Therapy In Cancer Care Research Articles

Cancer care and occupational therapy: A scoping review.

Cancer can disrupt participation in everyday activities, suggesting a place for occupational therapy; however, there is a need to articulate the nature, scope and available evidence supporting the occupational therapy role within cancer care. In this scoping review, we identify the breadth of practice and evidence for occupational therapy in cancer care, across all stages of the disease trajectory (diagnosis to palliation/survivorship) throughout the lifespan. Five electronic databases were searched in June 2018, for English language articles. Key words were: cancer care, OR oncolog*, OR oncologic care, OR neoplasms, OR cancer survivors, OR terminal cancer, OR cancer rehabilitation, AND occupational therap*. No date restrictions were imposed. Included were: all styles of literature including grey literature, all types of cancers and all age brackets. There were no restrictions on place of origin of papers. Following the Arksey and O'Malley (2006; International Journal of Social Research Methodology, 8: 19-32) framework for scoping reviews, the first author screened titles and abstracts, and all three authors reviewed sets of the included articles. Conflicts were discussed until consensus was reached. After evaluating 305 titles and abstracts and 111 full-text articles, 89 papers were retained. Articles included research studies (n=43), reviews (n=15), grey literature (n=16), practice analyses (n=14) and an editorial (n=1). The occupational therapy roles described were diverse, but largely descriptive in nature, with little evidence of outcomes from treatment. Furthermore, the majority of papers addressed adult populations, with few considering children, adolescents or young adults. Most papers focused on specific stages of the disease, and none addressed the disease along its full trajectory. Despite identifying a diverse range of occupational therapy roles in cancer care throughout the disease trajectory and across the lifespan, the need for professional discourse and research within our profession was highlighted. This was particularly evident for adolescents and young adults with cancer.

Oral and injectable Marsdenia tenacissima extract (MTE) as adjuvant therapy to chemotherapy for gastric cancer: a systematic review

BackgroundMarsdenia tenacissima extract (MTE) is a phytochemical widely used as complementary therapy in cancer care. This systematic review was conducted to investigate the anticancer and detoxification effects of MTE, as an adjuvant therapy to chemotherapy, for treating gastric cancer.MethodsTen databases were searched to identify randomized controlled trials (RCTs) comparing oral or injectable MTE plus chemotherapy versus chemotherapy alone for treating gastric cancer up to May 1, 2019. In meta-analyses, proportional odds ratios (PORs) with 95% confidence intervals (CIs) were pooled for the ordinal outcomes using the generalized linear model, and risk ratios (RRs) with 95% CIs were pooled for dichotomous outcomes using the Mantel-Haenszel method.ResultsSeventeen RCTs with 1329 individuals were included, with a moderate to high risk of selection and performance bias. Compared to chemotherapy alone, MTE adjuvant therapy significantly improved the response to anticancer treatment (POR 2.01, 95% CI 1.60–2.53) and patients’ performance status (POR 3.15, 95% CI 2.22–4.48) and reduce the incidences of chemotherapy-induced leukopenia (RR 0.66, 95% CI 0.56–0.78), thrombocytopenia (RR 0.64, 95% CI 0.48–0.86), anemia (RR 0.89, 95% CI 0.72–1.10), nausea/vomiting (RR 0.79, 95% CI 0.69–0.91), hepatic injury (RR 0.77, 95% CI 0.61–0.96), and peripheral neurotoxicity (RR 0.77, 95% CI 0.59–1.01). However, MTE did not significantly alleviate anemia, diarrhea, constipation, kidney injury, and oral mucosal lesions after chemotherapy. Incidence of nausea/vomiting was lower in patients receiving oral MTE than those receiving injectable MTE (RR 0.47 vs. 0.82, interaction P = 0.04). Heterogeneity was generally low among these outcomes. Three out of five RCTs that reported survival data supported the effects of MTE for prolonging progression-free and/or overall survival. No studies reported safety outcomes of MTE.ConclusionsThe current evidence with limitations of risk of selection and performance bias suggests that MTE, as an adjuvant therapy to chemotherapy, is effective for inhibiting cancer growth and reducing incidences of multiple chemotherapy side effects. Oral MTE may be a better choice. Uncertainty remains regarding the effects of MTE on survival endpoints and the subgroup differences between acute and chronic use of MTE and between different chemotherapy regimens.

The Impact of Home Infusion Therapies on Caregivers.

To describe the scope of home infusion therapy in cancer care, expectations related to caregiver involvement in home infusion therapy, literature addressing the impact upon caregivers, and nursing implications. Published data on cancer care and home infusion therapy. While the administration of home infusion therapy is not uncommon practice for patients with cancer and is generally well-accepted, there is scant research focused specifically on the impact upon caregivers. Caregiver support not only includes providing instruction in infusion-related tasks but also recognizing the potential impact on the caregiver's life and offering supportive interventions.

