Cancer

Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

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Improve Cancer Patient and Caregiver Well-Being with Spiritual Care

 

By John M. de Castro, Ph.D.

 

“Serious illnesses like cancer may cause patients or family caregivers to have doubts about their beliefs or religious values and cause much spiritual distress. Some studies show that patients with cancer may feel that they are being punished by God or may have a loss of faith after being diagnosed. Other patients may have mild feelings of spiritual distress when coping with cancer.” – National Cancer Institute

 

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.

 

Not only the patient but also the caregivers have difficult issues to cope with. Providing care for cancer patients can be can be a very satisfying, rewarding, and even joyful experience. But, over time, caregiving can wear the caregiver out and can lead to burnout. Caregiving comes at a cost to the caregiver. It exacts an economic toll in lost work hours, income, and even the opportunity to take a promotion or relocate for a better position. But, more significantly, it exacts a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality.

 

Obviously, there is a need to both care for the cancer patients and also for the caregivers. Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer and also for their caregivers. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens of cancer or on the quality of life of cancer patients and their caregivers. Hence, there is a need to study the effects of spiritual care on the cancer patient and their caregivers.

 

In today’s Research News article “Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/

Sankhe and colleagues recruited adult cancer patients undergoing surgery whose life expectancy exceeded 6 months and one of their caregivers. This was a pilot study without a control group in which all patients and caregivers were provided with spiritual care consisting of 90 minutes daily counseling, reading and chanting. They were measured at the baseline, discharge and 2, 4, and 6 months following the surgery, for spiritual well-being and quality of life, including physical well-being, social/family well-being, emotional well-being and functional well-being.

 

They found that both the cancer patients and their caregivers had large and significant improvements in spiritual well-being and in all quality of life domains. These improvements were maintained 6 months after discharge. These are impressive effects of spiritual care but, because of the lack of a control condition, any conclusions must be tempered with the understanding that there are a myriad of possible confounding factors. The results do though provide strong evidence for the conduct of a randomized controlled clinical trial of providing spiritual care for cancer patients and their caregivers.

 

So, improve cancer patient and caregiver well-being with spiritual care.

 

“Spirituality and religion can be important to the well-being of people who have cancer, enabling them to better cope with the disease. Spirituality and religion may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.” – National Comprehensive Cancer Network

 

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

Sankhe, A., Dalal, K., Agarwal, V., & Sarve, P. (2017). Spiritual Care Therapy on Quality of Life in Cancer Patients and Their Caregivers: A Prospective Non-randomized Single-Cohort Study. Journal of Religion and Health, 56(2), 725–731. http://doi.org/10.1007/s10943-016-0324-6

 

Abstract

Spiritual care is still in infancy stage all over the globe including India. The present study was an original study evaluating the role of spiritual care in cancer patients and their primary caregivers regarding their spiritual and general well-being. The study was a prospective, non-randomized single-group study involving cancer patients undergoing surgery and their primary caregivers. Functional assessment of cancer therapy—general and functional assessment of chronic illness therapy-spiritual care was evaluated during the admission and at the time of discharge, two, four  and 6 months following discharge from the hospital. Descriptive statistics was used for demographic details and repeated measure ANOVA with Dunn’s test was used for analysis of changes in the scores. A total of 107 (63 males and 44 females) patients with a mean (SD) of age 51 (13) years were recruited in the study. Similarly, for each patient one of their primary caregivers was recruited with their mean (SD) age of 39.4 (12.7) years. A total of 11/107 (10.3%) patients died and nine out of 107 (8.4%) were lost to follow-up eventually during the study period. There was a statistically significant (P < 0.0001) increase in the scores at all the follow-up periods in both the patient and their relative groups. To conclude, we found out that spiritual care on the basis of MATCH guideline improved the level of not only spiritual well-being but general well-being also in both the patients and their primary caregivers. Control group could have improved scientific validity of study in accessing effect of spiritual care. Authors believe that more robust comparative study on each principle against all five MATCH principles in future will add scientific validity and clear the various ambiguities in spiritual care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320005/

 

Spiritual Concerns Decrease Quality of Life in Cancer Patients

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Spiritual Concerns Decrease Quality of Life in Cancer Patients

 

By John M. de Castro, Ph.D.

 

“For some, a cancer diagnosis has the opposite effect on their sense of spirituality. It makes them doubt their beliefs or religious values, challenges their faith, and can cause spiritual distress. Some people become angry with God for allowing them to get cancer or wonder if they are being punished. Spiritual distress can make it harder for patients to cope with cancer and its treatment.” –  National Comprehensive Cancer Network

 

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.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer, when living with advanced cancer, and at end of life care. It is thought that people take comfort in the spiritual when facing their own mortality. There is very little information available, however, regarding the effectiveness of religion and spirituality in relieving the psychological burdens of cancer or on the quality of life of advance cancer patients. Additionally, the impact of spiritual concerns that the patient might have are not known. Concerns such as feelings of being abandoned by God or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort.

 

In today’s Research News article “The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Winkelman and colleagues study the relationship of patients’ spiritual concern to their quality of life with advanced cancer. They recruited terminal cancer patients who were undergoing palliative radiation treatments. They completed measures of religiousness, spirituality, spiritual concerns including spiritual struggles and spiritual seeking, and quality of life including physical and existential quality of life. The patients died on average of 180 days after completing the measures.

 

The majority of the patients experienced one or more forms of spiritual struggle (58%), and most (82%) experienced spiritual seeking. Their struggles included “wondering why God has allowed this to happen” and “wondering whether God has abandoned me.” The most common spiritual seekings were “seeking a closer connection to God” and “thinking about what gives meaning to life.”  They found that the greater the spiritual concerns, spiritual struggles, or spiritual concerns, the lower the patient’s quality of life. Virtually all of the patients indicated that spiritual care was important in their treatment.

