Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

 

By John M. de Castro, Ph.D.

 

“Spirituality plays a significant role for adolescents with cancer as it contributes to increased comfort and calmness, and better coping mechanisms when confronted with the illness, which indirectly improves the adolescent’s quality of life.” – Sembiring Lina Mahayati

 

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. Adolescents with cancer are particularly vulnerable with high levels of anxiety, depression, fatigue, and pain interference.

 

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 on the ability of adolescent cancer survivors to positively adjust to their situation.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/ ) Grossoehme and colleagues recruited adolescents, aged 14 to 21 years, who were diagnosed with cancer. They had them complete measures of spirituality, feeling God’s presence; praying privately; attending religious services; identifying as religious; identifying as spiritual, emotional distress–anxiety; emotional distress–depressive symptoms; fatigue; and pain interference, health-related quality of life

 

They found that the higher the levels of feeling God’s presence and identifying as a very religious person the lower the levels of anxiety, depressive symptoms, and fatigue. Structural equation modelling revealed that the levels of feeling God’s presence and identifying as a very religious person also were indirectly associated with anxiety, depressive symptoms, and fatigue via a positive association with a sense of meaning and peace. That is, the greater the feelings God’s presence and religiosity the greater the feelings of peace and meaningfulness in life and these feelings were in turn negatively associated with negative emotional states.

 

These results are correlational and as such no conclusions about causation can be definitively made. But the results clearly show that there are relationships between being spiritual and religious and better emotional states in adolescent cancer victims. They also suggest that this relationship is mediated by feelings of meaningfulness and peace. It could be speculated that these relationships occur due to causal connections and interpreted that being spiritual produces a state of peacefulness and meaning in life that counteracts the negative emotions associated with cancer. It remains for future research to determine if increasing spirituality would lead to better emotional adjustments to a cancer diagnosis.

 

Hence, spirituality is associated with better psychological health of adolescents with cancer.

 

As is true with older cancer survivors, spirituality is related to many aspects of well-being for AYA survivors, but relations are more consistent for meaning/peace and struggle.” – Crystal Park

 

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

 

Grossoehme, D. H., Friebert, S., Baker, J. N., Tweddle, M., Needle, J., Chrastek, J., Thompkins, J., Wang, J., Cheng, Y. I., & Lyon, M. E. (2020). Association of Religious and Spiritual Factors With Patient-Reported Outcomes of Anxiety, Depressive Symptoms, Fatigue, and Pain Interference Among Adolescents and Young Adults With Cancer. JAMA network open, 3(6), e206696. https://doi.org/10.1001/jamanetworkopen.2020.6696

 

Key Points

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

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Abstract

Importance

The associations of spiritual and religious factors with patient-reported outcomes among adolescents with cancer are unknown.

Objective

To model the association of spiritual and religious constructs with patient-reported outcomes of anxiety, depressive symptoms, fatigue, and pain interference.

Design, Setting, and Participants

This cross-sectional study used baseline data, collected from 2016 to 2019, from an ongoing 5-year randomized clinical trial being conducted at 4 tertiary-referral pediatric medical centers in the US. A total of 366 adolescents were eligible for the clinical trial, and 126 were randomized; participants had to be aged 14 to 21 years at enrollment and be diagnosed with any form of cancer. Exclusion criteria included developmental delay, scoring greater than 26 on the Beck Depression Inventory II, non-English speaking, or unaware of cancer diagnosis.

Exposures

Spiritual experiences, values, and beliefs; religious practices; and overall self-ranking of spirituality’s importance.

Main Outcomes and Measures

Variables were taken from the Brief Multidimensional Measurement of Religiousness/Spirituality (ie, feeling God’s presence, daily prayer, religious service attendance, being very religious, and being very spiritual) and the spiritual well-being subscales of the Functional Assessment of Chronic Illness Therapy (meaning/peace and faith). Predefined outcome variables were anxiety, depressive symptoms, fatigue, and pain interference from Patient-Reported Outcomes Measurement Information System pediatric measures.

Results

A total of 126 individuals participated (72 [57.1%] female participants; 100 [79.4%] white participants; mean [SD] age, 16.9 [1.9] years). Structural equation modeling showed that meaning and peace were inversely associated with anxiety (β = –7.94; 95% CI, –12.88 to –4.12), depressive symptoms (β = –10.49; 95% CI, –15.92 to –6.50), and fatigue (β = –8.90; 95% CI, –15.34 to –3.61). Feeling God’s presence daily was indirectly associated with anxiety (β = –3.37; 95% CI, –6.82 to –0.95), depressive symptoms (β = –4.50; 95% CI, –8.51 to –1.40), and fatigue (β = –3.73; 95% CI, –8.03 to –0.90) through meaning and peace. Considering oneself very religious was indirectly associated with anxiety (β = –2.81; 95% CI, –6.06 to –0.45), depressive symptoms (β = −3.787; 95% CI, –7.68 to –0.61), and fatigue (β = –3.11, 95% CI, –7.31 to –0.40) through meaning and peace. Considering oneself very spiritual was indirectly associated with anxiety (β = 2.11; 95% CI, 0.05 to 4.95) and depression (β = 2.8, 95% CI, 0.07 to 6.29) through meaning and peace. No associations were found between spiritual scales and pain interference.

