Abstract

BackgroundMindfulness has been applied to improve cancer care by enhancing psychological well-being. However, little is known about its impact on cognitive impairment experienced by cancer patients after chemotherapy. Mindfulness may be relevant in tackling cognitive impairment by decreasing emotional distress and fatigue, by decreasing inflammation, and by strengthening functional brain connectivity. The aim of the present study protocol is to evaluate the efficacy and mechanisms of a mindfulness-based intervention to reduce cognitive impairment in breast cancer patients after chemotherapy.Methods/designThe present study is a three-arm, parallel-group, randomized controlled trial with assessments at baseline, 1 to 3 weeks after the intervention and at 3 months’ follow-up. One hundred and twenty breast cancer patients who ended treatment a minimum of 6 months and a maximum of 5 years before, and who have cognitive complaints, will be enrolled. They will be randomized into one of the following three study arms: (1) a mindfulness-based intervention group (n = 40), (2) an active control condition based on physical training (n = 40), or (3) a treatment as usual (TAU) control group (n = 40). Both the mindfulness-based intervention and the active control condition consist of four group sessions (3 h for the mindfulness condition and 2 h for the physical training) spread over 8 weeks. The primary outcomes will be cognitive symptoms as measured by the Cognitive Failure Questionnaire and changes in functional brain connectivity in the attention network. Secondary outcomes will be (1) levels of emotional distress, fatigue, mindfulness, quality of life; (2) neurocognitive tests; (3) structural and functional brain changes using MR imaging and (4) measures of inflammation.DiscussionThe study will examine the impact of a mindfulness-based intervention on cognitive impairment in breast cancer patients. If the findings of this study confirm the effectiveness of a mindfulness-based program to reduce cognitive impairment, it will be possible to improve quality of life for ex-cancer patients. We will inform health care providers about the potential use of a mindfulness-based intervention as a non-pharmaceutical, low-threshold mental health intervention to improve cognitive impairment after cancer.Trial registrationClinicalTrials.gov, ID: NCT03736460. Retrospectively registered on 8 November 2018.

Highlights

  • Mindfulness has been applied to improve cancer care by enhancing psychological well-being

  • The study will examine the impact of a mindfulness-based intervention on cognitive impairment in breast cancer patients

  • Based on the preliminary results of one randomized controlled trial [53] and a small-scaled pilot study conducted by our research group [29], it is expected that Mindfulnes-Based Intervention (MBI) may have the potential to reduce cognitive impairment after chemotherapy

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Summary

Introduction

Mindfulness has been applied to improve cancer care by enhancing psychological well-being. Little is known about its impact on cognitive impairment experienced by cancer patients after chemotherapy. The aim of the present study protocol is to evaluate the efficacy and mechanisms of a mindfulness-based intervention to reduce cognitive impairment in breast cancer patients after chemotherapy. Women treated for breast cancer regularly self-report problems with cognitive processes involving memory, attention and executive functioning [3]. These cognitive deficits can be a worrying side effect of cancer and its treatment and can have a serious impact on quality of life and productivity at work, bringing undesirable direct and indirect costs to patients and society. While one group of women shows (partial) recovery at 1 year post chemotherapy [1], others still experience cognitive dysfunction 10 to 20 years after treatment [5, 6]

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