Mindfulness-Based Cancer Recovery Research Articles

A Phenomenological Qualitative Exploration of Mind-Body Therapy Use and Effectiveness Among Young, Middle, and Older Adult Cancer Survivors.

Having been diagnosed with and treated for cancer can have negative psychosocial repercussions that may differ across the lifespan. Mind-body therapies (MBTs), such as tai-chi/qigong (TCQ) or mindfulness-based cancer recovery (MBCR), have shown promise in decreasing negative psychosocial outcomes in cancer survivors, but few studies have explored potential differences in MBT use and effectiveness across age groups. A descriptive phenomenological qualitative design was used. Participants included young (18-39), middle (40-64), and older (65+) adult cancer survivors who were diagnosed with any type of cancer and had participated in Mindfulness-Based Cancer Recovery (MBCR) or Tai Chi/Qigong (TCQ) MBTs. Semi-structured qualitative interviews explored participants' experiences in MBTs and these were analyzed using descriptive phenomenological analysis. Among the interviews (n = 18), young (n = 6), middle-aged (n = 8), and older (n = 4) adults participated. 5 themes emerged: influences in joining the program, unique lifestyles, positive class experiences, use of media, and program impacts. Though all age groups benefitted from MBT participation, variations between age groups with respect to the benefits received and motivations for joining the program were observed. MBTs had beneficial physical and mental health effects on survivors of all age groups. These benefits were particularly connected to the ongoing life stresses common to each age cohort, such as relief from work and family roles for young adults or support during retirement transition for older adults. Hence, access to MBT programs may be beneficial as part of the survivorship plan for patients and the recruitment strategies or content can be adapted by MBT providers to better target and support age-specific groups. More research is required with a larger sample.

"A Hippo Out of Water": A Qualitative Inquiry of How Cancer Survivors' Experienced In-Person and Remote-Delivered Mind-Body Therapies.

Mind-body therapies (MBTs) are an effective treatment option for people living with and surviving from cancer to help manage unwanted physical and psychological symptoms and side-effects related to treatment and the illness itself. Many of these structured MBTs, such as Mindfulness Based Cancer Recovery (MBCR) and tai chi/qigong (TCQ) programs are common; however, COVID-19 caused most research intervention trials and clinical programs to halt completely, or rapidly adapt an online modality. The Mindfulness and Tai Chi for Cancer Health (MATCH) study, a large-scale study that compared MBCR to a structured TCQ program for treating psychological and physical health outcomes for cancer survivors, adapted to an online, Zoom delivered, program at the outset of COVID-19. Study objectives were to explore the experiences of MATCH study participants who took the MBCR or TCQ program completely in-person, those who took the program completely online (over zoom), and participants who had to shift from in-person to online delivery midway through their series of TCQ classes. Semi-structured interviews were conducted with 13 participants following participation in either the MBCR or TCQ program of the MATCH study. We derived four themes from the data: 1) attending to personal needs, 2) functional, interpersonal, and COVID19-related challenges, 3) unique engagement styles based on mode of delivery, and 4) ease of transitioning to remote delivery. We found that thematic outcomes were variable and largely based on individual preference, such as valuing more autonomy online, or appreciating the interpersonal connection of being in-person. Our results further indicated that the process of shifting from in-person to online within a short time-period was a relatively seamless transition that had minimal impact on participant experience. Insights from this study highlight the benefits of digital mind-body therapies for cancer survivors that extend beyond the acute effects of COVID19.

The SERENITY study: online Mindfulness-Based Cancer Recovery (e-MBCR) program for women living with breast and gynecological cancer—protocol for a pilot effectiveness-implementation randomized trial