Conclusions and Relevance

In this study, multiple facets of spirituality and religiousness were associated with anxiety, depression, and fatigue, all of which were indirectly associated with the participant’s sense of meaning and peace, which is a modifiable process. Although these results do not establish a causal direction, they do suggest palliative interventions addressing meaning-making, possibly including a spiritual or religious dimension, as a novel focus for intervention development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/Importance

 

Improve Health and Treat Illness with Qigong

Improve Health and Treat Illness with Qigong

 

By John M. de Castro, Ph.D.

 

in order to do qigong … we have to be pretend to be empty, so the first thing to empty is the mind, so we try not to think of anything and only listen to our breathing, relax all the strength and relax the mind, so it’s some kind of meditation.” – Joe Lok

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Tai Chi and Qigong are both mindfulness practices and exercises. They have been shown to be beneficial to the health and well-being of individuals of a variety of ages, but particularly the elderly. They also improve the symptoms of a variety of diseases. The studies of the benefits for health of Tai Chi and Qigong are accumulating and so it makes sense to take a moment to summarize what has been learned.

 

In today’s Research News article “Benefits of Qigong as an integrative and complementary practice for health: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365612/) Toneti and colleagues review and summarize the published research studies of the benefits for health of Qigong practice. They identified 28 published clinical trials.

 

They report that the published research studies found that Qigong practice significantly promotes health and is effective in the prevention and rehabilitation of diseases in adults and the elderly. The evidence supports the effectiveness of Qigong practice in treating the symptoms of cancer, fibromyalgia, Parkinson’s disease, cardiovascular disease, and COPD. It has also been shown to be effective in reducing chronic pain including low back pain, cervical pain, and osteoarthritis pain. In addition, it has been shown to be effective in reducing perceived stress, burnout, fatigue, social isolation, and depression.

 

Hence, the available published research suggests that Qigong practice is effective in promoting physical and psychological health in healthy people and people with diseases at a variety of ages including the elderly. These are impressive benefits for a gentle and safe practice that can be rolled out to a wide audience at low cost. This suggests that people should be encouraged to participate in Qigong practice to promote their health and well-being.

 

So, improve health and treat illness with Qigong.

 

Qi gong and tai chi are relaxing ways to improve your flexibility and balance. Both are great ways to stay active and vital. The gentle, flowing movements are easy on the joints.” – Jodi Helmer

 

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

 

Toneti, B. F., Barbosa, R., Mano, L. Y., Sawada, L. O., Oliveira, I. G., & Sawada, N. O. (2020). Benefits of Qigong as an integrative and complementary practice for health: a systematic review. Revista latino-americana de enfermagem, 28, e3317. https://doi.org/10.1590/1518-8345.3718.3317

 

Abstract

Objective:

to analyze, in the literature, evidence about the benefits of the integrative and complementary practice of Qigong with regard to the health of adults and the elderly.

Method:

a systematic review by searching for studies in the PubMed, CINAHL, LILACS, EMBASE and Cochrane Library databases. Randomized and non-randomized clinical trials were included; in Portuguese, English and Spanish; from 2008 to 2018. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy was adopted, as well as the recommendation of the Cochrane Collaboration for assessing the risk of bias in the clinical trials analyzed.

Results:

28 studies were selected that indicated the benefit of the practice to the target audience, which can be used for numerous health conditions, such as: cancer; fibromyalgia; Parkinson’s disease; Chronic Obstructive Pulmonary Disease; Burnout; stress; social isolation; chronic low back pain; cervical pain; buzz; osteoarthritis; fatigue; depression; and cardiovascular diseases. However, there was a great risk of bias in terms of the blinding of the research studies.

Conclusion:

the practice of Qigong produces positive results on health, mainly in the medium and long term. This study contributes to the advancement in the use of integrative and complementary practices in nursing, since it brings together the scientific production in the area from the best research results available.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365612/

 

Reduce Anxiety and Depression in Cancer Patients with Mindfulness

Reduce Anxiety and Depression in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness can assist with uncertainty about the future, depression, fear of recurrence and anxiety as well as mitigate physical symptoms such as fatigue, pain, and sleep disturbance.” – Erin Murphy-Wilczek

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness in treating anxiety in cancer patients.

 

In today’s Research News article “Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/) Oberoi and colleagues review, summarize, and perform a meta-analysis of the published research on the effectiveness of mindfulness in reducing anxiety in adult cancer patients. They found 28 published trials. The most common forms of mindfulness treatment were Mindfulness-Based Stress Reduction (MBSR) (13 studies) and Mindfulness-Based Cognitive Therapy (MBCT) (6 studies).

