Distress and Quality of Life

We published, in 2000, a randomized clinical trial comparing MBSR to a waiting-list control group for a mixed group of cancer patients, some of whom were on active treatment and some who were beyond the treatment phase.102 Patients in this study had a wide range of cancer diagnoses of all stages, and were not restricted in terms of treatment-related variables. Following the intervention, participants in the intervention group had significantly less overall mood disturbance, less tension, depression, anger, concentration problems, and more vigor than control subjects. They also reported fewer symptoms of stress, including peripheral manifestations of stress (e.g., tingling in hands and feet), cardiopulmonary symptoms of arousal (e.g., racing heart, hyperventilation) central neurological symptoms (e.g., dizziness, faintness), gastrointestinal symptoms (e.g., upset stomach, diarrhea), habitual stress behavioral patterns (e.g., smoking, grinding teeth, overeating, insomnia), anxiety/fear, and emotional instability compared to those still waiting for the program. Results of a 6-month follow-up, including both experimental and wait-list participants who had by then completed the program, indicated a maintenance of these gains over the follow-up period.103

The next study conducted by our group was a pre-post MBSR intervention with early-stage breast and prostate cancer survivors who were all at least 3 months posttreatment. Outcomes included biological measures of immune, endocrine, and autonomic function in addition to similar psychological variables as previously.104,105 Fifty-nine and 42 patients were assessed pre- and post-intervention, respectively. The 59 patients attended a median of eight of a possible nine sessions over the 8 weeks (range 1-9). They also practiced at home as instructed, reporting an average of 24 minutes/day of meditation and 13 minutes/day of yoga over the course of the 8 weeks. Significant improvements were seen in overall quality of life, symptoms of stress and sleep quality.

A unique modification on MBSR that has been applied to cancer patients is called mindfulness-based art therapy (MBAT), which combines the principles of MBSR with other creative modalities. In a recently completed 2-year RCT (N = 111), researchers compared the 8-week MBAT intervention to wait-list control in a heterogeneous cohort of women with mixed cancer types receiving usual oncologic care. They found that compared to the usual care group, the MBAT participants had less depression, anxiety, somatic symptoms of stress, and less hostility.106

Other groups are also applying modifications of the MBSR program to cancer patients, and presenting psychological results at scientific meetings. For example, Bauer-Wu and Rosenbaum have adapted MBSR for individual use in isolated hospitalized bone-marrow transplant (BMT) patients107 finding immediate effects on levels of pain and anxiety. Another group is investigating a shortened 4-session MBSR program for cancer patients.108 Clinical work is ongoing, including through the Wellness Community (e.g., ref. 109), but no publications have yet resulted from these programs.

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