ABSTRACT Background: Mindfulness-Based Interventions (MBIs) have been shown to improve mental and physical health as well as biological processes of patients living with cancer. More research is needed to inform on the determinants that might facilitate or hinder their implementation in hospitals. The primary objective of this study was to explore the feasibility and implementation of an online Mindfulness-Based Cancer Recovery program (e-MBCR) for women with breast and gynecological cancer treated at two academic oncology centers in Switzerland. The secondary objective was to explore the psychological and biological effects of the program. Methods: The SERENITY study is a pilot hybrid effectiveness-implementation trial using a randomized waitlist-controlled design, including a mixed methods approach. The intervention groups receive treatment as usual and the e-MBCR program, whereas the control groups are on a wait-list to receive an online Mindfulness-Based Stress Reduction program at the end of the study. Four e-MBCR programs are delivered consecutively, with 12 patients in each group. Participants' attendance to the sessions is the primary outcome. Implementation outcomes of interest are feasibility, acceptability, appropriateness, fidelity, costs, and early sustainability. Implementation determinants will be described, and an exploratory analysis of psychological outcomes and cancer-related biomarkers will be performed at three time points (baseline, postintervention, and 3 months of follow-up). Discussion: The results of this study will inform a future large trial and adjustments needed for a real-world implementation of the program. The translational part of this study will contribute to the collective effort to better understand how MBIs affect important cancer-related biomarkers.

The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis.

Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical well-being. This review aims to provide the most recent evaluation of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) treatments, in reducing symptoms of depression, anxiety and CRF in oncology populations. A search using the following search terms was conducted: (mindful* OR mindfulness* OR mindfulness-based* OR MBI* OR MBCT OR MBSR OR MBCR) AND (Oncol* OR cancer OR neoplasm OR lymphoma OR carcinoma OR sarcoma) to obtain relevant publications from five databases: PsycINFO, PubMed, Embase, and MEDLINE by EC, and ProQuest Dissertations & Theses Global from January 2000 to February 2022. 36 independent studies (n = 1677) were evaluated for their overall effect sizes (using random-effects models), subgroup analyses, and quality appraisals. Evaluations were performed separately for non-randomized (K = 20, n = 784) and randomized controlled trials (K = 16, n = 893). The results showed that MBIs have significant medium effects in reducing symptoms of depression (Hedges' g = 0.43), anxiety (Hedges' g = 0.55) and CRF (Hedges' g = 0.43), which were maintained at least three months post-intervention. MBIs were also superior in reducing symptoms of anxiety (Hedges' g = 0.56), depression (Hedges' g = 0.43), and CRF (Hedges' g = 0.42) in oncology samples relative to control groups. The superiority of MBIs to control groups was also maintained at least three months post-intervention for anxiety and CRF symptoms, but not for depressive symptoms. The risk of bias of the included studies were low to moderate. This review found that MBIs reduced symptoms of depression, anxiety and CRF in oncology populations. PROSPERO: International Prospective Register of Systematic Reviews: CRD42020143286.

A randomized control trial of the effectiveness of online Mindfulness-Based Cancer recovery program on psychological well-being, caregiver burden and resilience in cancer patients’ caregivers

A randomized control trial of the effectiveness of online Mindfulness-Based Cancer recovery program on psychological well-being, caregiver burden and resilience in cancer patients’ caregivers

Prospective assessment of a smartphone-app based mindfulness program for patients with metastatic renal cell carcinoma (mRCC).

324 Background: mRCC is associated with high rates of distress, high levels of symptom burden, and broad impairments in quality of life. In the setting of localized breast cancer, a smartphone application directed at enhancing mindfulness has been developed from a Mindfulness-Based Cancer Recovery program demonstrated to mitigate these factors (Utkarsh et al. Digital Health 2021); we sought to determine if the benefit of a similar application could be translated to patients with mRCC. Methods: Patients were recruited across two sites in the US and Brazil, and were eligible for the study if they had been diagnosed with mRCC, were receiving immunotherapy, reported clinically-relevant anxiety, had a smart phone with internet access, were currently not engaging in meditation, and had not participated in a mindfulness program in the past 5 years. Patients were asked to participate in mindfulness app-based activities for 20-30 minutes each day guided by the Mindfulness-Based Cancer Survivorship Journey program within AM Mindfulness smartphone app (AmDTx™), for a minimum of 4 days per week, over a period of 4 weeks. The application leads the patient through exercises in guided meditation and suggestions for cancer/cancer symptom coping. Patients were assessed at baseline and 2-weeks after using the 4-week smartphone-app based intervention using the Fear of Cancer Recurrence-7 and Functional Assessment of Chronic Illness Therapy-General scales. Reported data is evaluated using paired t-tests with a p-value of < 0.05 considered significant. Results: A total of 23 patients have been recruited to date. Median age was 59 years old; most were male (52%), white/Caucasian (52%), married (69%) and college educated (82%), and primarily receiving treatment with nivolumab (34%) or nivolumab/ipilimumab (30%). The majority of patients (78%) expressed satisfaction and engaged with the intervention; however, a minority (13%) noted that the intervention reminded them of their cancer diagnosis, which was seen as a negative aspect. Preliminary analyses of data after two weeks of the intervention have demonstrated a statistically significant decreases in fear of cancer progression (mean differences: baseline = 22; week 2 = 18, p = 0.012) and increases in quality of life (mean differences: baseline = 77; week 2 = 85, p = 0.001) over time. Physical and emotional well-being also showed significant improvement over time. Complete data with 12 weeks of follow-up will be presented at the meeting. Conclusions: This is the first study to implement an evidence-based, smartphone-accessible psychosocial support tool among mRCC patients. After only two weeks, we noted significant improvements in the fear of cancer progression and quality of life. This preliminary data suggests that this type of low-cost, mobile-app based intervention was acceptable to patients and may be effective at addressing psychosocial distress

