Cancer

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

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Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving 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 disturbance, fear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet 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. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

“Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

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

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/

 

Spirituality is Associated with the Long-Term Psychological Health of Cancer Survivors

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Spirituality is Associated with the Long-Term Psychological Health of Cancer Survivors

 

By John M. de Castro, Ph.D.

 

“spiritual or religious beliefs and practices create a positive mental attitude that may help a patient feel better and improve the well-being of family caregivers. Spiritual and religious well-being may help improve health and quality of life.” – National Cancer Institute

 

Surviving 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 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 surviving cancer is a challenge and there are no simple treatments for these psychological sequelae of cancer.

 

Religion and spirituality become much more important to people when they survive cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality may be useful for the survivors of cancer to cope with their illness and the psychological difficulties resulting from the disease. Thus, there is a need to study the relationships of spirituality on the long-term psychological health of cancer survivors.

 

In today’s Research News article “The Influence of Daily Spiritual Experiences and Gender on Subjective Well-Being Over Time in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500286/ ) Rudaz and colleagues garnered data from the longitudinal Midlife in the United States (MIDUS) study

of adults that was collected in 2005 and again in 2015. They selected participants who reported having survived cancer and extracted data on spiritual and religious coping, daily spiritual experiences, life satisfaction, positive emotions, and negative emotions.

 

They report that for both men and women the higher the levels of spiritual experiences at baseline the higher the levels of religious coping, life satisfaction, and positive emotions, and the lower the levels of negative emotions at baseline and 10 years later. In addition, they found that spiritual experiences at baseline moderated the association of life satisfaction at baseline with life satisfaction 10 years later such that participants with low life satisfaction at baseline had a greater increase in life satisfaction 10 years later when they were higher in spiritual experiences. Also, they found that for men but not women that spiritual experiences at baseline moderated the association of positive emotions at baseline with positive emotions 10 years later such that men with low positive emotions at baseline had a greater increase in positive emotions 10 years later when they were higher in spiritual experiences.

 

These results are correlational and as such causation cannot be determined. But they show that cancer survivors having high levels of spirituality is associated with better psychological health and this is maintained over time. They also show that spirituality is associated with better psychological health 10 years later in cancer survivors who were low in life satisfaction and positive emotions. Hence, spirituality is important for the psychological health of cancer survivors and this lasts over decades.

 

So, spirituality is associated with the long-term psychological health of cancer survivors.

 

“Patients reporting greater overall religiousness and spirituality also reported better physical health, greater ability to perform their usual daily tasks, and fewer physical symptoms of cancer and treatment.” – Science Daily

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Rudaz, M., Ledermann, T., & Grzywacz, J. G. (2019). The Influence of Daily Spiritual Experiences and Gender on Subjective Well-Being Over Time in Cancer Survivors. Archive for the psychology of religion = Archiv fur Religionspsychologie, 41(2), 159–171. https://doi.org/10.1177/0084672419839800

 

Abstract

Cancer survivors are at risk for poor subjective well-being, but the potential beneficial effect of daily spiritual experiences is unknown. Using data from the second and third wave of the Midlife in the United States (MIDUS) study, we examined the extent to which daily spiritual experiences at baseline moderate the association between subjective well-being at baseline and approximately 10 years later in cancer survivors (n = 288). Regression analyses, controlled for age, educational attainment, and religious/spiritual coping, showed that daily spiritual experiences moderated the association between life satisfaction at baseline and follow-up. Specifically, high spiritual experiences enhanced life satisfaction over time in cancer survivors with low life satisfaction at baseline. Also, daily spiritual experiences moderated the association between positive affect at baseline and follow-up, though this moderating effect was different for women and men. No moderating effect emerged for negative affect.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500286/

 

Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses

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Dyadic Mindfulness Training Improves the Mental Health of Metastatic Cancer Patients and their Spouses

 

By John M. de Castro, Ph.D.

