Reduce Fear of Cancer Return with Mind-Body Practices

Reduce Fear of Cancer Return with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

the mind and body are really one entity, not two separate parts. Stated simply, there is no separation or division between the mind, body, spirit, and emotions. The best stress management program is one that moves you from fear toward peace, however you understand that concept.” – Health Encyclopedia

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. Coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. But over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. Cancer survivors are also at greater risk for developing second cancers and other health conditions and as a result fear of cancer recurrence is a major problem that can interfere with recovery. Hence there is a need to identify safe and effective treatments to reduce fear of cancer return.

 

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. There has been considerable research conducted on the effectiveness of mind-body practices in treating fear of cancer return. So it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mind-body interventions for fear of cancer recurrence: 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/PMC6488231/), Hall and colleagues reviewed, summarized, and performed a meta-analysis of the published randomized controlled trials (RCTs) of the effects of mind-body practices on the fear of cancer recurrence. They included studies employing meditation, yoga, Tai Chi and Qigong, cognitive-behavioral skills, spirituality, relaxation, and various art therapies. They uncovered 18 published RCTs that included 2806 total participants.

 

They found that mind-body practices produced significant reduction in fear of cancer recurrence regardless of whether the comparison condition was an active control condition, whether the treatment occurred in group or individual format, whether the treatment contained cognitive behavioral skills or not, or whether the treatment contained meditation practice or not. These reductions were still present, albeit at reduced magnitude, up to 2 years after treatment.

 

Fear of cancer recurrence can produce behaviors that interfere with cancer recovery including increased stress, worry, rumination, etc. So, reducing this fear not only improves the psychological health of the patients but also improves their prognosis. These results suggest that mind-body are safe and effective, and have lasting effects reducing fear of cancer recurrence and thus should be incorporated in the treatments for patients recovering from cancer.

 

So, reduce fear of cancer return with mind-body practices.

 

“It is not usually possible for doctors to say for certain that your cancer has been cured. They can’t definitely say that it will never come back. Living with this uncertainty is one of the most difficult things about having cancer.” – 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 and on Twitter @MindfulResearch

 

Study Summary

 

Hall, D. L., Luberto, C. M., Philpotts, L. L., Song, R., Park, E. R., & Yeh, G. Y. (2018). Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis. Psycho-oncology, 27(11), 2546–2558. doi:10.1002/pon.4757

 

Abstract

Objective

Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind-body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR.

Methods

Six electronic databases were systematically searched from inception to May 2017, using a strategy that included multiple terms for RCTs, cancer, mind-body medicine, and FCR. Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled effect sizes on self-report measures of FCR were computed by using random-effects models.

Results

Nineteen RCTs (pooled N = 2806) were included. Most studies (53%) were published since 2015 and targeted a single cancer type (84%; mostly breast). Intervention sessions (median = 6, mode = 4) tended to last 120 minutes and occur across 1.5 months. Delivery was predominantly in-person (63%) to either groups (42%) or individuals (42%). Most interventions incorporated multiple mind-body components (53%), commonly cognitive-behavioral skills (58%), or meditative practices (53%). Small-to-medium pooled effect sizes were observed post-intervention (Hedges’ g = −0.36, 95% CI = −0.49, −0.23, P < .001) and at follow-up assessments (median = 8 months, P < .001). Potential modifiers (control group design, group/individual delivery, use of cognitive-behavioral or mindfulness skills, number of mind-body components, cancer treatment status, and number of sessions) did not reach statistical significance.

Conclusions

Mind-body interventions are efficacious for reducing FCR, with small-to-medium effect sizes that persist after intervention delivery ends. Recommendations include testing effects among survivors of various cancers and exploring the optimal integration of mind-body practices for managing fundamental uncertainties and fears during cancer survivorship.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488231/

 

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

It turns out that 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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: 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/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.

 

The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.

 

It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.

 

So, improve the physical and psychological health of cancer patients with mindfulness.

 

patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline

 

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

 

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214

 

Abstract

Objective

Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

Methods

Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

Results

Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

Conclusions

MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/

 

Improve Mental Health with Yoga Nidra and Meditation

Improve Mental Health with Yoga Nidra and Meditation

 

By John M. de Castro, Ph.D.

 

“Yoga nidra promotes deep rest and relaxation that isn’t found in your average meditation practice. The stages of body scan and breath awareness alone can be practiced to calm the nervous system, leading to less stress and better health.” – Allison Ray Jeraci

 

Meditation leads to concentration, concentration leads to understanding, and understanding leads to happiness” – This wonderful quote from the modern-day sage Thich Nhat Hahn is a beautiful pithy description of the benefits of meditation practice. Meditation allows us to view our experience and not put labels on it, not make assumptions about it, not relate it to past experiences, and not project it into the future. Rather meditation lets us experience everything around and within us exactly as it is arising and falling away from moment to moment.

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. Meditation techniques have common properties of restful attention on the present moment, but there are large differences. These differences are likely to produce different effects on the practitioner. Yoga Nidra is a deep relaxation technique where the practitioner lies on the back in a “corpse pose” and is guided through body scan and imagery into a deeply relaxed state. Meditation involves a more active and concentrated process on the part of the practitioner but also leads to relaxation. It is not known if these two different contemplative techniques have different effects on psychological health.