 

They report that the published research found that mindfulness training reduced anxiety and depression and increased quality of life over the short and medium term (up to 6 months post-treatment) with moderate effect sizes. The reduction in anxiety and depression may be responsible for the improvement in the patients’ quality of life. But 2 trials had longer term follow up measures (over 6 months) and did not find significant reductions. The fact that the effects do not appear to last beyond 6 months suggests that continued mindfulness practice or periodic booster sessions may be needed.

 

Fighting cancer is very stressful and amplifies negative emotions like anxiety and depression. The stress produced by these emotions can in turn interfere with the body’s ability to fight the cancer. So, treating these negative emotional states may be very important not only for the individual’s mental health but also to their physical well-being. So, mindfulness training may be important to the overall health of the cancer patient by reducing anxiety and depression.

 

So, reduce anxiety and depression in cancer patients with mindfulness.

 

“In summary, results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda Carlson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Oberoi, S., Yang, J., Woodgate, R. L., Niraula, S., Banerji, S., Israels, S. J., Altman, G., Beattie, S., Rabbani, R., Askin, N., Gupta, A., Sung, L., Abou-Setta, A. M., & Zarychanski, R. (2020). Association of Mindfulness-Based Interventions With Anxiety Severity in Adults With Cancer: A Systematic Review and Meta-analysis. JAMA network open, 3(8), e2012598. https://doi.org/10.1001/jamanetworkopen.2020.12598

 

Abstract

Importance

Mindfulness-based interventions (MBIs), grounded in mindfulness, focus on purposely paying attention to experiences occurring at the present moment without judgment. MBIs are increasingly used by patients with cancer for the reduction of anxiety, but it remains unclear if MBIs reduce anxiety in patients with cancer.

Objective

To evaluate the association of MBIs with reductions in the severity of anxiety in patients with cancer.

Data Sources

Systematic searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and SCOPUS were conducted from database inception to May 2019 to identify relevant citations.

Study Selection

Randomized clinical trials (RCTs) that compared MBI with usual care, waitlist controls, or no intervention for the management of anxiety in cancer patients were included. Two reviewers conducted a blinded screening. Of 101 initially identified studies, 28 met the inclusion criteria.

Data Extraction and Synthesis

Two reviewers independently extracted the data. The Cochrane Collaboration risk-of-bias tool was used to assess the quality of RCTs, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Summary effect measures were reported as standardized mean differences (SMDs) and calculated using a random-effects model.

Main Outcomes and Measures

Our primary outcome was the measure of severity of short-term anxiety (up to 1-month postintervention); secondary outcomes were the severity of medium-term (1 to ≤6 months postintervention) and long-term (>6 to 12 months postintervention) anxiety, depression, and health-related quality of life of patients and caregivers.

Results

This meta-analysis included 28 RCTs enrolling 3053 adults with cancer. None of the trials were conducted in children. Mindfulness was associated with significant reductions in the severity of short-term anxiety (23 trials; 2339 participants; SMD, −0.51; 95% CI, −0.70 to −0.33; I2 = 76%). The association of mindfulness with short-term anxiety did not vary by evaluated patient, intervention, or study characteristics. Mindfulness was also associated with the reduction of medium-term anxiety (9 trials; 965 participants; SMD, −0.43; 95% CI, −0.68 to −0.18; I2 = 66%). No reduction in long-term anxiety was observed (2 trials; 403 participants; SMD, −0.02; 95% CI, −0.38 to 0.34; I2 = 68%). MBIs were associated with a reduction in the severity of depression in the short term (19 trials; 1874 participants; SMD, −0.73; 95% CI; −1.00 to −0.46; I2 = 86%) and the medium term (8 trials; 891 participants; SMD, −0.85; 95% CI, −1.35 to −0.35; I2 = 91%) and improved health-related quality of life in patients in the short term (9 trials; 1108 participants; SMD, 0.51; 95% CI, 0.20 to 0.82; I2 = 82%) and the medium term (5 trials; 771 participants; SMD, 0.29; 95% CI, 0.06 to 0.52; I2 = 57%).

Conclusions and Relevance

In this study, MBIs were associated with reductions in anxiety and depression up to 6 months postintervention in adults with cancer. Future trials should explore the long-term association of mindfulness with anxiety and depression in adults with cancer and determine its efficacy in more diverse cancer populations using active controls.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414391/

 

Improve the Mental Health of Myeloproliferative Neoplasm Cancer Patients with a Mindfulness App

Improve the Mental Health of Myeloproliferative Neoplasm Cancer Patients with a Mindfulness App

 

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

 

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 fatigueanxietydepressionpain, 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 “Associations Between Global Mental Health and Response to an App-Based Meditation Intervention in Myeloproliferative Neoplasm Patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307391/) Puzia and colleagues recruited patients with Myeloproliferative Neoplasms (MPNs) and randomly assigned them to either receive a pamphlet on MPN symptom management or to practice mindfulness for 4 weeks using the “Calm” App for 10 minutes every day. “Calm meditations are developed using a combination of techniques drawn from Mindfulness-Based Stress Reduction and Cognitive Behavioral Therapy, encouraging users to practice moment-to-moment awareness without judgement and to develop awareness of their thoughts, interpretations, and emotional and physiological responses in order to alter their perception or create new, more balanced thoughts.” They were measured before and after the 4-week treatment period for depression, anxiety, sleep disturbance, and mental and physical health.

