internet. The patients were afflicted with chronic pain in 3 of the studies, and in single studies with fibromyalgia, heart disease, cancer post-treatment, anxiety disorder, major depressive disorder, residual depressive symptoms, and psychosis.

 

They found that internet-based mindfulness interventions in general had significant beneficial effects that improved patient functioning in comparison to the control groups. Half of the studies reported follow-up measurements that reflected persisting benefits. They noted that when measured participant adherence to the programs was in general low.

 

Hence, it appears that internet-based mindfulness interventions are safe and effective treatments for the well-being of patients with chronic diseases. This is potentially very important as these interventions can be administered inexpensively, conveniently, and to large numbers of patients regardless of their locations, greatly increasing the impact of the treatments.

 

There are some caveats. The majority of the participants by far were women and there was no study that compared the efficacy of the internet-based intervention to the comparable face-to-face intervention or another treatment. So, it was recommended that future studies include more males and a comparison to another treatment.

 

So, improve chronic conditions with mindfulness taught over the internet.

 

“MBSR programs might not reverse underlying chronic disease, but they can make it easier to cope with symptoms, improve overall well-being and quality of life and improve health outcomes.” – Monika Merkes

 

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

Russell, L., Ugalde, A., Milne, D., Austin, D., & Livingston, P. M. (2018). Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review. JMIR Mental Health, 5(3), e53. http://doi.org/10.2196/mental.9645

 

Abstract

Background

Internet-supported mindfulness-based interventions (MBIs) are increasingly being used to support people with a chronic condition. Characteristics of MBIs vary greatly in their mode of delivery, communication patterns, level of facilitator involvement, intervention period, and resource intensity, making it difficult to compare how individual digital features may optimize intervention adherence and outcomes.

Objective

The aims of this review were to (1) provide a description of digital characteristics of internet-supported MBIs and examine how these relate to evidence for efficacy and adherence to the intervention and (2) gain insights into the type of information available to inform translation of internet-supported MBIs to applied settings.

Methods

MEDLINE Complete, PsycINFO, and CINAHL databases were searched for studies assessing an MBI delivered or accessed via the internet and engaging participants in daily mindfulness-based activities such as mindfulness meditations and informal mindfulness practices. Only studies using a comparison group of alternative interventions (active compactor), usual care, or wait-list were included. Given the broad definition of chronic conditions, specific conditions were not included in the original search to maximize results. The search resulted in 958 articles, from which 11 articles describing 10 interventions met the inclusion criteria.

Results

Internet-supported MBIs were more effective than usual care or wait-list groups, and self-guided interventions were as effective as facilitator-guided interventions. Findings were informed mainly by female participants. Adherence to interventions was inconsistently defined and prevented robust comparison between studies. Reporting of factors associated with intervention dissemination, such as population representativeness, program adoption and maintenance, and costs, was rare.

Conclusions

More comprehensive descriptions of digital characteristics need to be reported to further our understanding of features that may influence engagement and behavior change and to improve the reproducibility of MBIs. Gender differences in determinants and patterns of health behavior should be taken into account at the intervention design stage to accommodate male and female preferences. Future research could compare MBIs with established evidence-based therapies to identify the population groups that would benefit most from internet-supported programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/

 

Improve Cognition in Breast Cancer Patients with Meditation

Improve Cognition in Breast Cancer Patients with Meditation

 

By John M. de Castro, Ph.D.

 

“Between diagnosis, treatment, recovery and ongoing treatment, living with cancer is a stressful roller-coaster set on repeat. Meditation is a very useful and powerful tool that can help you get in touch with your thoughts and emotions, cultivate compassion and find strength to keep going -maybe even to thrive.” -Jasmin Fiore Dodge

 

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. Cognitive impairments are a frequent side effect of cancer treatment. This has been dubbed “chemo brain.” Patients often refer to it as a mental cloudiness.