 

In today’s Research News article “The Impact of Yoga Nidra and Seated Meditation on the Mental Health of College Professors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134749/ ), Ferreira-Vorkapic and colleagues recruited healthy adults and randomly assigned them to either practice Yoga Nidra of meditation for 3 months, once a week for 45 minutes, or to a wait-list control. They were measured before and after training for anxiety, depression, fear, and perceived stress.

 

They found that in comparison to baseline and the wait-list control group, the participants who practiced either Yoga Nidra or meditation had significant reductions in anxiety, depression, fear, and perceived stress. There were no significant differences between the contemplative techniques on any of the measure of psychological health. Hence, the techniques would appear to be equally effective in improving the psychological state of the participants.

 

It should be mentioned that since the control condition did not receive any treatment and both treated groups had significant effects, that a subject expectancy (placebo effect), attention, of experimenter bias effects may account for the improvements. It is also possible that the techniques may produce different effects on variable that were not measured, as only negative mood states were measured and a variety of contemplative techniques have been shown to reduce anxiety, depression, fear, and perceived stress. Regardless, the present study demonstrates that the contemplative techniques of Yoga Nidra and meditation are effective in improving the psychological states of the practitioners.

 

So, improve mental health with Yoga Nidra and meditation.

 

“As you can imagine, feeling well rested is life changing, but yoga nidra also improves your overall health. A 2013 study showed that practicing yoga nidra improved anxiety, depression, and overall well-being.” – Karen Brody

 

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

 

Ferreira-Vorkapic, C., Borba-Pinheiro, C. J., Marchioro, M., & Santana, D. (2018). The Impact of Yoga Nidra and Seated Meditation on the Mental Health of College Professors. International journal of yoga, 11(3), 215-223.

 

Abstract

Background:

World statistics for the prevalence of anxiety and mood disorders shows that a great number of individuals will experience some type of anxiety or mood disorder at some point in their lifetime. Mind–body interventions such as Hatha Yoga and seated meditation have been used as a form of self-help therapy and it is especially useful for challenging occupations such as teachers and professors.

Aims:

In this investigation, we aimed at observing the impact of Yoga Nidra and seated meditation on the anxiety and depression levels of college professors.

Materials and Methods:

Sixty college professors, men and women, aged between 30 and 55 years were randomly allocated in one of the three experimental groups: Yoga Nidra, seated meditation, and control group. Professors were evaluated two times throughout the 3-month study period. Psychological variables included anxiety, stress, and depression.

Results:

Data analysis showed that the relaxation group presented better intragroup results in the anxiety levels. Meditation group presented better intragroup results only in the anxiety variable (physical component). Intergroup analysis showed that, except for the depression levels, both intervention groups presented better results than the control group in all other variables.

Conclusions:

Prepost results indicate that both interventions represent an effective therapeutic approach in reducing anxiety and stress levels. However, there was a tendency toward a greater effectiveness of the Yoga Nidraintervention regarding anxiety, which might represent an effective tool in reducing both cognitive and physiological symptoms of anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134749/

 

Improve Neuroticism with Mindfulness

Mindfulness Neuroticism2 Armstrong

By John M. de Castro, Ph.D.

 

“Self-deprecating comedians and complainers wear their neuroticism as a badge of honor. In truth, the negatively biased are more prone to depression, anxiety, self-consciousness and hypochondria, to name just a few behavioral tripwires. Neuroticism is no fun for anyone.” – Psychology Today

 

We often speak of people being neurotic. But, do we really know what we’re talking about? Do we really know what it is? Neurosis is actually an outdated diagnosis that is no longer used medically. The disorders that were once classified as a neurosis are now more accurately categorized as post-traumatic stress disorder, somatization disorders, anxiety disorder, panic disorder, phobias, dissociation disorder, obsessive compulsive disorder and adjustment disorder.

 

Neuroticism, however, is considered a personality trait that is a lasting characteristic of the individual. It is characterized by negative feelings, repetitive thinking about the past (rumination), and worry about the future, moodiness and loneliness. It appears to be linked to vulnerability to stress. People who have this characteristic are not happy with life and have a low subjective sense of well-being and recognize that this state is unacceptable. There is some hope for people with high neuroticism as this relatively stable characteristic appears to be lessened by mindfulness training. This is potentially important and deserves further investigation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1245647922125798/?type=3&theater

or below

Armstrong and Rimes examined the ability of Mindfulness Based Cognitive Therapy (MBCT) to treat individuals high in neuroticism. They randomly assigned participants with high neuroticism to either an 8-week, once a week for 2-hours, MBCT treatment group or and on-line self-help treatment control group. Measures were taken before and 4-weeks after treatment of mindfulness, neuroticism, impairment in everyday functioning, anxiety, depressive symptoms, self-compassion, beliefs about emotions, rumination, and decentering.