 

These results are somewhat surprising in that religiousness and spirituality were not associated with comfort but with poorer quality of life in these terminal cancer patients. In particular, it appears that concerns about the spiritual meaning of their situation were very common and greatly troubled the patients leading to poorer quality of life. Being at peace with God is a very important goal of these patients and their concerns interfered with attaining that peace. Hence, it appears that in hospice and palliative care there should be greater attention paid to the religiousness and spirituality of the patients, particularly to their spiritual concerns, struggles, and seeking. This is important as spiritual concerns trouble them deeply and decrease the quality of life of terminal cancer patients.

 

 “When we took a closer look, we found that patients with stronger spiritual well-being, more benign images of God (such as perceptions of a benevolent rather than an angry or distant God), or stronger beliefs (such as convictions that a personal God can be called upon for assistance) reported better social health. In contrast, those who struggled with their faith fared more poorly.” – Allen Sherman

 

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

Winkelman, W. D., Lauderdale, K., Balboni, M. J., Phelps, A. C., Peteet, J. R., Block, S. D., … Balboni, T. A. (2011). The Relationship of Spiritual Concerns to the Quality of Life of Advanced Cancer Patients: Preliminary Findings. Journal of Palliative Medicine, 14(9), 1022–1028. http://doi.org/10.1089/jpm.2010.0536

 

Abstract

Purpose

Religion and/or spirituality (R/S) have increasingly been recognized as key elements in patients’ experience of advanced illness. This study examines the relationship of spiritual concerns (SCs) to quality of life (QOL) in patients with advanced cancer.

Patients and Methods

Patients were recruited between March 3, 2006 and April 14, 2008 as part of a survey-based study of 69 cancer patients receiving palliative radiotherapy. Sixteen SCs were assessed, including 11 items assessing spiritual struggles (e.g., feeling abandoned by God) and 5 items assessing spiritual seeking (e.g., seeking forgiveness, thinking about what gives meaning in life). The relationship of SCs to patient QOL domains was examined using univariable and multivariable regression analysis.

Results

Most patients (86%) endorsed one or more SCs, with a median of 4 per patient. Younger age was associated with a greater burden of SCs (β = −0.01, p = 0.006). Total spiritual struggles, spiritual seeking, and SCs were each associated with worse psychological QOL (β = −1.11, p = 0.01; β = −1.67, p < 0.05; and β = −1.06, p < 0.001). One of the most common forms of spiritual seeking (endorsed by 54%)—thinking about what gives meaning to life—was associated with worse psychological and overall QOL (β = − 5.75, p = 0.02; β = −12.94, p = 0.02). Most patients (86%) believed it was important for health care professionals to consider patient SCs within the medical setting.

Conclusions

SCs are associated with poorer QOL among advanced cancer patients. Furthermore, most patients view attention to SCs as an important part of medical care. These findings underscore the important role of spiritual care in palliative cancer management.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206727/

Improve the Physical and Psychological State of Breast Cancer Survivors with Mindfulness

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Improve the Physical and Psychological State of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A brief mindfulness-based intervention has a positive short-term effect on psychological and behavioral measures as well as proinflammatory signal markers in younger breast cancer survivors,” – Joyce O’Shaughnessy

 

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 a death sentence. It is encouraging that the 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). In addition, breast cancer survivors can have to deal with a heightened fear of reoccurrence, and an alteration of their body image.

 

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.. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy, relieve neuromuscular symptoms, and improve the quality of life in cancer survivors. Also, Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels.

 

Hence various practices that have the common property of improving mindfulness, are able to relieve symptoms in breast cancer survivors. It is possible that they have a common mechanism of action. In today’s Research News article “A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1475016505855604/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125023/

Hulett and colleagues review the published research literature to explore whether psychoneuroimmunological factors may be the mechanism by which these various practices relieve the residual symptoms after breast cancer survival. They included all studies regardless of the type of mindfulness practice, including mindfulness, meditation, yoga, tai chi or qigong practices, that studied breast cancer survivors and included measures of mental influences on the brain and immune system. By far the most frequently used practice was Mindfulness-Based Stress Reduction (MBSR).

 

The found that the literature reports that mindfulness practices produce improvements in breast cancer survivors in the psychological symptoms of quality of life, depression, stress, anxiety, fatigue, and mood. In regards to psychoneuroimmunological factors, they found that the literature reports that mindfulness practices produce reductions in breast cancer survivors in cortisol levels, a marker if stress and inflammation, and some studies report preservations of DNA telomeres, a marker of cellular aging. They also found that MBSR was reported to improve inflammatory cytokine activity, improve lymphocyte function, improve or stabilize cortisol levels, and increase or preserve telomere activity.

 

Hence the research literature has found extensive and positive psychological and psychoneuroimmunological effects of mindfulness practices on breast cancer survivors. The association of psychoneuroimmunological effects with the psychological benefits of the practices is striking and suggests that there may be links between the two, but causation cannot be conclusively determined. But, nevertheless, mindfulness practices appear to both improve psychological health and also the body’s ability to withstand stress and reduce inflammation. These are very positive benefits that suggest that mindfulness practices are a safe and effective treatment for breast cancer survivors. It remains for future research to investigate possible causal connections.

 

So, improve the physical and psychological state of breast cancer survivors with mindfulness.