 

“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. Even occasional mindfulness practice can help provide a break from the stress of cancer and fill patients with a sense of calm to confront the challenges they face.” – 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 dealing with cancer. These issues extend not just to the patient but also to their partners in life. These symptoms markedly reduce the quality of life of both.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. But cancer does not occur in isolation. It effects both the patient but also their significant others. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. But there is little research on treating the cancer patients and their spouses in mindfulness as dyads.

 

In today’s Research News article “A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648356/ ) Milbury and colleagues recruited adult patients undergoing treatment for metastatic non‐small cell lung cancer and their romantic partners. Couples were randomly assigned to usual care or to receive 4 one-hour sessions via videoconference of either couple-based meditation or supportive-expressive practice. Couple-based meditation incorporated meditation and couple’s emotion sharing exercises. Supportive-expressive practice involved discussion of cancer-related issues that couples share. They were measured before and after treatment and 3 months later for depression, cancer-related stress symptoms, and spiritual well-being.

 

Attendance was high in both groups but the couple-based meditation reported that the sessions were more beneficial than the supportive-expressive practice group. They found that in comparison to baseline and the other groups at the 3-month follow-up the couple-based meditation patients and their significant others had significantly lower depression and cancer-related stress symptoms and higher spiritual well-being.

 

A strength of the study is that it had an active control condition, supportive-expressive practice, that contained therapeutic elements, expectancy effects and similar attention features to the couple-based meditation practice. This reduces the possibility of confounding variable being responsible for the results and suggests that the effects were due to the nature of the therapy. Another key aspect of this study is that the therapy was delivered via videoconference which may be responsible for the high attendance rates. This form of delivery is very convenient and flexible making it more likely to be effective.

 

There are great psychological and emotional problems co-occurring with cancer treatment for the patient and also for the patient’s romantic partner. So, these results are interesting and important suggesting that couple-based meditation practice can help relieve the suffering. The fact that the romantic partner was included was very important as the cancer effects both members of the dyad. Treating both prevents the suffering of one from interfering with the therapy for the other.

 

So, dyadic mindfulness training improves the mental health of metastatic cancer patients and their spouses.

 

“Being in this present moment, letting go, practicing non-attachment and acceptance are so helpful in dealing with uncertainty and fear. Mindfulness is something that they use for the rest of their lives for really great benefit.” – 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

 

Milbury, K., Li, Y., Durrani, S., Liao, Z., Tsao, A. S., Carmack, C., Cohen, L., & Bruera, E. (2020). A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial. The oncologist, 25(11), e1794–e1802. Advance online publication. https://doi.org/10.1634/theoncologist.2020-0125

 

Abstract

Background

Although mindfulness‐based interventions have been widely examined in patients with nonmetastatic cancer, the feasibility and efficacy of these types of programs are largely unknown for those with advanced disease. We pilot‐tested a couple‐based meditation (CBM) relative to a supportive‐expressive (SE) and a usual care (UC) arm targeting psychospiritual distress in patients with metastatic lung cancer and their spousal caregivers.

Patients and Methods

Seventy‐five patient‐caregiver dyads completed baseline self‐report measures and were then randomized to one of the three arms. Couples in the CBM and SE groups attended four 60‐minute sessions that were delivered via videoconference. All dyads were reassessed 1 and 3 months later.

Results

A priori feasibility benchmarks were met. Although attendance was high in both groups, dyads in the CBM group indicated greater benefit of the sessions than those in the SE group (patients, CBM mean = 2.63, SE mean = 2.20, p = .003; spouses, CBM mean = 2.71, SE mean = 2.00, p = .005). Compared with the UC group, patients in the CBM group reported significantly lower depressive symptoms (p = .05; d = 0.53) and marginally reduced cancer‐related stress (p = .07; d = 0.68). Medium effect sizes in favor of the CBM compared with the SE group for depressive symptoms (d = 0.59) and cancer‐related stress (d = 0.54) were found. Spouses in the CBM group reported significantly lower depressive symptoms (p < .01; d = 0.74) compared with those in the UC group.