 

They found that the results differed depending upon the participants’ levels of mental health. For those participants who had poor mental health at the beginning of the trial, using the “Calm” App produced significantly lower levels of depression and anxiety. These results replicate the previous findings that mindfulness meditation training produces significant decreases in depression and anxiety in a wide array of healthy and sick individuals. The present findings extend these benefits to patients with Myeloproliferative Neoplasms (MPNs) and appear to have maximum benefits for those who need it the most, the patients with the greatest mental health problems.

 

The findings that the use of an internet App is effective in improving the mental health of patients with MPN is important. These Apps make treatment available to large numbers of patients over widespread geographic areas, conveniently and inexpensively. This greatly expands the ability of mindfulness meditation for the treatment of the patients’ emotional problems.

 

Mindfulness meditation promotes present moment awareness with a non-judging and non-reacting attitude. Depression and anxiety are rooted in the individuals’ processing of past or projected future events and the judging and reacting to them. By focusing on the present moment this processing is interrupted and emphasizes what is actually present in the moment. In addition, not judging or reacting allows for a moderated emotional reaction and greater ability to regulate the emotions. This greatly improves the mental health of the patient.

 

So, improve the mental health of myeloproliferative neoplasm cancer patients with a mindfulness App.

 

“The intent of this practice is to help you begin to see that the traditional things you may consider important in defining your place in the world are often transitory. There’s a more stable and enduring part of your being, and connecting with this possibility through your meditation practice may help soothe the pain of changes to your self-image and identity that cancer triggers.” — 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

 

Puzia, M. E., Huberty, J., Eckert, R., Larkey, L., & Mesa, R. (2020). Associations Between Global Mental Health and Response to an App-Based Meditation Intervention in Myeloproliferative Neoplasm Patients. Integrative cancer therapies, 19, 1534735420927780. https://doi.org/10.1177/1534735420927780

 

Abstract

Background: Depression, anxiety, and sleep disturbance are common problems that greatly affect quality of life for many myeloproliferative neoplasm (MPN) patients. App-based mindfulness meditation is a feasible nonpharmacologic approach for managing symptoms. However, previous research has not considered how patients’ overall mental health may influence their responsiveness to these interventions. Objective: The purpose of this study was to conduct an exploratory, secondary analysis of the effects of a smartphone meditation app, Calm, on depression, anxiety, and sleep disturbance in MPN patients based on patients’ baseline levels of Global Mental Health (GMH). Methods: Participants (N = 80) were a subset of MPN patients from a larger feasibility study. Patients were enrolled into an intervention (use Calm for 10 minutes daily for 4 weeks) or educational control group. Results: In multilevel models, there were significant 3-way interactions between time, group, and baseline GMH for depression and anxiety symptoms, with participants in the meditation intervention who reported the poorest baseline GMH experiencing the greatest reduction in symptoms over time. For both intervention and control participants, poorer initial GMH was associated with increases in sleep disturbance symptoms over time. Conclusions: Mindfulness meditation apps, such as Calm, may be effective in reducing depression and anxiety symptoms in MPN patients, particularly for those experiencing mental health difficulties. Given the need for accessible tools to self-manage chronic cancer–related symptoms, especially strong negative emotions, these findings warrant larger efficacy studies to determine the effects of app-based meditation for alleviating depression and anxiety in cancer populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307391/

Improve Health, Well-Being, and Quality of Life with Breast Cancer with an Integrative Program Including Diet, Exercise, and Mindfulness

Improve Health, Well-Being, and Quality of Life with Breast Cancer with an Integrative Program Including Diet, Exercise, and Mindfulness

 

By John M. de Castro, Ph.D.

 

Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.  Mindfulness can also help during specific times of our cancer treatment – to prepare for surgery, while undergoing chemotherapy or radiotherapy, and before or during scans to help with scanxiety. “ – Karen Sieger

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. Diet and exercise have also been shown to be effective for breast cancer patients who tend to become overweight or obese. The majority of research, however, explores mindfulness, diet, and exercise separately as treatments for breast cancer patients. It will be important to establish if the combination of these treatments may be especially effective.