 

“Mindfulness meditation seems to help breast cancer patients better manage symptoms of fatigue, anxiety and fear of recurrence.” – Kathleen Doheny

 

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 Twitter @MindfulResearch

 

Study Summary

Hulett, J. M., & Armer, J. M. (2016). A Systematic Review of Spiritually Based Interventions and Psychoneuroimmunological Outcomes in Breast Cancer Survivorship. Integrative Cancer Therapies, 15(4), 405–423. http://doi.org/10.1177/1534735416636222

 

Abstract

Objective: This is a review of spiritually based interventions (eg, mindfulness-based stress reduction) that utilized psychoneuroimmunological (PNI) outcome measures in breast cancer survivors. Specifically, this review sought to examine the evidence regarding relationships between spiritually based interventions, psychosocial-spiritual outcomes, and biomarker outcomes in breast cancer survivors.

Methods: A systematic search of 9 online databases was conducted for articles of original research, peer-reviewed, randomized and nonrandomized control trials from 2005–2015. Data were extracted in order to answer selected questions regarding relationships between psychosocial-spiritual and physiological measures utilized in spiritually based interventions. Implications for future spiritually based interventions in breast cancer survivorship are discussed.

Results: Twenty-two articles were reviewed. Cortisol was the most common PNI biomarker outcome studied. Compared with control groups, intervention groups demonstrated positive mental health outcomes and improved or stable neuroendocrine-immune profiles, although limitations exist. Design methods have improved with regard to increased use of comparison groups compared with previous reviews. There are few spiritually based interventions that specifically measure religious or spiritual constructs. Similarly, there are few existing studies that utilize standardized religious or spiritual measures with PNI outcome measures. Findings suggest that a body of knowledge now exists in support of interventions with mindfulness-breathing-stretching components; furthermore, these interventions appear to offer potential improvement or stabilization of neuroendocrine-immune activity in breast cancer survivors compared to control groups.

Conclusion: From a PNI perspective, future spiritually based interventions should include standardized measures of religiousness and spirituality in order to understand relationships between and among religiousness, spirituality, and neuroendocrine-immune outcomes. Future research should now focus on determining the minimum dose and duration needed to improve or stabilize neuroendocrine-immune function, as well as diverse setting needs, including home-based practice for survivors who are too ill to travel to group sessions or lack economic resources.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125023/

 

Lessen Cognitive Problems Following Breast Cancer with Yoga

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By John M. de Castro, Ph.D.

 

““If you or your relatives are trying to improve your memory or offset the risk for developing memory loss or dementia, a regular practice of yoga and meditation could be a simple, safe and low-cost solution to improving your brain fitness,” – Helen Lavretsky

 

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 a death sentence. It is encouraging that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.

 

Unfortunately, even after successful treatment residual physical, psychological, and cognitive problems still persist and most of these residual problems go untreated. So, safe and effective treatments for these residual symptoms in breast cancer survivors are needed. Mindfulness training in general has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. The mindfulness practice of Yoga has also been shown to be helpful with the residual symptoms. In today’s Research News article Yoga and Self-Reported Cognitive Problems in Breast Cancer Survivors: A Randomized Controlled Trial “.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1434567009900554/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405403/

Derry and colleagues investigate the effectiveness of yoga practice on relieving the residual cognitive symptoms of breast cancer survivors.

 

They recruited women who had completed breast cancer treatment from 2-months to 3 years previously and randomly assigned them to either a wait-list control condition or to receive a 12-week Hatha yoga training. They received training twice a week for 90 minutes. Yoga participants were encouraged to continue yoga practice after training but no further classes or instruction were provided. The participants were measured before and after the 12-week treatment and 3 months later for cognitive symptoms (forgetfulness, difficulty concentrating, and being easily distracted), depression, anxiety, sleep quality, fatigue, inflammation, and general activity.

 

They found that the yoga treatment produced a significant decrease in anxiety, depression, fatigue and inflammation and improved sleep quality. Importantly, they found that the yoga practice produced a significant reduction in cognitive complaints (forgetfulness, difficulty concentrating, and being easily distracted), in comparison to the wait-list group, 3 months after completion of training but not immediately after training. This improvement was still present and significant even after taking into consideration the improvements in psychological distress, fatigue, and sleep quality. Hence, Yoga practice improved the physical, psychological, and cognitive residual symptoms in breast cancer survivors.

 

These results are interesting and important. They suggest that yoga practice is a safe and effective treatment for the residual symptoms that remain after successful treatment for breast cancer. Yoga practice has been shown to have a wide array of positive benefits for healthy and unhealthy practitioners. The present study adds to the list of patients who are helped by practicing yoga. It should be noted that yoga is a gentle exercise and there was no comparison to other exercises. So, it cannot be determined if it was the exercise in general or yoga in particular that produces the benefits.

 

So, lessen cognitive problems following breast cancer with yoga.

 

“The breathing and meditative exercises aim at calming the mind and body and keeping distracting thoughts away while you focus on your body, posture or breath. Maybe these processes translate beyond yoga practice when you try to perform mental tasks or day-to-day activities. . . meditation and breathing exercises are known to reduce anxiety and stress, which in turn can improve scores on some cognitive tests,” – Neha Gothe.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Derry, H. M., Jaremka, L. M., Bennett, J. M., Peng, J., Andridge, R., Shapiro, C., … Kiecolt-Glaser, J. K. (2015). Yoga and Self-Reported Cognitive Problems in Breast Cancer Survivors: A Randomized Controlled Trial. Psycho-Oncology, 24(8), 958–966. http://doi.org/10.1002/pon.3707

 

Abstract

Objectives: Cancer survivors often report cognitive problems. Furthermore, decreases in physical activity typically occur over the course of cancer treatment. Although physical activity benefits cognitive function in non-cancer populations, evidence linking physical activity to cognitive function in cancer survivors is limited. In our recent randomized controlled trial, breast cancer survivors who received a yoga intervention had lower fatigue and inflammation following the trial compared to a wait-list control group. This secondary analysis of the parent trial addressed yoga’s impact on cognitive complaints.

