Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness
By John M. de Castro, Ph.D.
“Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro
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. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of breast cancer survivors.
In today’s Research News article “Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/ ) Reich and colleagues recruited breast cancer survivors and randomly assigned them to either usual care or to receive a 6-week, once a week for 2-hours, Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors. They were measured before and after training and 6 weeks later for worry, fear of cancer recurrence, anxiety, depression, perceived stress, mindfulness, symptom severity, sleep quality, fatigue, pain, cognition, and health-related quality of life.
They found with factor analysis that the measures fit into 4 clusters; pain, cognition, fatigue, and psychological. They found that in comparison to baseline the usual care, Mindfulness-Based Stress Reduction (MBSR) produced significant improvement in the psychological and fatigue clusters, but not the cognitive or pain clusters. These effects were still present 6 weeks later.
These findings suggest that Mindfulness-Based Stress Reduction (MBSR) is an effective treatment to relieve the psychological and fatigue symptoms of breast cancer survivors. This corresponds with prior findings that mindfulness improves the symptoms of breast cancer survivors and reduces anxiety, depression, and perceived stress, and improves emotional well-being and also reduces fatigue and improves sleep quality.
The observed improvements produced by Mindfulness-Based Stress Reduction (MBSR) markedly improves the quality of life and reduces the suffering of these cancer patients. These are clinically significant. It has been shown that an improved psychological outlook is associated with better physical recovery. Hence, these findings suggest that MBSR or other mindfulness training programs, should be incorporated into the routine care of breast cancer survivors.
So, improve the psychological well-being of breast cancer survivors with mindfulness.
“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally. . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are.“ – Breast Cancer Now
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
Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., Han, H. S., Ismail-Khan, R., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Shivers, S., Cox, C. E., Goodman, M., & Park, J. (2017). Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. Journal of pain and symptom management, 53(1), 85–95. https://doi.org/10.1016/j.jpainsymman.2016.08.005
Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.
The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.
Three hundred twenty-two Stage 0–III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models offactor analysis and structural equation modeling.
Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.
Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.