 

In today’s Research News article “Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265566/), Ruiz-Vozmediano and colleagues recruited breast cancer patients who had completed treatment at least 12 months earlier. They were randomly assigned to a no-treatment control group or to receive a 6-month program of diet, exercise, and mindfulness. The diet intervention consisted of a 5-hour workshop on healthy eating that was repeated after 2 months. Exercise consisted of 7-weeks of 3 times per week for an hour stretching and weekly 50-minutes of dancing. Mindfulness training consisted of a 4-week, twice a week for 90 minutes Mindfulness-Based Stress Reduction (MBSR) program including discussion, meditation, yoga, and body scan. They were measured before and 6 months after the intervention for body size, food intake, and cancer quality of life. They also provided a blood sample that was assayed for glucose, triglycerides, and cholesterol levels, and tumor markers.

 

They found that in comparison to baseline and the control group the participants who received the diet, exercise, and mindfulness intervention had significantly higher adherence to a Mediterranean diet, and greater quality of life including physical, role, and social functioning quality of life. They also had significant reductions in body weight, body mass index (BMI), blood triglycerides, and high-density lipoprotein.

 

The results suggest that an integrated treatment of diet, exercise, and mindfulness training produces positive changes in breast cancer survivors including improvements in their quality of life, diet, body size, and blood lipid levels. Future research should perform a component analysis to determine the effects of each treatment component and their combinations on the patients. Regardless, the effects observed in the present study tend to predict maintained psychological and physical health in these patients.

 

So, improve health, well-being, and quality of life with breast cancer with an integrative program including diet, exercise, and 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.” – 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

 

Ruiz-Vozmediano, J., Löhnchen, S., Jurado, L., Recio, R., Rodríguez-Carrillo, A., López, M., Mustieles, V., Expósito, M., Arroyo-Morales, M., & Fernández, M. F. (2020). Influence of a Multidisciplinary Program of Diet, Exercise, and Mindfulness on the Quality of Life of Stage IIA-IIB Breast Cancer Survivors. Integrative cancer therapies, 19, 1534735420924757. https://doi.org/10.1177/1534735420924757

 

Abstract

Background: Integrative oncology has proven to be a useful approach to control cancer symptoms and improve the quality of life (QoL) and overall health of patients, delivering integrated patient care at both physical and emotional levels. The objective of this randomized trial was to evaluate the effects of a triple intervention program on the QoL and lifestyle of women with breast cancer. Methods: Seventy-five survivors of stage IIA-IIB breast cancer were randomized into 2 groups. The intervention group (IG) received a 6-month dietary, exercise, and mindfulness program that was not offered to the control group (CG). Data were gathered at baseline and at 6 months postintervention on QoL and adherence to Mediterranean diet using clinical markers and validated questionnaires. Between-group differences at baseline and 3 months postintervention were analyzed using Student’s t test for related samples and the Wilcoxon and Mann-Whitney U tests. Results: At 6 months postintervention, the IG showed significant improvements versus CG in physical functioning (p = .027), role functioning (p = .028), and Mediterranean diet adherence (p = .02) and a significant reduction in body mass index (p = .04) and weight (p = .05), with a mean weight loss of 0.7 kg versus a gain of 0.55 kg by the CG (p = .05). Dyspnea symptoms were also increased in the CG versus IG (p = .066). Conclusions: These results demonstrate that an integrative dietary, physical activity, and mindfulness program enhances the QoL and healthy lifestyle of stage IIA-IIB breast cancer survivors. Cancer symptoms may be better managed by the implementation of multimodal rather than isolated interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265566/

 

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

Reduce Blood Pressure in Patients with Noncommunicable Diseases with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness practice can be an effective way to reduce blood pressure (and along with it, the risk of stroke or heart attack).” – NICABM

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control. Treatment frequently includes antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. Indeed, meditation, tai chi, and yoga, have also been shown to be helpful for heart health. Hypertension is frequently cooccurring with in patients with non-communicable diseases. In today’s Research News article “Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: 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), Intarakamhang and colleagues review, summarize and perform a meta-analysis of the effectiveness of mindfulness training in reducing blood pressure in patients with non-communicable diseases.

 

They defined non-communicable diseases (NCDs) to include cancers, cardiovascular diseases, respiratory diseases and diabetes and identified 14 published controlled studies including a total of 1117 patients. They report that the studies found that mindfulness training significantly reduced both systolic and diastolic blood pressure in the patients with NCDs.

 

The results are compatible with previous findings that mindfulness training reduces blood pressure in a wide variety of healthy and ill individuals. The present study demonstrates that mindfulness training is effective in reducing blood pressure in patients with non-communicable diseases (NCDs). This is reasonable given that mindfulness training has been shown to improve the symptoms of patients with the included NCDs, cancers, cardiovascular diseases, respiratory diseases and diabetes.

 

There are a number of possible mechanisms for this blood pressure reduction. Mindfulness training is known to reduce the physiological and psychological responses to stress and this may in turn lower blood pressure. Also mindfulness training has been shown to affect the autonomic nervous system increasing parasympathetic activity that tends to reduce blood pressure.

 

So, reduce blood pressure in patients with noncommunicable diseases with mindfulness.