 

The patients report problems including forgetting things, trouble concentrating, trouble remembering details like names and dates, trouble multi-tasking, like answering the phone while cooking, taking longer to finish things, disorganized and slower thinking, and trouble remembering common words. These cognitive impairments generally produce problems with work and even social relationships such that patients tend to isolate themselves. They can also produce treatment problems as the patients often forget to take their medications.

 

These problems result from the fact that chemotherapy, radiation therapy and many cancer drugs directly affect the nervous system. At present, there are no known treatments for these cognitive impairment side effects of chemotherapy. Contemplative practices have been shown to affect memory and have positive effects on cancer treatment and recovery.  There is some evidence that contemplative practices may be useful for the alleviation of “chemo brain” symptoms. So, it makes sense to further study the ability of mindfulness training to improve the cancer patient’s cognitive abilities.

 

In today’s Research News article “Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083855/ ), Milbury and colleagues recruited women who had breast cancer and had completed chemotherapy at least 6 months ago. They were randomly assigned to receive either Tibetan Sound Meditation or were assigned to a wait-list control condition. Tibetan Sound Meditation was practiced in twice weekly, 1-hour sessions, for 6 weeks. It included focused meditation, mindfulness development, breathing exercises, and cognitive tasks. The participants were measured before training and one month after the completion of the program for cognitive performance, perceived cognitive function, depression, sleep disturbance, fatigue, health related quality of life, and spiritual well-being.

 

They found that after training the women receiving meditation training had significant albeit small improvements in cognitive function including verbal memory, short-term memory, processing speed and significant decreases in perceived cognitive function. Hence the women following meditation treatment had improve objective and subjective cognitive abilities. In addition, the treated women had significantly higher levels of overall mental health and spiritual well-being and lower levels of depression.

 

This was a relatively small pilot study, so it was surprising and encouraging to discover significant improvements. Tibetan Sound Meditation is a complex practice consisting of a number of different practices. It would be interesting to begin to determine which components or combination of components were responsible for the benefits. It would also be interesting to compare the effectiveness of Tibetan Sound Meditation to other forms of meditation practice such as open monitoring meditation or loving kindness meditation.

 

It should be noted that the control condition received no activities other than treatment as usual. So, the results may have been affected by participant and experimenter bias and expectancy effects. It would be better in future studies to use an active control condition such as light exercise of health education. Nevertheless, the results suggest that training in Tibetan Sound Meditation improves the thinking ability and spiritual and mental health of women who completed chemotherapy for breast cancer.

 

So, improve cognition in breast cancer patients with meditation.

 

“Enduring treatment is not only unpleasant, but time-consuming and expensive. Meditation is one method that can be extremely beneficial throughout the healing process. Like many illnesses, breast cancer can be worsened by stress. Meditation can help you reduce stress levels throughout the day.” – Laura Sage

 

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

 

Milbury, K., Chaoul, A., Biegler, K., Wangyal, T., Spelman, A., Meyers, C. A., … Cohen, L. (2013). Tibetan sound meditation for cognitive dysfunction: results of a randomized controlled pilot trial. Psycho-Oncology, 22(10), 2354–2363. http://doi.org/10.1002/pon.3296

 

Abstract

Objective

Although chemotherapy-induced cognitive impairment is common among breast cancer patients, evidence for effective interventions addressing cognitive deficits is limited. This randomized controlled trial examined the feasibility and preliminary efficacy of a Tibetan Sound Meditation (TSM) program to improve cognitive function and quality of life in breast cancer patients.

Methods

Forty-seven breast cancer patients (mean age 56.3 years), who were staged I–III at diagnosis, 6–60 months post-chemotherapy, and reported cognitive impairment at study entry were recruited. Participants were randomized to either two weekly TSM sessions for 6 weeks or a wait list control group. Neuropsychological assessments were completed at baseline and 1 month post-treatment. Self-report measures of cognitive function (Functional Assessment of Cancer Therapy (FACT)-Cog), quality of life (SF-36), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sleep disturbance (Pittsburgh Sleep Quality Index), fatigue (Brief Fatigue Inventory), and spirituality (FACT-Sp) were completed at baseline, the end of treatment, and 1 month later.