Methods: Post-treatment stage 0 – IIIA breast cancer survivors (N = 200) were randomized to a 12-week twice-weekly Hatha yoga intervention or a wait-list control group. Participants reported cognitive complaints using the Breast Cancer Prevention Trial (BCPT) Cognitive Problems scale at baseline, immediately post-intervention, and 3-month follow-up.

Results: Cognitive complaints did not differ significantly between groups immediately post-intervention (p = .250). However, at the 3-month follow-up, yoga participants’ BCPT Cognitive Problems scores were an average of 23% lower than wait-list participants’ scores (p = .003). These group differences in cognitive complaints remained after controlling for psychological distress, fatigue, and sleep quality. Consistent with the primary results, those who practiced yoga more frequently reported significantly fewer cognitive problems at the 3-month follow-up than those who practiced less frequently (p < 0.001).

Conclusions: These findings suggest that yoga can effectively reduce breast cancer survivors’ cognitive complaints, and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405403/

 

Lower Stress and Improve Mood with Cancer with Mindfulness

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By John M. de Castro, Ph.D.

 

“Through Mindfulness, you can embrace that staying positive in the face of cancer includes recognizing and validating all the feelings you are experiencing, negative ones included.” – Richard Dicken

 

Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. 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. Unfortunately, most of these residual problems go untreated. Psychologically, 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.

 

So, coping with the emotions and stress of cancer is a challenge and there are no simple treatments for these psychological sequelae of surviving cancer. Mindfulness training, however, may be helpful. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions. One form of mindfulness training, Mindfulness-Based Stress Reduction (MBSR) was specifically designed to help people cope with stress and emotions. In today’s Research News article “Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1410585555632033/?type=3&theater

or see summary below: Rush and Sharma reviewed the published research literature on the effectiveness of MBSR for the treatment of stress and negative mood in cancer patients (13 articles). They found that the majority of studies indicate that Mindfulness-Based Stress Reduction (MBSR) is significantly effective in improving mood and reducing stress in cancer patients.

 

Hence, the published research literature indicates that MBSR is a safe and effective treatment for the psychological issues consequent upon cancer diagnosis and treatment. MBSR contains a number of components including meditation, yoga, and body scan. The literature does not isolate which components or which combination of components are necessary for MBSR’s effectiveness. The literature also does not identify what changes produced by this practice underlie its reduction in stress responses and improves mood. But, it can be speculated that the focus on the present moment is crucial. Ruminations about the past and worries about the future can by themselves impair mood and increase stress in cancer patients. So, it is possible that the focus on present moment awareness in MBSR is the crucial process, allowing the patients to focus on their present problems without amplifying them through worry and rumination. These are important questions for future research.

 

MBSR reduces both the physiological and psychological responses to stress. Since stress can exacerbate all of the symptoms of cancer treatment and can reduce the body’s ability to cope with the disease, improvement in the stress response is extremely important to enduring and recovering from cancer and its treatment. In addition, a positive mood can help the individual relax and cope with the difficulties of cancer treatment. So, the reduction in stress and the improvement in mood produced by MBSR likely improves the prognosis for cancer patients and may lead to a greater likelihood of remission and even survival.

 

So, lower stress and improve mood with cancer with mindfulness.

 

“meditation can help to relieve particular symptoms and improve quality of life for people with cancer. Research has shown that it can improve your mood, improve your ability to concentrate, reduce severe depression and anxiety, and boost the immune system.” – Cancer Research UK
CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Rush SE, Sharma M. Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care: A Systematic Review. J Evid Based Complementary Altern Med. 2016 Aug 3. pii: 2156587216661467. [Epub ahead of print]

 

Abstract

Cancer is acknowledged as a source of stress for many individuals, often leading to suffering, which can be long-lasting. Mindfulness-based stress reduction offers an effective way of reducing stress among cancer patients by combining mindfulness meditation and yoga in an 8-week training program. The purpose of this study was to inspect studies from October 2009 to November 2015 and examine whether mindfulness-based stress reduction can be utilized as a viable method for managing stress among cancer patients. A systematic search from Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving mindfulness-based stress reduction interventions targeting cancer patients. A total of 13 articles met the inclusion criteria. Of these 13 studies, 9 demonstrated positive changes in either psychological or physiological outcomes related to anxiety and/or stress, with 4 describing mixed results. Despite the limitations, mindfulness-based stress reduction appears to be promising for stress management among cancer patients.

 

Improve the Physical Discomfort from Cancer Treatment with Yoga

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yoga-cancer2-peppone

 

By John M. de Castro, Ph.D.

 

“Cancer patients who practice yoga as therapy during their treatment often refer to their yoga practice as a life-saver. No matter how sick from treatments and no matter how little energy, many find that the one thing that would bring relief were a gentle set of therapeutic yoga poses geared for cancer patients.” – Yoga U

 

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 a death sentence. It is encouraging that the 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). In addition, breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image.

 

Treatments often involve aromatase inhibitor therapy which have been shown to be beneficial for survival and reduced rates of reoccurrence, but produce problematic side effects such as joint pain and stiffness, bone loss, and menopausal symptoms. This can lead to patients not adhering to, or even discontinuing treatments. So there is a need for safe and effective treatment for these side effects. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Indeed, yoga practice has been found to improve sleep quality and memory, reduce the side effects from chemotherapy and improve the quality of life in cancer survivors. So, it makes sense to see if yoga can help to improve the side effects of aromatase inhibitor therapy in breast cancer survivors.