 

“The hope is that if we can start mindfulness training early in life, we can promote a trajectory of healthy aging across the rest of people’s lives. That will reduce their chances of getting high blood pressure in the first place.” – Eric Loucks

 

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

 

Intarakamhang, U., Macaskill, A., & Prasittichok, P. (2020). Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: A systematic review and meta-analysis. Heliyon, 6(4), e03834. https://doi.org/10.1016/j.heliyon.2020.e03834

 

Abstract

Purpose

Mindfulness based interventions (MBIs) are an emerging area of empirical study, not only in positive psychology, but also in clinical health care. This research aims to synthesize the evidence about whether MBIs reduce blood pressure (BP) in patients with non-communicable diseases (NCDs).

Methods

Relevant studies were identified via PubMed, the Cochrane Library, Embase and the CINAHL database between 2009 and 2019. The papers selected focused on mindfulness and the effect of these on the BP of patients with NCDs. The change in SBP and DBP were meta-analyzed, stratified by type of intervention (Breathing awareness meditation (BAM), Mindfulness Meditation (MM), and Mindfulness-based Stress Reduction (MBSR).

Results

Fourteen articles met eligibility criteria and were included in the final review. Among the studies using the type and duration of intervention, systolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-6.90 mmHg [95% CI: -10.82, -2.97], p < .050), followed by the breathing awareness meditation for 12 weeks (-4.10 mmHg [95% CI: -7.54, -0.66], p < .050) and the mindfulness-based intervention for 8 weeks (-2.69 mmHg [95% CI: -3.90, -1.49], p < .050) whereas diastolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-2.45 mmHg [95% CI: -3.74, -1.17], p < .050) and the mindfulness-based intervention for 8 weeks (-2.24 mmHg [95% CI: -3.22, -1.26], p < .050).

Conclusion

MBIs can provide effective alternative therapies to assist in blood pressure reduction for patients with NCDs.

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

 

Tai Chi Improves the Quality of Life and Relieves Physical and Psychological Symptoms of Breast Cancer Survivors.

Tai Chi Improves the Quality of Life and Relieves Physical and Psychological Symptoms of Breast Cancer Survivors.

 

By John M. de Castro, Ph.D.

 

For patients with cancer, Tai Chi and Qigong provide benefit to many of the side effects associated with cancer and cancer treatment.” – Susan Yaguda

 

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 stress,  sleep disturbance, and anxiety and depressionTai 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 on the effectiveness of Tai Chi training for breast cancer patients is accumulating. So, it makes sense to take a step back and summarize what has been learned.

 

In today’s Research News article “Effect of Tai Chi Chuan in Breast Cancer Patients: 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/PMC7191057/), Luo and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled clinical trials of the effectiveness of Tai Chi training for breast cancer patients. They found 15 published research controlled clinical trials.

 

They report that the published research found that Tai Chi training practice produced significant improvements in the quality of life of the patients that persisted for 6 months after the cessation of training. They also report that Tai Chi training improved shoulder function including arm function and reduced shoulder pain. They also found significant reductions in anxiety and fatigue with Tai Chi training in breast cancer patients.

 

These results demonstrate that Tai Chi training produces substantial and lasting improvements in the physical and psychological well-being of breast cancer patients, relieving suffering and improving quality of life. Tai Chi is an ancient mindfulness practice that involves slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence Tai Chi training should be recommended for breast cancer patients.

 

So, Tai Chi improves the quality of life and relieves physical and psychological symptoms of breast cancer survivors.

 

tai chi helps counteract the body’s natural inflammatory response when it’s subjected to harsh cancer treatments like radiation and chemotherapy.” – Karen Mustian

 

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

 

Luo, X. C., Liu, J., Fu, J., Yin, H. Y., Shen, L., Liu, M. L., Lan, L., Ying, J., Qiao, X. L., Tang, C. Z., & Tang, Y. (2020). Effect of Tai Chi Chuan in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Frontiers in oncology, 10, 607. https://doi.org/10.3389/fonc.2020.00607

 

Abstract

Background: Tai Chi Chuan(TCC), as a mind-body exercise, may have a positive impact on physical function and psychological well-being in breast cancer patients. The latest systematic review and meta-analysis of TCC for breast cancer was made 4 years ago and some new clinical trials about it were published. We remade a systematic review and meta-analysis to evaluate the effect of TCC in breast cancer patients.

Methods: In this systematic review and meta-analysis, we searched MEDLINE (via PubMed), EMBASE (via embase.com), CENTRAL, CNKI, COVIP, Wanfang, Chaoxing, CiNii, J-SSTAGE, DBpia, and ThaiJO with no language restrictions from inception to December 31, 2018 (updated on February 16, 2020), for randomized clinical trials comparing TCC with non-exercised therapy in breast cancer patients. The primary outcome was quality of life in patients with breast cancer and data pooled by a random-effects model. Subgroup analyses were conducted to estimate the effect of different durations of TCC for breast cancer patients. This study was registered in PROSPERO, number CRD 4201810326.