Conclusion

It seems feasible and possibly efficacious to deliver dyadic interventions via videoconference to couples coping with metastatic lung cancer. Mindfulness‐based interventions may be of value to managing psychological symptoms in the palliative care setting

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648356/

 

Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

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Reduce Fatigue and Improve Quality of Life of Breast Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“For women with breast cancer, research shows those who practice yoga may also have less stress and fatigue, and better quality of life.” – Stacie Simon

 

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. 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 practices have been shown to improve the residual symptoms in cancer survivors.  Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. The research on yoga practice as a treatment for patients recovering from breast cancer has been accumulating. It is thus reasonable to take a step back and summarize what has been learned.

 

In today’s Research News article “The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/ ) O’Neill and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effects of yoga practice on the fatigue and quality of life of breast cancer survivors. They identified 24 published randomized controlled trials.

 

They report that the published trials revealed that yoga practice produced significant reductions in cancer related fatigue and increases in the women’s quality of life. This was true overall and for the 18 trials with a passive control group such as a wait-list control, but not for the 6 trials with an active control group, such as physical exercise or supportive therapy. Hence, yoga practice appears to be beneficial for breast cancer survivors reducing fatigue and improving quality of life. But the benefits are comparable to those produced by other exercises or therapies.

 

So, reduce fatigue and improve quality of life of breast cancer survivors with yoga.

 

“A targeted yoga intervention led to significant improvements in fatigue and vigor among breast cancer survivors with persistent fatigue symptoms.” – Julienne Bower

 

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

 

O’Neill, M., Samaroo, D., Lopez, C., Tomlinson, G., Santa Mina, D., Sabiston, C., Culos-Reed, N., & Alibhai, S. (2020). The Effect of Yoga Interventions on Cancer-Related Fatigue and Quality of Life for Women with Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Integrative cancer therapies, 19, 1534735420959882. https://doi.org/10.1177/1534735420959882

 

Abstract

Background:

Women with breast cancer (BC) are living longer with debilitating side effects such as cancer-related fatigue (CRF) that affect overall well-being. Yoga promotes health, well-being and may be beneficial in reducing CRF. Although there have been previous systematic reviews and meta-analyses, the effects of yoga on CRF and quality of life (QOL) remain unclear, particularly in comparison with other types of physical activity (PA). Our objective is to carry out a systematic review and meta-analysis of the effects of yoga on CRF and QOL in women with BC.

Methods:

Electronic databases were searched (MEDLINE, Embase Classic+Embase and EMB Reviews, Cochrane Central CT) from inception to May 2018. Randomized controlled trials were included if they were full text, in English, included a yoga intervention, a comparator (including non-PA usual care or alternate PA intervention), and reported on CRF or QOL. Effects of yoga were pooled using standardized mean difference (SMD) via a random effects model.

Results:

Of the 2468 records retrieved, 24 trials were included; 18 studies compared yoga to a non-PA comparator and 6 to a PA comparator. Yoga demonstrated statistically significant improvements in CRF over non-PA (SMD −0.30 [−0.51; −0.08]) but not PA (SMD −0.17 [−0.50; 0.17]) comparators. Additionally, yoga demonstrated statistically significant improvements in QOL over non-PA (SMD −0.27 [−0.46; −0.07]) but not PA (SMD 0.04 [−0.22; +0.31]) comparators.

Discussion:

This meta-analysis found that yoga provides small to medium improvements in CRF and QOL compared to non-PA, but not in comparison to other PA interventions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580184/

 

Manage Symptoms in Cancer Survivors with Yoga

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Manage Symptoms in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

“when it’s used alongside conventional medical treatment, yoga may help relieve some of the symptoms linked to cancer.” – American Cancer Society

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery . Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. So, it’s reasonable to review what has been learned about the benefits of yoga practice to improve the residual symptoms of patients who have survived cancer.

