A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Cecile A. Lengacher, RN, PhD, of the University of South Florida, Tampa, and colleagues.
In the study, 322 patients with stage 0 to III disease who had completed treatment from 2 weeks to 2 years prior to study entry were randomized to a 6-week mindfulness-based stress-reduction program (n = 155) or usual care (n = 167). The program consisted of 2-hour once-weekly sessions with a clinical psychologist trained in mindfulness-based stress reduction, with patients receiving training manuals and CDs to guide their practice. The program addressed the specific needs, concerns, and symptoms of breast cancer survivors and consisted of educational materials, practice sessions of four meditative techniques (sitting meditation, walking meditation, body scan, and gentle Hatha yoga), and group processes regarding barriers to meditation practice, application in daily life, and supportive interaction among group members. Psychological (depression, anxiety, and fear of recurrence) and physical (fatigue and pain) symptoms and health-related quality of life were assessed at baseline and at 6 and 12 weeks.
The mindfulness-based stress-reduction group exhibited significant (all P < .01) improvement in symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems (12-week effect sizes of d = 0.27–0.35) and in fatigue severity and interference (effect sizes of d = 0.23 and 0.27). The largest improvements occurred during the 6-week intervention, with most being maintained at 12 weeks. Reduction in depression symptoms was similar to other psychological symptom outcomes but did not reach significance (P = .06). No differences in pain outcomes were observed. Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27).
A trend in improvement in health-related quality of life was observed (P < .05, with significance defined as < .01; d = 0.21). Benefit was greatest among patients in the mindfulness-based stress-reduction group with higher levels of stress at baseline.
The investigators concluded: “The MBSR [mindfulness-based stress reduction breast cancer] program significantly improved a broad range of symptoms among [breast cancer survivors] up to 6 weeks after MBSR [breast cancer] training, with generally small to moderate overall effect sizes.”
The study was supported by the National Cancer Institute and the H. Lee Moffitt Cancer Center and Research Institute.