The effectiveness of online mindfulness-based cancer recovery program on psychological Variables of colorectal and stomach cancer patients: A randomized control trial

The effectiveness of online mindfulness-based cancer recovery program on psychological Variables of colorectal and stomach cancer patients: A randomized control trial

The Positive Effect of Mindfulness-Based Cancer Recovery on Cancer-Related Fatigue in a Transitional Health Management Model

Compared with general fatigue, cancer-related fatigue is characterized by rapid onset, high severity, substantial energy expenditure, long duration, unpredictability, and inability of relief. There has been no effective treatment for it so far, which greatly affects the patients' self-care ability and quality of life. It has been proved in previous studies that mindfulness-based cancer recovery (MBCR) can effectively alleviate the negative reactions of cancer patients such as fatigue, pain and fear during the treatment process and enhance the level of cancer recovery. In this article, we propose to intervene in cancer-related fatigue by resorting to mindfulness based on a "hospital-family transitional health management model". It is expected that this model will play a positive role in the adjuvant treatment of cancer-related fatigue because of its operability and low medical cost.

Evidence of psychological and biological effects of structured Mindfulness-Based Interventions for cancer patients and survivors: A meta-review.

ObjectiveA large number of studies have been conducted exploring the effects of mindfulness programs on health outcomes, such as psychological and biological outcomes. However, there is substantial heterogeneity among studies and, consequently, in the systematic reviews/meta‐analyses. Since clinical practice is massively informed by evidence on review studies, our main objective was to summarize the reported evidence regarding the effects of structured mindfulness‐based programs on psychological, biological, and quality‐of‐life outcomes in cancer patients.MethodsWe conducted a meta‐review, using a literature search from inception to June 2020 in several electronic databases using a combination of keywords including MBSR, MBCT, cancer, and meta‐analysis OR “systematic review” (PROSPERO registration CRD42020186511).ResultsTen studies met the eligibility criteria and were included. The main findings were beneficial small to medium effect sizes of Mindfulness‐Based Stress Reduction (MBSR)/Mindfulness‐Based Cognitive Therapy (MBCT)/Mindfulness‐Based Cancer Recovery (MBCR) on psychological health, such as anxiety, depression, stress, and quality of life. A beneficial effect was found for biological outcomes, albeit based on a reduced number of studies. Studies were moderate homogenous regarding the intervention, population, and outcomes explored. Results on long‐term follow‐up seem to indicate that the effects tend not to be maintained, namely in shorter follow‐ups (6 months).ConclusionsThis meta‐review brings a broad perspective on the actual evidence regarding MBSR/MBCT/MBCR. We expect to contribute to future project design, focused on developing high‐quality studies and exploring the moderating effects that might contribute to biased results, as well as exploring who might benefit more from MBSR/MBCT/MBCT interventions.