 

In today’s Research News article “Yoga for symptom management in oncology: A review of the evidence base and future directions for research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/ ) Danhauer and colleagues review and summarize the published randomized controlled studies of the effectiveness of yoga practice for the treatment of the symptoms of cancer survivors. They identified 29 published randomized controlled trials, 13 conducted during treatment, 12 after treatment, and 4 both before and after.

 

They report that the published research found that yoga during treatment for cancer significantly improved the patient’s quality of life, including physical, emotional social, and cognitive quality of life. They also report that yoga significantly reduced fatigue, distress, perceived stress, and biomarkers of stress and inflammation. Yoga after treatment completion was found to significantly reduce fatigue and sleep disturbance and improve quality of life. There were no serious adverse events resulting from yoga practice reported.

 

The published research then suggests that yoga practice is a safe and effective treatment both during and after cancer treatment for the relief of the patients’ residual physical and psychological symptoms. Yoga practice is a complex of practices that includes postures, breath control, and meditation. It has not been clearly established which of these components or which combination of components are required for the benefits. So, conclusions cannot be made regarding mechanisms of action by which yoga produces its benefits. But it can be concluded that yoga practice is very beneficial for cancer sufferers.

 

So, manage symptoms in cancer survivors with yoga.

 

“yoga can combat fatigue and improve strength and range of motion for patients undergoing cancer treatment,” – Dr. Maggie DiNome

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Danhauer, S. C., Addington, E. L., Cohen, L., Sohl, S. J., Van Puymbroeck, M., Albinati, N. K., & Culos-Reed, S. N. (2019). Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer, 125(12), 1979–1989. https://doi.org/10.1002/cncr.31979

 

Abstract

As yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. We reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N=29; n=13 during treatment, n=12 post-treatment, n=4 with mixed samples). Findings both during and after treatment demonstrated efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results additionally suggest that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. A number of RCTs showed evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (e.g., anxiety, depression, pain, cancer-specific symptoms such as lymphedema, positive psychological outcomes such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541520/

 

Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

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Improve Mindfulness’ Benefits for Cancer Survivors with Smart-Messaging

 

By John M. de Castro, Ph.D.

 

“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

 

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 depression. Mindfulness-Based Cognitive Therapy (MBCT) consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to cancer. MBCT has been found to help relieve the symptoms of cancer survivors. It makes sense to explore ways to improve the effectiveness of MBCT for cancer patients.

 

In today’s Research News article “Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/ ) Wells and colleagues evaluated whether providing text message reminders could enhance the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the relief of anxiety and depression in cancer patients. They recruited adult cancer patients with mild to moderate anxiety and/or depression and provided them with 8 weekly sessions of MBCT along with 40 minutes daily home practice. The patients could refuse messaging or opt to receive text messages 3 times per week reminding them of their home practice and could request up to 9 more messages per week. They were measured before and after each session and 1 month after the completion of the training for depression, anxiety, and general mental health.

 

They found that 87% of the patients receiving smart messaging completed the 8-week Mindfulness-Based Cognitive Therapy (MBCT) program while only 38% of the non-messaging patients completed the MBCT program. Both groups had significant reductions in anxiety and depression that were maintained 1 month after treatment. But the smart messaging group had significantly greater reductions in depression.

 

This is a proof of concept study which demonstrated that smart messaging could be effectively used in conjunction with Mindfulness-Based Cognitive Therapy (MBCT). The results, though, need to be interpreted with great caution. The patients decided whether to receive the messages or not and very different patients might have opted in compared those that refused the messaging. These differences in the groups could account for the observed differences in participation and depression. But this study establishes that this smart messaging method is feasible with cancer patients with suggestions of improved impact of the therapy. A randomized controlled trial is now needed.

 

So, improve mindfulness’ benefits for cancer survivors with smart-messaging.