Results: Fifteen articles involving a total of 885 breast cancer participants were included in this review. Compared with non-exercised therapy, TCC had a significant effect on quality of life in breast cancer patients (SMD = 0.37, 95% CI 0.15–0.59, p = 0.001), and subgroup analysis found that TCC showed beneficial effect in 12 weeks and 25 weeks (12 weeks: SMD = 0.40, 95% CI 0.19–0.62, p = 0.0003; 25 weeks: SMD = 0.38, 95% CI 0.15–0.62, p = 0.002). Meta-analyses of secondary outcomes showed that 3 weeks TCC increased shoulder function (SMD = 1.08, 95% CI 0.28–1.87, p = 0.008), 12 weeks TCC improved pain (SMD = 0.30, 95% CI 0.08–0.51, p = 0.007), shoulder function (SMD = 1.34, 95% CI 0.43–2.25, p = 0.004), strength of arm (SMD = 0.44, 95% CI 0.20–0.68, p = 0.0004), and anxiety (MD = −4.90, 95% CI −7.83 to −1.98, p = 0.001) in breast cancer patients compared with the control group.

Conclusions: TCC appears to be effective on some physical and psychological symptoms and improves the quality of life in patients with breast cancer. Additional randomized controlled trials with a rigorous methodology and low risk of bias are needed to provide more reliable evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191057/

 

Reduce Biochemical Stress Responses in Hispanic Breast Cancer Patients with Mindfulness

Reduce Biochemical Stress Responses in Hispanic Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer. . . experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.“ – Karin Sieger

 

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 . Mindfulness practice have been shown to improve the residual symptoms in cancer survivors. Most research, however, examines women from affluent western populations and may not be sensitive to the unique situations, cultures, and education levels of diverse populations. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation with different populations.

 

In today’s Research News article “). A Large Randomized Trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for Breast Cancer (BC) Survivors on Salivary Cortisol and IL-6.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700883/), Lengacher and colleagues recruited adult breast cancer survivors and randomly assigned them to receive either usual care of a once a week for 2 hours, 6 week program of Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer patients. The program included meditation, body scan, yoga practices, and discussion along with daily home practice. At baseline, before and after the MBSR session at weeks 1 1nd 6, and after treatment the participants provided saliva samples that were assayed for cortisol and IL-6 levels. They also completed questionnaires measuring fear of cancer recurrence, depression, anxiety, perceived stress, sleep, fatigue, and quality of life.

 

They found that in comparison to baseline and the usual care group, the group that received Mindfulness-Based Stress Reduction (MBSR) had significant reductions in both cortisol and IL-6 levels. In addition, both cortisol and IL-6 levels decreased significantly over the course of the MBSR sessions at weeks 1 1nd 6. They also found that the higher the levels of IL-6 at baseline and the end of treatment the higher the levels of fear of cancer recurrence, sleep problems and fatigue and the lower the levels of quality of life and physical health. After MBSR they found that the higher the levels of IL-6 the higher the levels of fear of cancer recurrence, depression, pain, perceived stress, sleep disturbance and fatigue and the lower the levels of quality of life and physical health.

 

Cortisol and IL-6 levels are markers of stress and inflammation. So, these results suggest that Mindfulness-Based Stress Reduction (MBSR) reduces the biochemical markers of stress and inflammation in breast cancer survivors and that the levels of IL-6, an inflammatory cytokine, are related to their health and well-being. These findings lend support to prior findings that mindfulness training is an effective treatment for the psychological health of breast cancer survivors and demonstrate that this may, at least in part, be due to the effects of mindfulness training on stress hormones and inflammatory biomarkers. The ability of mindfulness training to reduce stress and inflammatory responses is thought to be a primary mechanism by which it improves health and well-being.

 

The results also demonstrate that Mindfulness-Based Stress Reduction (MBSR) treatment is effective in Hispanic breast cancer survivors. This suggests that MBSR is an effective treatment across ethnic groups. MBSR appears to effectively reduce stress and inflammatory responses regardless of ethnicity and produce improvements in health and well-being.

 

So, reduce biochemical stress responses in Hispanic breast cancer patients with mindfulness.