 

In today’s Research News article “The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1401246889899233/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

Peppone and colleagues recruited breast cancer survivors who were receiving aromatase inhibitor therapy and randomly assigned them to either participate in a twice a week, 75-minute session, 4-week community based yoga training or to receive treatment as usual. Participants were measured for musculoskeletal symptoms both before and after treatment. They found that the yoga treatment group relative to controls improved significantly on almost all measured dimensions of musculoskeletal symptoms, including pain, illness, time in bed, fatigue, muscle aches, arm weakness, sluggishness, and physical ability.

 

These results are very encouraging and suggest that yoga practice may be a safe and effective treatment for the musculoskeletal side effects of aromatase inhibitor therapy for breast cancer survivors. This is important not just for the comfort of the patients, but for their compliance with treatment and ultimate survival. This adds to the long list of beneficial effects of yoga practice. It would be expected that these women would not only have improved side effects but also receive a myriad of other physical and psychological benefits from the yoga practice.

 

So, improve the physical discomfort from cancer treatment with yoga.

 

“one of the main reasons that people with cancer use yoga is because it makes them feel good. Yoga teachers promote it as a natural way to help you relax and cope with stress, anxiety and depression. Generally, it can help to lift your mood and enhance well being. Some people with cancer who have used yoga say that it helps calm their mind so that they can cope better with their cancer and its treatment. Others say that it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression. Yoga can sometimes help you to move around more quickly and easily after surgery for cancer.” Cancer Research UK
CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Peppone, L. J., Janelsins, M. C., Kamen, C., Mohile, S. G., Sprod, L. K., Gewandter, J. S., … Mustian, K. M. (2015). The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research and Treatment, 150(3), 597–604. http://doi.org/10.1007/s10549-015-3351-1

 

Abstract

Up to 50 % of breast cancer survivors on aromatase inhibitor therapy report musculoskeletal symptoms such as joint and muscle pain, significantly impacting treatment adherence and discontinuation rates. We conducted a secondary data analysis of a nationwide, multisite, phase II/III randomized, controlled, clinical trial examining the efficacy of yoga for improving musculoskeletal symptoms among breast cancer survivors currently receiving hormone therapy (aromatase inhibitors [AI] or tamoxifen [TAM]). Breast cancer survivors currently receiving AI (N = 95) or TAM (N = 72) with no participation in yoga during the previous 3 months were randomized into 2 arms: (1) standard care monitoring and (2) standard care plus the 4-week yoga intervention (2×/week; 75 min/session) and included in this analysis. The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS©®) program consisting of breathing exercises, 18 gentle Hatha and restorative yoga postures, and meditation. Musculoskeletal symptoms were assessed pre- and post-intervention. At baseline, AI users reported higher levels of general pain, muscle aches, and total physical discomfort than TAM users (all P ≤ 0.05). Among all breast cancer survivors on hormonal therapy, participants in the yoga group demonstrated greater reductions in musculoskeletal symptoms such as general pain, muscle aches and total physical discomfort from pre-to post-intervention than the control group (all P ≤ 0.05). The severity of musculoskeletal symptoms was higher for AI users compared to TAM users. Among breast cancer survivors on hormone therapy, the brief community-based YOCAS©® intervention significantly reduced general pain, muscle aches, and physical discomfort.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467273/

 

Improve Quality of Life during and after Radiotherapy with Yoga

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By John M. de Castro, Ph.D.

 

“When you say yoga, some people think of standing on their heads, but it’s the non-physical aspects of yoga, such as breathing, that are fundamental to healing.” – Jnani Chapman

 

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 a death sentence. It is encouraging that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.

 

But treatments for breast cancer can be difficult on the patient markedly reducing their mental and physical quality of life. Chemotherapy or radiotherapy can produce increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image. With the loss of a breast or breasts, scars, hair shedding, complexion changes and weight gain or loss many young women feel ashamed or afraid that others will reject or feel sorry for them. As a result, breast 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.

 

Unfortunately, most of these residual problems often go untreated. So, safe and effective treatments for the effects of radiotherapy on breast cancer patients are needed. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Yoga has also been shown to be helpful with the residual symptoms. In today’s Research News article “Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1348160035207919/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972683/

Ratcliff and colleagues recruited women diagnosed with breast cancer and scheduled to undergo radiotherapy for 6-weeks. They were randomly assigned to receive either yoga practice, stretching, or to a wait list while receiving treatment as usual. The yoga group and the stretching group practiced 3 times per week for 60 minutes during the 6-weeks of radiotherapy. Measurements were taken before treatment during the last week of radiotherapy and 1, 3, and 6 months later of health related quality of life, depression, sleep disturbance, posttraumatic stress symptoms, benefits finding, and salivary cortisol levels.

 

They found that the greater the distress prior to treatment the greater the effect of yoga practice.

Women who were high in sleep disturbance and depression prior to treatment showed the greatest improvement in mental health related quality of life with the effect getting stronger 3 and 6 months following treatment. This suggests that yoga practice has the greatest impact when the women are particularly distressed before treatment and the effects are lasting. They also found that yoga practice led to increased benefits finding, that is to increased acceptance of life’s imperfections, change in priorities, and development of a sense of purpose in life as a result of having been diagnosed with cancer. This increased benefits finding at 3-months led to improvements in physical health related quality of life at 6-months.

 

These results are interesting and demonstrate that yoga practice can be of benefit to women with breast cancer undergoing radiotherapy, improving their mental and physical health related quality of life. Yoga practice appears to be most beneficial to women who have the most problems with sleep and depression before treatment and the benefits appear to be lasting. So yoga practice helps the most those who need it the most. Yoga practice appears to work, in part, by improving the patient’s ability to find benefits in being diagnosed with cancer.