 

“It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – 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

 

Wells, C., Malins, S., Clarke, S., Skorodzien, I., Biswas, S., Sweeney, T., Moghaddam, N., & Levene, J. (2020). Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation. Psycho-oncology, 29(1), 212–219. https://doi.org/10.1002/pon.5256

 

Abstract

Objective

Depression and anxiety lead to reduced treatment adherence, poorer quality of life, and increased care costs amongst cancer patients. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment, but dropout reduces potential benefits. Smart‐message reminders can prevent dropout and improve effectiveness. However, smart‐messaging is untested for MBCT in cancer. This study evaluates smart‐messaging to reduce dropout and improve effectiveness in MBCT for cancer patients with depression or anxiety.

Methods

Fifty‐one cancer patients attending MBCT in a psycho‐oncology service were offered a smart‐messaging intervention, which reminded them of prescribed between‐session activities. Thirty patients accepted smart‐messaging and 21 did not. Assessments of depression and anxiety were taken at baseline, session‐by‐session, and one‐month follow‐up. Logistic regression and multilevel modelling compared the groups on treatment completion and clinical effectiveness. Fifteen post‐treatment patient interviews explored smart‐messaging use.

Results

The odds of programme completion were eight times greater for patients using smart‐messaging compared with non‐users, controlling for age, gender, baseline depression, and baseline anxiety (OR = 7.79, 95% CI 1.75 to 34.58, p = .007). Smart‐messaging users also reported greater improvement in depression over the programme (B = ‐2.33, SEB = .78, p = .004) when controlling for baseline severity, change over time, age, and number of sessions attended. There was no difference between groups in anxiety improvement (B = ‐1.46, SEB = .86, p = .097). In interviews, smart‐messaging was described as a motivating reminder and source of personal connection.

Conclusions

Smart‐messaging may be an easily integrated telehealth intervention to improve MBCT for cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004102/

 

Mindfulness Improves Breast Cancer Symptoms in Women with Particular Genetic Polymorphisms

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Mindfulness Improves Breast Cancer Symptoms in Women with Particular Genetic Polymorphisms

 

By John M. de Castro, Ph.D.

 

“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

 

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 disturbance, fear of reoccurrence, and anxiety and depression. The genes are known to be highly involved in the development of cancer and mindfulness training has been shown to alter the genes. The genes differ considerably between different individuals. It is possible that mindfulness training may improve cancer symptoms in patients with particular genetic polymorphisms. Identifying these polymorphisms could then help in identifying patients who would respond best to mindfulness training.

 

In today’s Research News article “Translational genomic research: the role of genetic polymorphisms in MBSR program among breast cancer survivors (MBSR[BC]).” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184864/ ) Park and colleagues recruited adult women who were at least 2 weeks since the end of treatment for breast cancer and randomly assigned them to a usual care wait-list control condition or to receive 6 weekly 2-hour sessions of Mindfulness-Based Stress Reduction (MBSR) program. The program consists of discussion, meditation practice, body scan, and yoga along with daily home practice. They were measured before and after training and 6 weeks later for anxiety, depression, perceived stress, fatigue, pain, and quality of life.

 

At baseline blood was drawn for genetic analysis. They assayed the blood for 10 single-nucleotide polymorphisms (SNPs) that had been shown in the past to be associated with the symptoms of women recovering from breast cancer. They found that 3 SNPs, rs4680 in COMT, rs6314 in HTR2A, and rs429358 in APOE were associated with improvements in symptoms produced by the Mindfulness-Based Stress Reduction (MBSR) program. The symptom improvements associated with these SNPs were depression, fatigue, pain, and quality of life.

 

Mindfulness training has been shown to improve the residual symptoms present in women recovering from breast cancer. The present results suggest that the effectiveness of mindfulness training in improving these symptoms is different for women with different genetic profiles. These findings may prove useful in tailoring treatment for the women to maximize its impact. Women with single-nucleotide polymorphisms (SNPs), rs4680 in COMT, rs6314 in HTR2A, and rs429358 in APOE would be good candidates for treatment with Mindfulness-Based Stress Reduction (MBSR). Women without these SNPs may be better treated with other treatments.