 

They found that after treatment in comparisons to the control group the MBCT group had significantly lower neuroticism scores, and rumination, and a trend toward lower functional impairment due to stress. In addition, the MBCT group had significantly higher self-compassion and decentering and trends toward lessened unhelpful beliefs and emotions and higher mindfulness. Surprisingly, since MBCT was developed specifically to treat depression, there were no significant differences in anxiety or depression.

 

These results are interesting and potentially important. This, however, was a pilot study that had relatively small group sizes (17). The fact that significant differences were detected nonetheless indicates that the effects were fairly strong. The results clearly indicate that a larger randomized controlled trial is called for.

 

Mindfulness may affect neuroticism in a number of ways. By focusing the individual on the present moment, mindfulness should lessen the neuroticism characteristics of rumination about the past and worry about the future. Mindfulness is also known to reduce the psychological and physiological responses to stress and stress is known to contribute to neuroticism. Finally, mindfulness has been shown to produce heightened emotion regulation. So, the mindful individual feels and appreciates their emotions but responds appropriately and adaptively. This should lessen the moodiness, negative feelings, and loneliness characteristic of neuroticism. So, it is not surprising the mindfulness based treatments would be effective in lowering neuroticism. This is a hopeful development, as people high in neuroticism are very unhappy people. Mindfulness may provide some relief and help them toward a happier life.

 

So, improve neuroticism with mindfulness.

 

“Being in the moment with those thoughts and recognizing them for what they are has really helped me to kind of shove them aside, or to kind of diffuse them,” she says. “I think it’s really helped me become a more aware person of what other people might be feeling.” – JoSelle Vanderhooft

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Armstrong L, Rimes KA. Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study. Behav Ther. 2016 May;47(3):287-98. doi: 10.1016/j.beth.2015.12.005. Epub 2016 Jan 5. PMID: 27157024. doi:10.1016/j.beth.2015.12.005

 

Highlights

  • A new MBCT intervention for neuroticism versus online general self-help is examined
  • Compared with self-help, MBCT results in significantly lower levels of neuroticism
  • Rumination and self-compassion improved more in the MBCT group than the control group
  • MBCT is an acceptable and feasible intervention for neuroticism
  • Neuroticism may be amenable to change through psychological intervention

Abstract

Objective: Neuroticism, a characteristic associated with increased stress vulnerability and the tendency to experience distress, is strongly linked to risk of different forms of psychopathology. However, there are few evidence-based interventions to target neuroticism. This pilot study investigated the efficacy and acceptability of mindfulness-based cognitive therapy (MBCT) compared with an online self-help intervention for individuals with high levels of neuroticism. The MBCT was modified to address psychological processes that are characteristic of neuroticism. Method: Participants with high levels of neuroticism were randomized to MBCT (n = 17) or an online self-help intervention (n = 17). Self-report questionnaires were administered preintervention and again at 4 weeks postintervention. Results: Intention-to-treat analyses found that MBCT participants had significantly lower levels of neuroticism postintervention than the control group. Compared with the control group, the MBCT group also experienced significant reductions in rumination and increases in self-compassion and decentering, of which the latter two were correlated with reductions in neuroticism within the MBCT group. Low drop-out rates, high levels of adherence to home practice, and positive feedback from MBCT participants provide indications that this intervention may be an acceptable form of treatment for individuals who are vulnerable to becoming easily stressed. Conclusions: MBCT specifically modified to target neuroticism-related processes is a promising intervention for reducing neuroticism. Results support evidence suggesting neuroticism is malleable and amenable to psychological intervention. MBCT for neuroticism warrants further investigation in a larger study.

 

Don’t be afraid!

Fear is a worry that something dreadful will occur in the future. In the case of recovery from dire health conditions, it is the fear of reoccurrence. That worry isn’t unreasonable, but often it is excessive relative to the real danger.

When this occurs, it stresses the individual and makes them anxious. This in turn, produces physiological reactions similar to those that occur when something is truly wrong that requires a response. But nothing is really wrong. The unneeded pro-inflammatory responses when nothing is actually wrong can itself induce damage. This, to some extent makes the fears come true. This can create a self-fulfilling fear cycle.

Mindfulness shifts perspective from the future to now where everything actually is well. When we’re mindful in the present moment we are not fearing the future, we’re not ruminating about the past, instead we’re focused on how we’re feeling and what we’re experience right now. Since everything is fine at this present time, we can relax and distress.

In today’s Research News “Mindfulness Based Stress Reduction (MBSR(BC)) in Breast Cancer: Evaluating Fear of Recurrence (FOR) as a Mediator of Psychological and Physical Symptoms in a Randomized Control Trial (RCT)”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627743/pdf/nihms-424471.pdf

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1013640941993165/?type=1&theater

it is demonstrated that Mindfulness Based Stress Reduction reduces  the fear of reoccurrence in breast cancer survivors and this, in turn, reduces stress and anxiety. This mindfulness induced reduction in the fear, stress and anxiety produces improved physical functioning.

Mind and body are amazingly interconnected. Today’s study shows how altering the mind by focusing it in the present moment with MBSR can result in favorable physical functioning. This is one of the many ways that mindfulness improves both physical and psychological health.

CMCS