In a phase III trial (Pathways to Wellness) reported in the Journal of Clinical Oncology, Julienne E. Bower, PhD, and colleagues found that both mindfulness meditation and survivorship education interventions significantly reduced depressive symptoms in younger breast cancer survivors.
Study Details
In the U.S. multicenter trial, 247 women aged ≤ 50 years diagnosed with stage 0 to III breast cancer with at least mild depressive symptoms on the Patient Health Questionnaire-8 were randomly assigned between February 2017 and September 2019 to 6 weeks of mindful awareness practices (n = 85), survivorship education (n = 81), or wait-list control (n = 81).
The mindful awareness practices intervention included presentation of theoretical materials on mindfulness, relaxation, and the mind-body connection; experiential practice of meditation; and a psychoeducational component. Survivorship education uses a written curriculum and annotated slides covering major topic areas such as quality of life after breast cancer; medical management and quality of care after treatment; relationships and work-life balance; body image, sexuality, and fertility; energy balance, nutrition, and physical activity; and cancer in the family, genetics, and related issues.
Mindfulness meditation and survivorship education reduced depressive symptoms in younger breast cancer survivors. These interventions can be widely disseminated over virtual platforms and have significant potential benefit for quality of life and overall survivorship in this vulnerable group.— Julienne E. Bower, PhD
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The primary outcome measure was change in depressive symptoms from preintervention to postintervention on the Center for Epidemiologic Studies-Depression (CES-D) Scale; CES-D scores ≥ 16 indicate clinically significant depressive symptoms.
Key Findings
Mean CES-D scores preintervention were 18.5 in the mindful awareness practices group, 17.9 in the survivorship education group, and 16.5 in the wait-list control group.
The mindful awareness practices group showed significant improvement in depressive symptoms vs the wait-list control group at postintervention (mean relative change in CES-D score = -4.7, 95% CI = -7.5 to -1.9, P = .001), and at 3-month (-5.9, 95% CI = -8.9 to -2.9, P < .001) and 6-month follow ups (-3.7, 95% CI = -6.6 to -0.8, P = .013).
The survivorship education group showed significant improvement in depressive symptoms vs the wait-list control group at postintervention (mean relative change in CES-D score = -4.0, 95% CI = -6.9 to -1.1, P = .007) and at 3-month follow-up (-4.7, 95% CI = -7.8 to -1.6, P = .003) but not 6-month follow up (-2.8, 95% CI = -5.9 to 0.2, P = .063).
Compared with the wait-list control group, the mindful awareness practices group showed significant improvement in: fatigue (Fatigue Symptom Inventory) at postintervention (P < .001) and at 6-month follow-up (P = .002); insomnia (Insomnia Severity Index) at postintervention (P = .006) and at 3-month (P < .001) and 6-month follow-ups (P = .002); and in vasomotor symptoms (Breast Cancer Prevention Trail Symptom Checklist) at 3-month (P = .002) and 6-month follow-ups (P = .001).
The investigators concluded, “Mindfulness meditation and survivorship education reduced depressive symptoms in younger breast cancer survivors. These interventions can be widely disseminated over virtual platforms and have significant potential benefit for quality of life and overall survivorship in this vulnerable group.”
Dr. Bower, of the Department of Psychology, UCLA, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute, National Center for Advancing Translational Science, Breast Cancer Research Foundation, and Komen Foundation. For full disclosures of the study authors, visit ascopubs.org.