 

So, mindfulness improves breast cancer symptoms in women with particular genetic polymorphisms.

 

“When used in a cancer setting, mindfulness can help patients cope with their disease and its treatment.” – Carrie Ernhout

 

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

 

Park, J. Y., Lengacher, C. A., Reich, R. R., Alinat, C. B., Ramesar, S., Le, A., Paterson, C. L., Pleasant, M. L., Park, H. Y., Kiluk, J., Han, H., Ismail-Khan, R., & Kip, K. E. (2019). Translational genomic research: the role of genetic polymorphisms in MBSR program among breast cancer survivors (MBSR[BC]). Translational behavioral medicine, 9(4), 693–702. https://doi.org/10.1093/tbm/iby061

 

Abstract

Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms, such as depression, stress, fatigue, and cognitive impairment. The objective of this study was to investigate whether particular single-nucleotide polymorphisms (SNPs) moderated symptom improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. An overarching goal of personalized medicine is to identify individuals as risk for disease and tailor interventions based on genetic profiles of patients with diseases including cancer. BCS were recruited from Moffitt Cancer Center and University of South Florida’s Breast Health Program and were randomized to either the 6-week MBSR(BC) program (n = 92) or Usual Care (n = 93). Measures of symptoms, demographic, and clinical history data were attained at baseline, 6 weeks, and 12 weeks. A total of 10 SNPs from eight genes known to be related to these symptoms were studied using genomic DNA extracted from blood. Our results were examined for effect sizes, consistency, and statistical significance (p < .05). Three SNPs (rs4680 in COMT, rs6314 in HTR2A, and rs429358 in APOE) emerged as having the strongest (though relatively weak) and most consistent effects in moderating the impact of the MBSR program on symptom outcomes. Although effects were generally weak, with only one effect withstanding multiple comparisons correction for statistical significance, this translational behavioral research may help start the identification of genetic profiles that moderate the impact of MBSR(BC). The ultimate goal of this study is the development of personalized treatment programs tailored to the genetic profile of each patient.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184864/

Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

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Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

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

 

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 disturbance, fear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. These practices work to relieve the emotional distress of cancer survivors.

 

A potential mechanism by which mind-body practices may relieve emotional distress is by altering the balance in the autonomic nervous system. A measure of this balance is Heart Rate Variability (HRV). It refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This all signals greater physiological relaxation.

 

In today’s Research News article “Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/ ) Larkey and colleagues recruited female breast cancer survivors and randomly assigned them to receive 12 weeks of either Tai Chi or Sham-Tai Chi practice. Sham-Tai Chi used the same movements but did not incorporate breath control or meditative states. They were measured before and after training for fatigue, sleep, and depression and the electrocardiogram was measured and analyzed for Heart Rate Variability (HRV).

 

They found that after Tai Chi Practice, but not Sham-Tai Chi, there were significant reductions in fatigue and depression and significant improvements in sleep. In addition, in the Tai Chi group there was a significant reduction in low coherence Heart Rate Variability (HRV). Also, the greater the change, over training, in high coherence HRV the greater the reduction in depression levels.

 

This study replicates previous findings that Tai Chi practice reduces fatigue, and depression, and improves sleep. And produces changes in Heart Rate Variability (HRV). But this study used a unique control, comparison, condition of Sham-Tai Chi that had the same movements but lacked the breath control and meditative state of true Tai Chi practice. This suggests that it is not the movements of Tai Chi that produces the benefits but the mindfulness components that are essential.

 

The study also presents some evidence as to the mechanism by which Tai Chi practice improves that physical and psychological state of cancer survivors. The observed changes in Heart Rate Variability (HRV) are indicative of greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This suggests that Tai Chi practice results in a physiological relaxation that in turn may be responsible for the physical and psychological benefits of the practice.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by cancer survivors.

 

So, improve autonomic nervous system function and well-being in cancer survivors with mind-body practices.