 

So, improve quality of life during and after radiotherapy with yoga.

 

“Yoga is known as a great way to ease stress and boost the body’s immune system. But it can be another way to fight chemo-related nausea and vomiting. And that’s not all. The gentle stretching and movement of yoga might give you more energy and help you sleep better.” –  Amanda Gardner

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Ratcliff, C. G., Milbury, K., Chandwani, K. D., Chaoul, A., Perkins, G., Nagarathna, R., … Cohen, L. (2016). Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy. Integrative Cancer Therapies, 15(3), 250–262. http://doi.org/10.1177/1534735415624141

 

Abstract

Hypothesis

This study examines moderators and mediators of a yoga intervention targeting quality-of-life (QOL) outcomes in women with breast cancer receiving radiotherapy.

Methods

Women undergoing 6 weeks of radiotherapy were randomized to a yoga (YG; n = 53) or stretching (ST; n = 56) intervention or a waitlist control group (WL; n = 54). Depressive symptoms and sleep disturbances were measured at baseline. Mediator (posttraumatic stress symptoms, benefit finding, and cortisol slope) and outcome (36-item Short Form [SF]-36 mental and physical component scales [MCS and PCS]) variables were assessed at baseline, end-of-treatment, and 1-, 3-, and 6-months posttreatment.

Results

Baseline depressive symptoms (P = .03) and sleep disturbances (P < .01) moderated the Group × Time effect on MCS, but not PCS. Women with high baseline depressive symptoms in YG reported marginally higher 3-month MCS than their counterparts in WL (P = .11). Women with high baseline sleep disturbances in YG reported higher 3-months MCS than their counterparts in WL (P < .01) and higher 6-month MCS than their counterparts in ST (P = .01). YG led to greater benefit finding than ST and WL across the follow-up (P = .01). Three-month benefit finding partially mediated the effect of YG on 6-month PCS. Posttraumatic stress symptoms and cortisol slope did not mediate treatment effect on QOL.

Conclusion

Yoga may provide the greatest mental-health–related QOL benefits for those experiencing pre-radiotherapy sleep disturbance and depressive symptoms. Yoga may improve physical-health–related QOL by increasing ability to find benefit in the cancer experience.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972683/

 

Improve Elderly Cancer Survivors’ Health with Tai Chi

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By John M. de Castro, Ph.D.

 

“A growing body of carefully conducted research is building a compelling case for tai chi as an adjunct to standard medical treatment for the prevention and rehabilitation of many conditions commonly associated with age.” – Peter M. Wayne

 

Modern medicine has markedly improved the treatments for cancer. But, unfortunately, these treatments themselves can be difficult on the patient and produce great discomfort and suffering. In addition, if the treatment is successful, the cancer survivor is left with a whole different set of challenges. Fatigue accompanies cancer and its treatment in from half to all cancer patients depending upon the type of cancer and treatment regimen. The lasting impact of the cancer and its treatment are particularly evident and dangerous for the elderly. “Senior cancer survivors are a particularly vulnerable population because they have an increased risk for the development or progression of chronic diseases (e.g., cardiovascular, hypertension, stroke, Type 2 diabetes mellitus, arthritis, etc). . .  In senior cancer survivors, this is highly relevant as twice as many deaths occur as a result of chronic diseases other than cancer, with cardiovascular disease emerging as a leading cause of death” (Campo et al. 2016).

 

Tai Chi has been practiced for thousands of years with benefits for health and longevity. Tai Chi training is designed to enhance function and regulate the activities of the body through regulated breathing, mindful concentration, and gentle movements. Only recently though have the effects of Tai Chi practice been scrutinized with empirical research. It has revealed that it is effective for an array of physical and psychological issues. It appears to strengthen the immune system, reduce inflammation and increase the number of cancer killing cells in the bloodstream. All of these effects suggest that Tai Chi may be effective for elderly cancer survivors.

 

In today’s Research News article “Blood Pressure, Salivary Cortisol, and Inflammatory Cytokine Outcomes in Senior Female Cancer Survivors Enrolled in a Tai Chi Chih Randomized Controlled Trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1329823277041595/?type=3&theater

or see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344390/

Campo and colleagues examine the effectiveness of Tai Chi practice to improve the health of elderly (>= 55 yrs.) female cancer survivors. The women were randomly assigned to receive 12 weeks of Tai Chi practice or Health Education for one hour three times per week. They were measured before and after training for blood pressure, salivary cortisol levels, and inflammatory cytokines. Campo and colleagues found that the Tai Chi group had a significantly greater reduction in systolic blood pressure (12%) and salivary cortisol levels (24%), but not inflammatory cytokines, than the Health Education group.

 

These are excellent findings. The fact that Tai Chi improved systolic blood pressure suggests that it improved cardiovascular health. This is particularly significant as cardiovascular disease is the greatest threat to the longevity of these vulnerable patients. The fact that Tai Chi reduced the salivary cortisol levels, an indicator of stress, suggests that Tai Chi reduced the levels of physiological stress in these patients which is also associated with decreased health and longevity. Hence, Tai Chi practice lowers chronic illness risk factors in elderly female cancer survivors.

 

It is known that exercise lowers cardiovascular and stress related risk factors and Tai Chi is a gentle exercise. This may be responsible for its effectiveness. Mindfulness practice is also known to reduce these risk factors. So, it is also possible that this is the reason for the effectiveness of Tai Chi practice. Regardless, Tai Chi is an almost perfect practice for elderly cancer survivors. It is gentle, has virtually no adverse side effects, and can be practiced in groups or alone at home at very low cost.