No effect of mindfulness-based cancer recovery on cardiovascular or cortisol reactivity in female cancer survivors

Psychosocial stress in cancer survivors may contribute to compromised quality of life and negative cancer outcomes, which can be exacerbated by poor coping skills and emotional reactivity. Mindfulness based interventions (MBIs) have shown effectiveness in reducing stress, improving quality of life and coping skills in cancer survivors. We tested whether an MBI would also improve reactivity to an acute laboratory stress task. A total of 77 women with a cancer diagnosis were recruited for a waitlist-controlled trial of Mindfulness-Based Cancer Recovery (MBCR). Participants completed a laboratory-based psychosocial stress paradigm (the Trier Social Stress Test-TSST) pre- and post-intervention, throughout which cortisol and cardiovascular profiles were measured. Neither cortisol nor cardiovascular reactivity to the TSST was changed pre-to post intervention, either between or within groups. Blunted cortisol, but not cardiovascular, reactivity was observed across both groups, which may have contributed to the lack of intervention effect. Previous research suggests that diurnal cortisol is blunted following cancer treatment; the current findings suggest this blunting may also occur during exposure to acute stress.

A Mixed-Method, Multi-Perspective Investigation of Barriers to Participation in Mindfulness-Based Cancer Recovery

Mindfulness-based cancer recovery (MBCR) is a mindfulness-based intervention (MBI) evidenced to improve the psychosocial well-being of cancer survivors. Like many MBI group programs, there is typically attrition of 20–30% of participants who initially register for the program. Understanding the barriers to participation in and completion of MBCR may highlight potential avenues to improve uptake and adherence to MBIs, which would help more survivors benefit from MBCR. The present study included: (1) quantitative analysis of barriers to practice; (2) qualitative analysis of survivors’ perceived barriers to participation, and; (3) qualitative analysis of MBCR instructors’ perceptions of barriers to participation. Most survivors reported relatively low levels of barriers and tended to report similar types of barriers, but those who dropped out were twice as likely to report experiencing barriers “daily” than those who did not drop out. In interviews, survivors’ reported barriers fell into four themes that were practical, person-related, cancer-related, and program-related. Instructors identified themes of practical barriers, there being a “right time”, participant attitudes, and the group setting as factors that influenced participation. Barriers are ubiquitous and those who eventually dropped out did not appear to experience distinct barriers, just more of them. In light of this, broad strategies that might help facilitate the participation of all survivors in MBCR and other MBIs are discussed.

P1.16-32 Empowering Lung Cancer Survivors and Family Members to “Breathe Easier”: Adaptation and Evaluation of a M-Health Intervention

Survivors of lung cancer often experience a myriad of symptoms that have devastating effects on their physical and psychological functioning such as dyspnea, fatigue, and stress. To combat these symptoms, the American College of Chest Physicians has recommended the use of complementary therapies. Mindfulness-based Cancer Recovery (MBCR) can empower survivors, and family members who often cope with their own health problems and the stress related to caring for a survivor. Our goal is to deliver a tailored, culturally sensitive, MBCR intervention to survivors and family members via a mHealth app. This research was comprised of four phases. Phase I was the development and testing of an 8-week in-person intervention called Breathe Easier with survivors and family members (dyads). Phase II adapted Breathe Easier into a mHealth app prototype utilizing user-centered design. Phase III was a focus-group evaluation of the usability and acceptance of the mHealth app prototype by survivors and family members. Phase IV was comprised of additional interviews with an African-American subset of survivors and family members to assess the cultural sensitivity of the mHealth app. Findings from the in-person intervention (n = 62) showed that all agreed the intervention materials were acceptable, different levels of yoga, breathing exercises, and meditations helped them, and involving a family member was important. Preliminary analyses showed survivors had less dyspnea and perceived stress over time (T1 vs T2). Both groups had improved fatigue and sleep scores. Findings from the mHealth app design and acceptance evaluation were organized into two primary categories: usefulness and ease of use. User-friendly design recommendations included aesthetic appeal, navigation layout, and display of content. Furthermore, potential health outcomes, privacy concerns, and comparison to in-person interventions also influenced app usefulness and acceptance. Lastly, findings from our cultural sensitivity assessment demonstrated that the mHealth app was culturally sensitive for African-Americans, but some changes were recommended. MBCR interventions hold great promise for improving the lives of racially diverse survivors of lung cancer and family members. An mHealth app will increase accessibility. However, special consideration of app design is needed to ensure future acceptance and longer-term usage.