Results

Relative to the control group, women in the TSM group performed better on the verbal memory test (Rey Auditory Verbal Learning Test trial 1) (p = 0.06) and the short-term memory and processing speed task (Digit Symbol) (p = 0.09) and reported improved cognitive function (p = 0.06), cognitive abilities (p = 0.08), mental health (p = 0.04), and spirituality (p = 0.05) at the end of treatment but not 1 month later.

Conclusions

This randomized controlled trial revealed that TSM program appears to be a feasible and acceptable intervention and may be associated with short-term improvements in objective and subjective cognitive function as well as mental health and spirituality in breast cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083855/

 

Improve Inflammatory Responses in Breast Cancer Survivors with Mindfulness

Improve Inflammatory Responses in Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Several studies have documented the value of meditation in managing both psychological and physical symptoms associated with cancer and its treatments. But it is important for patients considering meditation to note that regular, ongoing practice is essential for sustained benefits.” – Shelly Latte-Naor

 

About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not always a death sentence. Death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%. The improved survival rates mean that more women are now living with cancer.

 

Mindfulness training has been shown to help with general cancer recovery and breast cancer recovery. Mindfulness helps to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. One important benefit of mindfulness practices appears to be a strengthening of the immune system, the body’s primary defense against disease. The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works to fight off infections and injuries. Unfortunately, breast cancer treatment tend to suppress the inflammatory response making the women more susceptible to infection. Mindfulness training have been shown to adaptively alter the inflammatory response.

 

In today’s Research News article “A Randomized Controlled Trial of the Effects of Mindfulness-Based Stress Reduction (MBSR[BC]) on Levels of Inflammatory Biomarkers Among Recovering Breast Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942506/ ), Reich and colleagues recruited adult survivors of breast cancer who had completed treatment. They were randomly assigned to receive either a 6-week program of Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors or to usual care. The MBSR program consists of 6 weekly 2-hour sessions involving meditation, yoga, body scan, and discussion and encouraged daily practice for 15-45 minutes. Blood was drawn before and after treatment and 6 weeks later and assayed for cytokines; IL-1β, IL-6, IL-10, TNFα, and TGF-β1.

 

They found that in comparison to baseline and to the usual care group, participation in the Mindfulness-Based Stress Reduction (MBSR) program produced significant increases in the proinflammatory cytokines IL-6 and TNFα. Hence, mindfulness training alters the activity of the inflammatory systems, increasing the inflammatory response. This is important as breast cancer treatment tends to decrease the activity of the inflammatory system and this results in increases in susceptibility to infection. By increasing the activity of the proinflammatory cytokines, IL-6 and TNFα, MBSR training tends to produce a normalization of their levels. This would tend to make these women better able to fight off infection and better recover from their treatment.

 

This normalization of the proinflammatory response produced by MBSR practice may be the underlying mechanism by which mindfulness practice helps with general cancer recovery and breast cancer recovery.

 

So, improve inflammatory responses in breast cancer survivors with mindfulness.

 

“A growing body of research points to direct benefits related to meditation practices. These benefits extend to cancer patients. .  .  . As a result, a number of cancer centers now offer programs that include types of meditation and mindfulness practices,”

 

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

 

Reich, R. R., Lengacher, C. A., Klein, T. W., Newton, C., Shivers, S., Ramesar, S., … Kip, K. E. (2017). A Randomized Controlled Trial of the Effects of Mindfulness-Based Stress Reduction (MBSR[BC]) on Levels of Inflammatory Biomarkers Among Recovering Breast Cancer Survivors. Biological Research for Nursing, 19(4), 456–464. http://doi.org/10.1177/1099800417707268

 

Abstract

Purpose:

The purpose of this substudy of a large randomized controlled trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction (Breast Cancer) (MBSR[BC]) program compared to usual care (UC) in normalizing blood levels of pro-inflammatory cytokines among breast cancer survivors (BCS).