 

So, improve elderly cancer survivors’ health with tai chi.

 

“The gentle approach makes tai chi an ideal physical and mental exercise for cancer patients. The world of cancer treatment is filled with messages that tell patients to fight a war against their cancer, which can make them feel at war with their own bodies. Tai chi is particularly beneficial for anyone affected by cancer because it teaches people to respond peacefully and mindfully to forces out of their control.” – Michelle Whitmer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Campo, R. A., Light, K. C., O’Connor, K., Nakamura, Y., Lipschitz, D., LaStayo, P. C., … Kinney, A. Y. (2015). Blood Pressure, Salivary Cortisol, and Inflammatory Cytokine Outcomes in Senior Female Cancer Survivors Enrolled in a Tai Chi Chih Randomized Controlled Trial. Journal of Cancer Survivorship : Research and Practice, 9(1), 115–125. http://doi.org/10.1007/s11764-014-0395-x

Abstract

Purpose: Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, & cortisol) are important in this population. Tai Chi Chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases.

Methods: Sixty-three senior female cancer survivors (Mage=67 years, SD=7.15) with physical functioning limitations (SF-12 physical functioning≤80 or role-physical≤72) were randomized to 12-weeks (60-minutes, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention.

Results: Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP,p=0.002) and cortisol area-under-curve (AUC, p=0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p’s>0.05).

Conclusions: This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344390/

 

Reduce Anxiety and Depression Among Patients with Cancer with Mindfulness

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Mindfulness cancer2 Zhang

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is known to have a positive emotional and psychological impact on cancer survivors. But some groundbreaking new research has found that meditation is also doing its work on the physical bodies of cancer survivors, with positive impacts extending down to the cellular level.” – Carolyn Gregoire

 

Receiving a diagnosis of cancer can have a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing 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. But, cancer diagnosis is not a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly improving. It is estimated that 14,483,830 adults and children with a history of cancer alive in the United States today. So, there are a vast number of cancer survivors.

 

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. Unfortunately, most of these residual problems go untreated. Psychologically, 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.

 

Mindfulness training may be helpful for dealing with these psychological residual symptoms of cancer. It has been shown to improve recovery from cancer and to reduce anxiety and depression in people with a wide variety of conditions.  In today’s Research News article “Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1290482744308982/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Zhang and colleagues examine the published research literature investigating the effectiveness of mindfulness training for anxiety and depression in cancer patients. They report that the most common form of mindfulness training used in the published research for cancer were 8-week Mindfulness-Based Stress Reduction (MBSR) programs involving meditation, body scan and yoga practices. All studies examined contained a control condition, most commonly a treatment as usual wait-list group.

 

They found that the literature made a clear case that mindfulness based therapies produce significant improvements in both anxiety and depression in the cancer patients. Since mindfulness training involves training to focus on the present moment, it is easy to see how it could be effective against anxiety and depression. Anxiety involves fear of potential future problems while depression involves rumination about the past. The focus on what’s happening now, produced by mindfulness training, prevents thinking about the past producing depression and thinking about the future producing anxiety.

 

The findings in the research literature are important as depression causes great distress, impairs functioning, and might even make the person with cancer less able to follow their cancer treatment plan. In addition, high levels of anxiety are stressful, depleting the patient’s energy and reducing their ability to fight the cancer or other potential infections. Hence the ability of mindfulness training to reduce the depression and anxiety is important for not only the patients’ mental health but also for their physical ability to fight the cancer.

 

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

 

“Cancer is not something that any of us would ever want to have happen to us, but it can be a tremendous opportunity to look at some of our conditioning. It can also be an opportunity to look deeply and make amends for some things we don’t like. We can come into a greater sense of peace with ourselves and with others.”  – Elana Rosenbaum

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Zhang, M.-F., Wen, Y.-S., Liu, W.-Y., Peng, L.-F., Wu, X.-D., & Liu, Q.-W. (2015). Effectiveness of Mindfulness-based Therapy for Reducing Anxiety and Depression in Patients with Cancer: A Meta-analysis. Medicine, 94(45), e0897. http://doi.org/10.1097/MD.0000000000000897

 

Abstract

Anxiety and depression are common among patients with cancer, and are often treated with psychological interventions including mindfulness-based therapy.

The aim of the study was to perform a meta-analysis of the effectiveness of mindfulness-based interventions for improving anxiety and depression in patients with cancer.

Medline, the Cochrane Library, EMBASE, and Google Scholar were searched. The randomized controlled trials designed for patients diagnosed with cancer were included. Mindfulness-based interventions were provided.

The outcomes assessed were the changes in anxiety and depression scores from before to after the intervention. The treatment response was determined by calculating the standardized mean difference (SMD) for individual studies and for pooled study results. Subgroup analyses by cancer type, type of therapy, and length of follow-up were performed.

Seven studies, involving 469 participants who received mindfulness-based interventions and 419 participants in a control group, were included in the meta-analysis. Mindfulness-based stress reduction and art therapy were the most common interventions (5/7 studies). All studies reported anxiety and depression scores. The pooled SMD of the change in anxiety significantly favored mindfulness-based therapy over control treatment (−0.75, 95% confidence interval −1.28, −0.22, P = 0.005). Likewise, the pooled SMD of the change in depression also significantly favored mindfulness-based therapy over control (−0.90, 95% confidence interval −1.53, −0.26, P = 0.006). During the length of follow-ups less than 12 weeks, mindfulness-based therapy significantly improved anxiety for follow-up ≤12 weeks after the start of therapy, but not >12 weeks after the start of therapy.