P1.16-11 A Dyad-Based Mindfulness Cancer Recovery Program for Survivors and Family Members to Reduce Lung Cancer Symptoms

Although the five-year survival rate for individuals with NSCLC stages I-IIIa, is increasing, excessive symptom burden remains a distressing problem that negatively impacts quality of life. Our long-term goal is to improve clinical outcomes for survivors of localized lung cancer (NSCLC; stages I–IIIa). The study objective is to test a tailored intervention, Breathe Easier, which encompasses meditation, varying levels of yoga, and breathing exercises to evaluate feasibility and preliminary effects for survivors and family members (dyads). A community-based participatory research approach was used to adapt a mindfulness-based cancer recovery program. Using a prospective, one-group, repeated measures, mixed method design, this study collected feasibility and preliminary data to test the hypothesis that survivors and family members (dyads) who receive an 8-week intervention will demonstrate (a) less dyspnea, (b) less fatigue, (c) improved sleep quality and quantity, (d) improved exercise tolerance and (e) less stress immediately after the intervention. The intervention known as “Breathe Easier” consisted of breathing exercises, individual and partner sitting, standing and floor yoga movements, meditations and participant interaction. The outcome variables were measured pre and immediately post intervention by the FACIT Dyspnea Short Form (Parts 1 and 2), FACIT Fatigue Scale v.4. Pittsburgh Sleep Quality Index, 6-Minute Walk Test, and the Perceived Stress Scale v.4. Post-intervention qualitative interviews were conducted. Descriptive statistics were obtained for five quantitative feasibility measures (recruitment, retention, intervention dose, adherence, acceptability). Thematic analysis was used to interpret the qualitative data. In six iterations of the intervention,164 survivors were reached, and 32 dyads enrolled (62 participants; 20% recruitment and 94% retention rates). Survivors were 44% male and 62% African American. Among all, 74% were not current smokers, 22% used oxygen, and 71% completed a six-minute walk test post-intervention. Adherence was demonstrated by good attendance and exceeding expectations on home assignments for breathing exercises and meditations. All participants practiced gentle movements (yoga), meeting approximately 80% of expectations. Survivors reported completing daily home assignments slightly more than family members. All agreed that the intervention materials were easy to use, learning yoga and breathing exercises helped, and involving a family member was important. For each outcome variable, differences in survivors versus partners were calculated. Survivors had less dyspnea and perceived stress over time. Both groups had improved fatigue and sleep scores. Interview data enriched the understanding of feasibility and preliminary outcome measures. Six themes illustrated participants’ experiences: (1) Learning to Breathe Easier, (2) Enhanced Closeness with Committed Partners, (3) Stretching, Releasing Tension, and Feeling Energized, (4) Interacting with Others as Beneficial, (5) Refocused on Living, and (6) Sustainability as a Decision. Recruitment, retention, adherence, and acceptability demonstrated strong feasibility. Preliminary outcome data indicate benefits over time for both survivors and family members.

Empowering lung cancer survivors and family members to “breathe easier”: Adaptation and evaluation of a m-health intervention.

e23046 Background: Survivors of lung cancer often experience a myriad of symptoms that have devastating effects on their physical and psychological functioning such as dyspnea, fatigue, and stress. To combat these symptoms, the American College of Chest Physicians has recommended the use of complementary therapies. Mindfulness-based Cancer Recovery (MBCR) can empower survivors, and caregivers who often cope with their own health problems and the stress related to caring for a survivor. Our goal is to deliver a tailored, culturally sensitive, MBCR intervention to survivors and family members via a mHealth app. Methods: This research was comprised of four phases. Phase I was the development and testing of an 8-week in-person intervention called Breathe Easier with survivors and family members (dyads). Phase II adapted Breathe Easier into a mHealth app prototype utilizing user-centered design. Phase III was a focus-group evaluation of the usability and acceptance of the mHealth app prototype by survivors and family members. Phase IV was comprised of additional interviews with an African-American subset of survivors and family members to assess the cultural sensitivity of the mHealth app. Results: Findings from the in-person intervention (n = 62) showed that all agreed the intervention materials were acceptable, different levels of yoga, breathing exercises, and meditations helped them, and involving a family member was important. Preliminary analyses showed survivors had less dyspnea and perceived stress over time (T1 vs T2). Both groups had improved fatigue and sleep scores. Findings from the mHealth app design and acceptance evaluation were organized into two primary categories: usefulness and ease of use. User-friendly design recommendations included aesthetic appeal, navigation layout, and display of content. Furthermore, potential health outcomes, privacy concerns, and comparison to in-person interventions also influenced app usefulness and acceptance. Lastly, findings from our cultural sensitivity assessment demonstrated that the mHealth app was culturally sensitive for African-Americans, but some changes were recommended. Conclusions: MBCR interventions hold great promise for improving the lives of racially diverse survivors of lung cancer and family members. An mHealth app will increase accessibility. However, special consideration of app design is needed to ensure future acceptance and longer-term usage.