 

“Research in breast cancer patients has shown that tai chi may help to increase strength, balance, flexibility, heart and lung function, [and] feelings of well-being.” – Breast Cancer.org

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Larkey, L., Kim, W., James, D., Kishida, M., Vizcaino, M., Huberty, J., & Krishnamurthi, N. (2020). Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integrative cancer therapies, 19, 1534735420949677. https://doi.org/10.1177/1534735420949677

 

Abstract

Background:

Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization.

Methods:

HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction.

Results:

HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states.

Conclusion:

Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/

 

Improve the Physical and Psychological Well-Being of Cancer Survivors with Mind-Body Practices

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Improve the Physical and Psychological Well-Being of Cancer Survivors with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. . .  to help patients manage the psychosocial challenges of diagnosis and treatment of cancer.” – Alejandro Chaoul

 

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 disturbance, fear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. There have been a number of research studies conducted on the effectiveness of mind-body practices for the relief of the physical and mental symptoms of cancer survivors. So, it makes sense to summarize what has been learned.

 

In today’s Research News article “Effects of Mind-Body Exercise in Cancer Survivors: 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/PMC7487122/ ) Duan and colleagues

review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mind-body practices for the treatment of cancer survivors. They found 15 published controlled clinical trials including a total of 1461 patients.

 

They report that the published controlled clinical trials found that mind-body practices produced significant increases in physical fitness and sleep quality and decreases in fatigue, depression, anxiety, and body mass index. Of the different mind-body practices Tai Chi practice appears to be superior in decreasing fatigue and sleep problems, Qigong practice appears to be superior in increasing physical fitness, while yoga practice appears to be superior in decreasing depression and anxiety.

 

These results are important in that they demonstrate that mind-body practices are effective in relieving the psychological and physical symptoms present in cancer survivors. These findings are generalizable in that a wide variety of types of cancers with a wide variety of patients were included. This suggests that mind-body practices are applicable to relieving the suffering of cancer survivors in general.

 

The review suggested, however, that different mind-body practices may be superior in addressing specific symptoms. Qigong appears to be best for improving physical fitness, Tai Chi appears to be best for reducing sleep problems and fatigue, and yoga appears to be best for alleviating mental disorders. So, tailoring the program for the greatest problems experienced by specific cancer patients may maximize the benefits for the individual patient.

 

So, improve the physical and psychological well-being of cancer survivors with mind-body practices.

 

“Life with cancer can be stressful. . . Mind-body medicine helps you relax and buffer some of these effects. It can also help you manage your condition better.” – WebMD

 

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

 

Duan, L., Xu, Y., & Li, M. (2020). Effects of Mind-Body Exercise in Cancer Survivors: A Systematic Review and Meta-Analysis. Evidence-based Complementary and Alternative Medicine : eCAM, 2020, 7607161. https://doi.org/10.1155/2020/7607161

 

Abstract

Objective

Mind-body exercise may have potential benefits for cancer survivors according to previous studies. We performed a systematic review and meta-analysis to summarize the published evidence and evaluate the safety and efficacy of mind-body exercise on general quality of life (QOL) and symptom management in cancer survivors.

Methods

Four English language databases were systematically searched for existing randomized controlled trials (RCTs) of mind-body exercise in cancer survivors from database inception through October 23, 2019. Methodological quality was appraised with the Cochrane Risk of Bias tool. A meta-analysis of comparative effects was performed using the Review Manager v.5.3 software.

Results

Fifteen studies encompassing 1461 patients were included. Analysis results showed that mind-body exercise could have a statistically significant effect on the outcomes of physical fitness, fatigue, sleep quality, depression, anxiety, and BMI, while effects on general QOL and stress were not statistically significant (all p > 0.05). No serious adverse events were reported.

Conclusions

The current evidence demonstrates that mind-body exercise is relatively safe and modestly effective for symptom management in cancer survivors. Furthermore, randomized trials with larger sample sizes and of higher methodological quality are needed to confirm these results.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487122/

 

Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

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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.

Go to:

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