Method:

A total of 322 BCS were randomized to either a 6-week MBSR(BC) program or a UC. At baseline and 6 and 12 weeks, 10 ml of venous blood and demographic and clinical data were collected and/or updated. Plasma cytokines (interleukin [IL]-1β, IL-6, IL-10, tumor necrosis factor [TNF] α, transforming growth factor [TGF] β1, soluble tumor necrosis factor receptor [sTNFR] 1) were assayed. Linear mixed models were used to assess cytokine levels across three time points (baseline and 6 and 12 weeks) by group (MBSR[BC] vs. UC).

Results:

Of the six measured cytokines, three were nondetectable at rates greater than 50% (IL-10, IL-1β, TGF-β1) and, because of overall low prevalence, were not analyzed further. For the remaining cytokines (TNFα, IL-6, sTNFR1), results showed that TNFα and IL-6 increased during the follow-up period (between 6 and 12 weeks) rather than during the MBSR(BC) training period (between baseline and 6 weeks), while sTNFR1 levels did not change significantly across the 12-week period.

Conclusions:

Study results suggest that MBSR(BC) affects cytokine levels in BCS, mainly with increases in TNFα and IL-6. The data further suggest that B-cell modulation may be a part of immune recovery during breast cancer management and that increases in TNFα and IL-6 may be markers for MBSR(BC)-related recovery.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942506/

 

Treat Insomnia in Breast Cancer Survivors with Tai Chi

Treat Insomnia in Breast Cancer Survivors with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Breast cancer survivors often don’t just come to physicians with insomnia. They have insomnia, fatigue and depression. And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia.” – Leigh Hopper

 

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. Insomnia is a common occurrence 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 stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatiguelower blood pressure and cortisol levelsimprove balance and reduce the likelihood of falls. Mindfulness-based practices have been reported to improve sleep amount and quality. Tai Chi practice has also been shown to improve sleep. It is not known, however, how effective Tai Chi practice is relative to other know insomnia treatments.

 

In today’s Research News article “Tai Chi Chih Compared with Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549450/ ), Irwin and colleagues recruited women who had survived breast cancer and who were diagnosed with insomnia. They were randomly assigned to receive a 3-month program of either Tai Chi or Cognitive Behavioral Therapy for Insomnia (CBT-I). Both treatments were delivered in groups of 7 to 10 participants in weekly 120-minute sessions. CBT-I contained cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation. Tai Chi consisted of mindful performance of repetitious, nonstrenuous, slow-paced movement. Participants were measured during baseline, at the end of the treatment period and three months and one year later, for insomnia severity, insomnia remission, sleep quality, sleep diary records, fatigue, daytime sleepiness, depression, body size, and physical activity.

 

They found that both groups showed equivalent and significant improvement in insomnia severity, insomnia remission, sleep quality, fatigue, daytime sleepiness, and depression at posttreatment and 3 and 12 months later. Hence, both Tai Chi practice and Cognitive Behavioral Therapy for Insomnia (CBT-I) were effective in treating insomnia in breast cancer survivors with insomnia.

 

It is remarkable that Tai Chi practice is just as effective as a psychotherapy that was designed specifically to treat insomnia and which is considered the gold standard of insomnia treatments. Tai Chi practice, though, has marked advantages over CBT-I. Tai Chi is gentle and safe, is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion, 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 almost ideal gentle exercise to releive insomnia is breast cancer survivors.

 

So, treat insomnia in breast cancer survivors with Tai Chi

 

given that standardized TCC is both scalable and community accessible compare with the limited availability of CBT in most medical centers, immediate access to TCC would address the need to reduce the morbidity associated with insomnia in survivors of breast and other cancers.” – Irwin et al. 2017

 

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

 

Irwin, M. R., Olmstead, R., Carrillo, C., Sadeghi, N., Nicassio, P., Ganz, P. A., & Bower, J. E. (2017). Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. Journal of Clinical Oncology, 35(23), 2656–2665. http://doi.org/10.1200/JCO.2016.71.0285

 

Abstract

Purpose

Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer.

Patients and Methods

This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response—that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index—at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression.

Results

Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months (P = .02) and at months 3 (P = .02) and 6 (P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups.

Conclusion

CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549450/