The ONE‐MIND Study: Rationale and protocol for assessing the effects of ONlinE MINDfulness‐based cancer recovery for the prevention of fatigue and other common side effects during chemotherapy

Cancer patients often experience poor quality of life (QoL) during chemotherapy (CT) treatments due to side effects including fatigue, insomnia, pain and nausea/vomiting. Mindfulness-based cancer recovery (MBCR) is an evidence-based intervention for treating such symptoms, but has not been investigated as an adjunctive treatment during CT. This study aims to determine the efficacy of an online group MBCR programme delivered during CT in 12 real-time interactive weekly sessions for managing fatigue (primary outcome). Secondary outcomes include sleep disturbance, pain, nausea/vomiting, mood, stress and QoL. Exploratory outcomes include cognitive function, white blood cell counts and return to work. The study is a two-armed randomised controlled waitlist trial with 2:1 allocation to treatment (online group MBCR during CT) or control (waitlist usual care; online MBCR following CT completion) with a target sample size of N=178. Participants are breast or colorectal cancer patients undergoing common CT regimens in Calgary, Canada. Online assessments using validated self-reported instruments will take place at baseline, post-MBCR, post-CT and 12months' post-baseline. If online MBCR delivered during CT significantly reduces fatigue in cancer patients' post-CT and also impacts secondary symptoms, this would provide evidence for including mindfulness training as an adjunctive symptom management therapy during CT.

Integrative Oncology Trials in the Real World: Assessing the Pragmatism of an Ongoing Integrative Oncology Trial of Mindfulness and T'ai Chi/Qigong

The aim of this study was to highlight features of pragmatic real-world integrative oncology research by applying the PRagmatic Explanatory Continuum Indicator Summary (PRECIS-2) criteria to an ongoing integrative oncology clinical trial. The ongoing trial is a preference-based randomized comparative effectiveness trial of mindfulness-based cancer recovery (MBCR) versus t'ai chi/qigong (TCQ) for cancer survivors (the Mindfulness and T'ai Chi for Cancer Health [MATCH] study). The primary outcome of the MATCH study is distress, and secondary outcomes are quality of life, sleep disturbance, and physical functioning. The clinical trial is being undertaken at tertiary care cancer centers across two sites in Canada: Calgary (AB) and Toronto (ON), with a sample of 600 cancer survivors who have finished all cancer treatments and are distressed. The MATCH trial was scored on the explanatory-pragmatic continuum for each of the nine domains of the PRECIS-2 criteria on a scale of 1-5, and was rated as more explanatory than pragmatic, despite initial design efforts being more pragmatic. Areas that were least pragmatic were methods of recruitment, follow-up, and intervention delivery. The more pragmatic areas were setting, outcomes, and data analysis. More efforts toward conducting pragmatic trials are needed in the field of integrative oncology, as cancer-care institutions and policy makers are looking for sustainable interventions within already established treatment models. The PRECIS-2 criteria can help researchers meet these goals in the planning stages of trial development.