Tumor Board Shadowing: A Unique Approach for Integrating Radiation Oncologists Into General Medical Student Education

Radiation oncology is often overlooked in US medical school curricula, with few opportunities for most students to learn about the specialty or the value of radiation therapy in cancer care. Tumor boards represent a potential avenue not only to increase students' exposure to radiation oncologists but also to provide a fundamental understanding of the multidisciplinary nature of cancer care and effective collaboration in clinical practice. In this study, we evaluated a novel radiation oncologist-driven tumor board shadowing experience at 3 medical schools in the United States and Canada. A total of 323 first- and second-year medical students participated, of whom 77.4% completed a follow-up survey assessing the effectiveness of the program as a learning tool. Compared with traditional clinical shadowing, students were more likely to believe that tumor board shadowing provided a similar or better experience in termsof educational content (85%), exposure to a new field (96%), and overall experience (89%). Forty-eight percent of students perceived a greater amount of multidisciplinary collaboration in oncologic care than they thought existed prior to attending. Forty-eight percent of students also felt more competent interacting with oncologists after participating, whereas 21% felt more competent interacting with patients with cancer. Students' perception of increased competence was correlated with the amount of time their assigned physician mentor spent answering their questions after the tumor board (P<.01). Second-year medical students also had a more favorable overall experience than first-year medical students did (P=.04). Multidisciplinary tumor boards can be used effectively as a unique immersive learning opportunity that can be feasibly implemented to improve knowledge of clinical oncology and multidisciplinary care in medical schools and expose students to physicians in smaller fields such as radiation oncology.

Current developments of clinical research on mistletoe therapy in cancer care

Current developments of clinical research on mistletoe therapy in cancer care

Painting Therapy in Cancer Care: A Descriptive Systematic Review

Background: Despite art therapy has been widely used in cancer population to improve their physical and mental health, painting therapy, as one form of art therapy, is seldom applied to adult cancer patients independently. Therefore, how painting therapy affects adult cancer patients’ health outcomes needed to be explored sufficiently. Objectives: The purpose of this review was to assess and synthesize the latest evidence of painting therapy concerning adult cancer patients, and to provide some inspiration for clinical staff. Methods: A literature research of PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, PsychoInfo, Psydex, CENTRAL, Google Scholar, British Library, CNKI, Wanfang, CQVIP electronic databases were undertaken with the following key words: art therapy, painting, drawing, cancer, neoplasm, tumor, carcinoma and oncology. A narrative synthesis was used according to PRISMA and the quality of study was assessed using acritical assessment tool. Results: Eleven papers reporting nine different research projects met the inclusion criteria. Generally speaking, painting therapy positively affected health outcomes. The impacts on patients include improvements in quality of life, coping with disease, mental health and somatic symptoms. However, inconsistency still exists. Three studies failed to show positive effects of painting therapy on post-traumatic growth, distress and coping behavior in participants. Conclusion: Robust evidence was found in rehabilitation of patients with various types of cancer. Painting therapy evidently affected cancer patients in a positive direction. However, the application of painting therapy to cancer patients needs to be explored further due to few studies on this topic.

P2.08-013 Integrated Complementary ‘Energy' Therapy Improves Patient Experience of a Lung Cancer Diagnosis: Topic: Other

40,000 people were diagnosed with Lung cancer in the UK in 2012. Invasive procedures and repeated clinic visits compound the stress of diagnosis. This study reports a non pharmacological approach to improving patient experience. Energy therapies exist in many medical traditions healing through interaction with the patient’s biofield –the invisible psychophysical entity including the body but extending beyond it in the form of energy. In this case a technique where a trained therapist uses light touch or hands held a short distance from the subject to transfer energy to the recipient and bring a greater sense of well being. 112 patients were invited to receive an ‘Energy therapy’ session alongside their clinic appointment or bronchoscopy. The primary endpoint was reduction in anxiety. Pre and post treatment data was collected from self completed anonamised questionnaires using a 0-10 scale for subjective variables and non-invasive blood pressure recordings. Data was analysed using a students t-test. 83 patients took part in the study. 60% female, mean age 62.69. Table 1 summarises the questionnaire scores. Patients reported statistically significant reduction in anxiety, tension, stress and pain following a session of energy therapy. There was also an improvement in mood and sense of calm.Tabled 1Change in mood scores before and after Energy therapyVariable ( 0= best 10= worst)Pre-treatment mean score N = 80Post-treatment mean score N= 80Degree of change (p)Anxiety (Do you feel anxious)5.452.33.15 (<0.001)Calm (do you feel calm)4.891.713.175 (<0.001)Tension (do you have tension in your body?)5.232.163.062 (<0.001)Stress (do you feel stressed)5.462.093.375 (<0.001)Mood (do you feel low in mood)4.682.352.35 (<0.001)Pain (are you in pain)3.401.731.675 (<0.001)Systolic BP (n=78)135.28131.154.12 (0.007 Open table in a new tab The role of complementary therapy in cancer care has long been recognised internationally and there are reports of Energy therapy used synergistically in palliative care and management of chemotherapy side effects [i]. We believe this is the first study to look at the role of complementary Energy therapy in supporting patients undergoing a cancer diagnosis. Complementary ‘energy’ therapy is a powerful tool to significantly reduce anxiety, tension and boost mood for patients undergoing investigation and treatment for lung cancer [i] Jain S, Mills P: Biofield therapies: Helpful or full of hype? A best evidence synthesis. Int J Behav Med 17:1–16, 2010