There was a lack of consistency between the studies in the type of mindfulness-based/control intervention implemented. Patients had different forms of cancer. Subgroup analyses included a relatively small number of studies and did not account for factors such as the severity of anxiety and/or depression, the time since diagnosis, and cancer stage.

Mindfulness-based interventions effectively relieved anxiety and depression among patients with cancer. However, additional research is still warranted to determine how long the beneficial effects of mindfulness-based therapy persist.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912240/

Improve Symptoms in Breast Cancer Survivors with Mindfulness

psyjdc 17 Comments

 

By John M. de Castro, Ph.D.

 

“The mindfulness elements of accepting things as they are, turning towards rather than away from difficult emotional experience, and embracing change as a constant are helpful antidotes to these difficult realities. The emotion-regulation strategies practiced in mindfulness-based interventions help to prevent worry about the future and rumination over past events, and allow people to live more fully in the present moment, regardless of what lies ahead. The inevitability of loss, change and eventual death are helpful to face in general, but are both more challenging and more powerful for people directly facing a life threat like cancer.” – Linda Carlson

 

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 a death sentence. It is encouraging that the 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. In addition, breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image. With the loss of a breast or breasts, scars, hair shedding, complexion changes and weight gain or loss many young women feel ashamed or afraid that others will reject or feel sorry for them. As a result, survivors often develop psychological symptoms of stress, anxiety, depression, and impaired cognitive functioning.

Psychologically, 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.

 

Unfortunately, most of these residual problems often go untreated. So, safe and effective treatments for the residual symptoms in breast cancer survivors are needed. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Most of the research, however, has been performed with postmenopausal women. But, 25% of breast cancer survivors are younger and premenopausal. In today’s Research News article “Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1252924528064804/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393338/

Bower and colleagues examine the efficacy of mindfulness training for premenopausal breast cancer survivors. They recruited premenopausal breast cancer survivors who had completed primary treatment at least 3 months prior to participation and randomly assigned them to either receive a 6-week Mindful Awareness Practice program or to a wait-list control group. The participants were assessed with a battery of psychological tests. They also measured a set of genetic markers of inflammation. Assessments were performed before and 1-2 weeks after treatment and also 3 months later.

 

They found that mindfulness training produced significant improvements in the patients’ psychological state. In comparison to control participants, the mindfulness training group had significant decreases in perceived stress, depression, fatigue, subjective sleep disturbance, and hot flashes/night sweats, and significant increases in positive emotions, peace and meaning. For the most part the effects were not maintained at 3-month follow-up. In addition, the mindfulness training appeared to decrease inflammation as the mindfulness trained group showed a reduction in pro-inflammatory genetic markers and an increase in anti-inflammatory genetic markers.

 

These results are encouraging and suggest that the psychological well-being and inflammation can be improved with mindfulness training for premenopausal breast cancer survivors. Previous studies have demonstrated that mindfulness training with healthy individuals improves their psychological and emotional state and reduces inflammation. These results suggest that breast cancer survivors benefit as well. These improvements are particularly important for the breast cancer survivors as they are generally struggling with the psychological, emotions, and physical ramifications of their diagnosis and treatment. It is reassuring that mindfulness training can help.

 

Of concern is the fact that the psychological treatment effects were not maintained 3-months later. It is unclear if the women maintained their mindfulness practices following training as they were encouraged to do. It is possible that more encouragement and perhaps booster sessions may be needed to maintain the benefits.

 

Regardless, improve symptoms in breast cancer survivors with mindfulness.

 

“We already know that psychosocial interventions like mindfulness meditation will help you feel better mentally, but now for the first time we have evidence that they can also influence key aspects of your biology.”  – Dr. 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

 

Study Summary

Bower, J. E., Crosswell, A. D., Stanton, A. L., Crespi, C. M., Winston, D., Arevalo, J., … Ganz, P. A. (2015). Mindfulness meditation for younger breast cancer survivors: A randomized controlled trial. Cancer, 121(8), 1231–1240. http://doi.org/10.1002/cncr.29194

 

Abstract

Purpose: Premenopausal women diagnosed with breast cancer are at risk for psychological and behavioral disturbances after cancer treatment. Targeted interventions are needed to address the needs of this vulnerable group.

Methods: This randomized trial provided the first evaluation of a brief mindfulness-based intervention for younger breast cancer survivors designed to reduce stress, depression, and inflammatory activity. Women diagnosed with early-stage breast cancer before age 50 who had completed cancer treatment were randomly assigned to a 6-week Mindful Awareness Practices (MAPS) intervention (n = 39) or wait-list control (n = 32). Participants completed questionnaires at pre- and post-intervention to assess stress and depressive symptoms (primary outcomes) as well as physical symptoms, cancer-related distress, and positive outcomes. Blood samples were collected to examine genomic and circulating markers of inflammation. Participants also completed questionnaires at a three-month follow-up.

Results: In linear mixed models, the MAPS intervention led to significant reductions in perceived stress (P = .004) and marginal reductions in depressive symptoms (P = .094), as well as significant reductions in pro-inflammatory gene expression (P = .009) and inflammatory signaling (P = .001) at post-intervention. Improvements in secondary outcomes included reduced fatigue, sleep disturbance, and vasomotor symptoms and increased peace and meaning and positive affect (Ps < .05). Intervention effects on psychological and behavioral measures were not maintained at three-month follow-up, though reductions in cancer-related distress were observed at this assessment.

Conclusions: A brief mindfulness-based intervention showed preliminary short-term efficacy in reducing stress, behavioral symptoms, and pro-inflammatory signaling in younger breast cancer survivors.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393338/