Effectiveness of mindfulness-based cancer recovery (MBCR) program among Hungarian cancer patients

Employment of mindfulness-based programs and techniques in the treatment of cancer patients have spread exponentially in the past decade. A large number of studies have proved the effectiveness of the program in the reduction of stress symptoms, depression and anxiety, and the improvement of sleep and mood patterns. The present study was done at Firebird Foundation and examines the effectiveness of the complex, MBCR (mindfulness-based cancer recovery)-based psycho-social intervention in the treatment of cancer patients. The experimental group consisted of 101 people with various types and states of cancer. The control group consisted of 72 adjusted people. We did measurements (PPS, HADS, FACT-G, POMS-SF, Freiburg Adaptation Questionnaire) before the intervention (T1), right after the 8-week intervention (T2), and 6 months after the intervention (T3). The experimental group showed significant improvement in the measured psychological variables, and in few aspects of life quality between T1 and T2. There was a decrease in levels of observed stress and depression, and an escalation in optimism and vitality. We found a decrease in depressive and minimizing coping scores as well. There was a significant improvement in two dimensions of quality of life, and all these positive changes remained present by the end of the follow-up period (T3). In the control group, we only found a significant increase in minimizing coping scores at the time of T3 measurements. This is the first impact assessment study done on cancer patients using MBCR techniques in Hungary. The MBCR program is a very effective psychosocial intervention among cancer patients; it has a long term significant impact on mood and quality of life. Orv Hetil. 2017; 158(33): 1293-1301.

Protocol for the MATCH study (Mindfulness and Tai Chi for cancer health): A preference-based multi-site randomized comparative effectiveness trial (CET) of Mindfulness-Based Cancer Recovery (MBCR) vs. Tai Chi/Qigong (TCQ) for cancer survivors

PurposeA growing number of cancer survivors suffer high levels of distress, depression and stress, as well as sleep disturbance, pain and fatigue. Two different mind-body interventions helpful for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared to usual care, they have never been evaluated in the same study or directly compared. This study will be the first to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. It will also allow for secondary analyses of which program best targets specific symptoms in particular groups of survivors, based on preferences and baseline characteristics. Methods and significanceThe design is a preference-based multi-site randomized comparative effectiveness trial. Participants (N=600) with a preference for either MBCR or TCQ will receive their preferred intervention; while those without a preference will be randomized into either intervention. Further, within the preference and non-preference groups, participants will be randomized into immediate intervention or wait-list control. Total mood disturbance on the Profile of mood states (POMS) post-intervention is the primary outcome. Other measures taken pre- and post-intervention and at 6-month follow-up include quality of life, psychological functioning, cancer-related symptoms and physical functioning. Exploratory analyses investigate biomarkers (cortisol, cytokines, blood pressure/Heart Rate Variability, telomere length, gene expression), which may uncover potentially important effects on key biological regulatory and antineoplastic functions. Health economic measures will determine potential savings to the health system.

Mindfulness-Based Cancer Recovery (MBCR) versus Supportive Expressive Group Therapy (SET) for distressed breast cancer survivors: evaluating mindfulness and social support as mediators

Despite growing evidence in support of mindfulness as an underlying mechanism of mindfulness-based interventions (MBIs), it has been suggested that nonspecific therapeutic factors, such as the experience of social support, may contribute to the positive effects of MBIs. In the present study, we examined whether change in mindfulness and/or social support mediated the effect of Mindfulness-Based Cancer Recovery (MBCR) compared to another active intervention (i.e. Supportive Expressive Group Therapy (SET)), on change in mood disturbance, stress symptoms and quality of life. A secondary analysis was conducted of a multi-site randomized clinical trial investigating the impacts of MBCR and SET on distressed breast cancer survivors (MINDSET). We applied the causal steps approach with bootstrapping to test mediation, using pre- and post-intervention questionnaire data of the participants who were randomised to MBCR (n = 69) or SET (n = 70). MBCR participants improved significantly more on mood disturbance, stress symptoms and social support, but not on quality of life or mindfulness, compared to SET participants. Increased social support partially mediated the impact of MBCR versus SET on mood disturbance and stress symptoms. Because no group differences on mindfulness and quality of life were observed, no mediation analyses were performed on these variables. Findings showed that increased social support was related to more improvement in mood and stress after MBCR compared to support groups, whereas changes in mindfulness were not. This suggests a more important role for social support in enhancing outcomes in MBCR than previously thought.

Mindfulness-based cancer recovery in survivors recovering from chemotherapy and radiation

Mindfulness-based cancer recovery in survivors recovering from chemotherapy and radiation