Healing the Feelings and Feeling the Healing: Hypnotic Approaches in Cancer and Palliative Care

This workshop will focus on clinical demonstrations of hypnotic suggestion through metaphors for self-regulation improvements, pain relief, palliation of symptoms, and amelioration of hope in the face of advanced or progressive illness. These materials were designed (Néron and Handel, In Press) for health care professionals who use – or may decide to use – clinical hypnosis in their professional work with patients. The role of adjunctive hypnotic therapy in cancer care is to help manage distressing symptoms and to give the sufferer a sense of control via mind-body regulation. Physicians and health care professionals can integrate personalized hypnotic approaches in order to help patients regulate physiological functions, alleviate pain, enhance the release of tension, reframe hope, facilitate new levels of personal adjustments, and promote or restore healing spiritual experiences.The workshop will include case-based, video clip demonstrations to cover the following topic areas: a) addressing patients’ misconceptions about hypnosis, b) establishing appropriate clinical goals, c) using hypnotic techniques in different medical settings, d) developing quick ways of reaching a hypnotic state, e) teaching self-hypnosis, f) preparing for medical procedures, g) reframing hope, and h) promoting healing spiritual experiences.Objectives: Participants will be introduced to ways of: a) Integrating guided clinical hypnosis procedures at bedside and in several medical contexts. b) Empowering the sufferer by teaching him or her how to use self-hypnosis for symptom relief and for addressing their existential issues.ReferenceNéron, S., and Handel, D. Hypnotic Approaches in Cancer and Palliative Care. Quebec: Presses de l’Université du Québec, In Press.

Art therapy's contribution to the psychological care of adults with cancer: A survey of therapists and service users in the UK

While art therapy in cancer care has been documented for over 60 years, there remains a lack of awareness of art therapists within the UK cancer workforce. The study addressed this knowledge gap. This cross-sectional mixed-methods survey used web-based questionnaires for art therapists and service users, and semi-structured interviews with service users. The sampling frame covered England, Scotland, Wales and Northern Ireland; data collection occurred in May–July 2011. Inclusion criteria were cancer, art therapy experience and an age of at least 18 years. Art therapists had to be registered with the Health and Care Professions Council. Therapists' questionnaires used the cancer care pathway and NICE four levels model of psychological difficulties. Thirty-two art therapists and 55 service users participated. Service users found art therapy helpful (92%), agreeing that it benefited coping, aided communication, facilitated expression of feelings, provided new perspectives and assisted distraction from worries. Thematic analysis identified five themes: accessibility; mental wellbeing; creativity; support; and multiple perspectives. Art therapists are part of the UK cancer workforce, contributing their services from diagnosis to end of life. Service users confirmed the psychological importance of art therapy. The non-verbal, embodied, aesthetic aspects of art therapy provide a distinctive addition to verbal psychosocial support.

Medical Family Therapy in Cancer Care: Patient and Family Experiences

This study used a phenomenological approach to explore the experience of patients and family members who received Medical Family Therapy (MedFT) services as a part of their cancer care treatment. Narratives were collected from fourteen participants, resulting in the formation of 3 main categories and 13 thematic clusters. Participants described in detail what made the services unique to their treatment, methods of engagement that were meaningful, and interventions and strategies they found beneficial. Recommendations for future research and clinical implications are provided.

Molecular Targeting Agents in Cancer Therapy: Science and Society

The inception of targeted agents has revolutionized the cancer therapy paradigm, both for physicians and patients. A large number of molecular targeted agents for cancer therapy are currently available for clinical use today. Many more are in making, but there are issues that remain to be resolved for the scientific as well as social community before the recommendation of their widespread use in may clinical scenarios can be done, one such issue being cost and cost effectiveness, others being resistance and lack of sustained efficacy. With the current knowledge about available targeted agents, the growing knowledge of intricate molecular pathways and unfolding of wider spectrum of molecular targets that can really matter in the disease control, calls for only the just use of the agents available now, drug companies need to make a serious attempt to reduce the cost of the agents. Research should focus on agents that show sustained responses in preclinical data. More needs to be done in laboratories and by the pharmaceutical industries, before we can truly claim to have entered a new era of targeted therapy in cancer care.