 

Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

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

 

Lengacher, C. A., Reich, R. R., Paterson, C. L., Shelton, M., Shivers, S., Ramesar, S., Pleasant, M. L., Budhrani-Shani, P., Groer, M., Post-White, J., Johnson-Mallard, V., Kane, B., Cousin, L., Moscoso, M. S., Romershausen, T. A., & Park, J. Y. (2019). A Large Randomized Trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for Breast Cancer (BC) Survivors on Salivary Cortisol and IL-6. Biological research for nursing, 21(1), 39–49. https://doi.org/10.1177/1099800418789777

 

Abstract

Breast cancer survivors (BCS) often experience psychological and physiological symptoms after cancer treatment. Mindfulness-based stress reduction (MBSR), a complementary and alternative therapy, has reduced subjective measures of stress, anxiety, and fatigue among BCS. Little is known, however, about how MBSR affects objective markers of stress, specifically the stress hormone cortisol and the pro-inflammatory cytokine interleukin-6 (IL-6). In the present study, BCS (N = 322) were randomly assigned to a 6-week MBSR program for BC or usual-care control. Measurements of cortisol, IL-6, symptoms, and quality of life were obtained at orientation and 6 weeks. Cortisol and IL-6 were also measured prior to and after the MBSR(BC) class Weeks 1 and 6. The mean age of participants was 56.6 years and 69.4% were White non-Hispanic. Most had Stage I (33.8%) or II (35.7%) BC, and 35.7% had received chemotherapy and radiation. Cortisol levels were reduced immediately following MBSR(BC) class compared to before the class Weeks 1 and 6 (Wilcoxon-signed rank test; p < .01, d = .52–.56). IL-6 was significantly reduced from pre- to postclass at Week 6 (Wilcoxon-signed rank test; p < .01, d = .21). No differences were observed between the MBSR(BC) and control groups from baseline to Week 6 using linear mixed models. Significant relationships with small effect sizes were observed between IL-6 and both symptoms and quality of life in both groups. Results support the use of MBSR(BC) to reduce salivary cortisol and IL-6 levels in the short term in BCS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700883/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for 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/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

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

 

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

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People don’t ask to be diagnosed with cancer, but they’re given an opportunity to, in a real sense, experience the vividness and the exquisiteness of the moment.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. 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 disturbancefear, and anxiety and depression. The effectiveness of mindfulness training for the psychological symptoms of cancer has been established. But whether it is cost-effective relative to other treatments has not been investigated.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents 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 parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the cost effectiveness of these online trainings.

 

In today’s Research News article “Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/), Compen and colleagues recruited past or present cancer patients with high anxiety levels and randomly assigned them to be on a wait-list receiving treatment as usual or Mindfulness-Based Cognitive Therapy (MBCT) either delivered face-to-face or over the internet. Face-to-face MBCT occurred in 8 weekly 2.5-hour sessions with 45 minutes of daily practice at home. The internet version had similar content but was delivered asynchronously personally with email exchanges with therapists.

Costs were calculated by calculating the costs of normal treatment as usual as well as indirect costs from absenteeism, productivity losses etc. and the costs of delivering the services. Quality of life was assessed for each patient.

 

They found that the costs of delivery of Mindfulness-Based Cognitive Therapy (MBCT) was equivalent between face-to-face and internet delivery. The productivity losses and total costs were significantly less with both MBCT deliveries compared to treatment as usual. Quality of life was significantly higher with both MBCT deliveries and was maintained at a 9-month follow-up.

 

The results suggest that delivering Mindfulness-Based Cognitive Therapy (MBCT) either face-to-face or over the internet reduces total costs of treatment and work-related losses and improved the quality of life of cancer patients. This suggests that MBCT is a cost effective way of delivering treatment to cancer patients, making their lives better.

 

So, cost effectively improve cancer patients’ quality of life with mindfulness.

 

Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. – Erin Murphy-Wilczek

 

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

 

Compen, F., Adang, E., Bisseling, E., van der Lee, M., & Speckens, A. (2020). Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients. Psycho-oncology, 29(2), 294–303. https://doi.org/10.1002/pon.5246

 

Abstract

Objective

It was previously determined that group‐based face‐to‐face Mindfulness‐Based Cognitive Therapy (MBCT) and individual internet‐based MBCT (eMBCT) are equally efficacious compared with treatment as usual (TAU) in reducing psychological distress. In this study, the incremental cost‐utility of both interventions compared with TAU was assessed.

Methods

This cost‐utility study included 245 self‐referred heterogeneous cancer patients with psychological distress who were randomized to MBCT, eMBCT or TAU. Healthcare costs and (informal) work‐related productivity losses were assessed by interview. Outcomes were expressed in EuroQol‐5D‐3L utility scores and quality‐adjusted life years (QALY). An economic evaluation with a time‐horizon of 3 months was conducted from the societal perspective in the intention‐to‐treat sample. In addition, secondary explorative analyses of costs and quality of life during the 9‐month follow‐up were conducted based on linear extrapolation of TAU.

Results

Paid work‐related productivity losses and societal costs were lower in both intervention conditions compared with TAU during the 3‐month intervention period. Moreover, quality of life (utility scores) improved in eMBCT versus TAU (Cohen’s d: .54) and MBCT versus TAU (.53). At a willingness to pay of €20000 per QALY, the mean incremental net monetary benefit was €1916 (SD=€783) in eMBCT and €2365 (SD=€796) in MBCT versus TAU. Exploration of costs demonstrated an equal pattern of eMBCT and MBCT being superior to TAU. Quality of life at 9‐month follow‐up remained improved in both interventions.

Conclusions

Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/