The Healing and Spiritual Properties of Music Therapy at a Cancer Care Center

This article explores the theme of spirituality, health, and well-being, in relation to an emerging body of research on the impact of music therapy in cancer care. The focus of this article is a music therapy service established as part of a residential 5-day retreat program at a cancer care center. The aim of the study was to explore the experiences of patients with cancer with one-off group music therapy at a cancer care center. Central emphasis is given to exploring a range of themes relating to the healing and spiritual properties of music therapy group work. This is a qualitative study, following a modified grounded-theory approach. Twenty-three (23) in-depth tape-recorded telephone interviews were conducted with people who had taken part in the music therapy sessions. The results focus on those findings relevant to notions of spirituality and healing, drawing on four overarching spirituality themes of transcendence, connectedness, search for meaning, and faith and hope. The authors consider the applicability of broader schemas that attempt to define and explore the role and significance of spirituality.

Abstract 1948: Functional profiling of signal transduction pathway proteins in gastric cancer (GC) patients

Abstract Although gastrectomy is the only curative treatment in gastric cancer (GCA) patients, a high recurrence rate ranging from 40 ∼ 60% following curative surgery still accounts for poor overall survival. In order to further improve survival, there is an urgent need to identify reliable molecular prognostic markers for survival or recurrence following adjuvant chemoradiation therapy. With the advent of molecularly targeted therapy in cancer care, profiling of pathway proteins for targeted drug is of utmost importance. Hence, we have developed a multiplexed immunoassay platform for functional profiling of the signal transduction pathway proteins using a multiplexed immuno-microarray platform. A multiplexed protein microarray platform, Collaborative Enzyme Enhanced Reactive-immunoassay (CEER) that utilizes the formation of a unique immuno-complex requiring co-localization of two detector-antibodies (d-abs) has been utilized to profile targetable biomarkers in 447 fresh frozen tumor tissues procured during surgical procedure from GCA patients with localized disease. The collaboration between two channeling-enzymes conjugated on two d-abs in proximity enables the profiling of the target proteins with extreme sensitivity and specificity in multiplexed fashion. As CEER can also be configured for each specific target protein, it allows differential detection of truncated targets (i.e., p95HER2) from their normal counter parts (i.e., HER2). Here we report the profiling of HER2, p95HER2, HER1, HER3, PI3K, cMET, Shc and IGF1R in GCA for their levels of expression and phosphorylation. Approximately 12% of patients in this cohort expressed high levels of HER2. Varying levels of truncated HER2 were detected in 7.1% (27/447) of GCA pts. HER3 were found in approximately 40% of pts. The prevalence of biomarker expression/activation along with the outcome of unsupervised clustering analysis of signaling molecules revealing diverse and distinct disease subtypes will be presented. The treatment of recurrent or metastatic GC may be optimized based on patient-specific functional profiling of biomarker leading to patient-tailored treatment strategies. In addition, the incidence of alteration in transduction pathway proteins may guide oncologists for further clinical development of targeted therapies or combined / sequenced targeted therapies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1948. doi:10.1158/1538-7445.AM2011-1948

Functional profiling of signal transduction pathway proteins in gastric cancer (GC) patients.

e14555 Background: With the advent of molecularly targeted therapy in cancer care, identification of target population for target drug is of utmost importance. Gastric cancer has not been extensively profiled for transduction pathway proteins. Here we report the prevalence of HER1, HER2, p95HER2, HER3, IGF1-R, c-MET, PI3K, Shc, VEGFR, panCK, and other signal transduction pathway protein expression and their levels of activation in GC patients. Methods: From 2004 to 2006, 500 GC surgical specimens were procured at Samsung Medical Center. All of the specimens were collected during gastrectomy and were appropriately frozen at – 80 °C. All of the specimens were analyzed at Prometheus, CA, USA. We applied COPIA to investigate the levels of expression and activation of signaling proteins in frozen tissues collected from GC patients. The Collaborative Proximity Immunoassay (COPIA) is a multiplexed protein microarray platform that utilizes the formation of a unique immuno-complex requiring co-localization of two detector-antibodies. The detector-antibodies are conjugated with corresponding channeling-enzymes, glucose oxidase (GO) and horseradish peroxidase (HRP). Once target proteins are bound by the capture antibodies, the channeling events between GO and HRP in proximity enables the profiling of the target proteins with extreme sensitivity. COPIA delivers extremely high analytical specificity as it requires multiple entities within target specific proximity for the signal generation/amplification. COPIA can also be configured for each specific target protein to allow differential detection of truncated targets (i.e., p95HER2) from their normal counter parts (i.e., HER2). Results: We will be reporting on the prevalence of HER1, HER2, p95HER2, HER3, IGF1-R, c-MET, PI3K, Shc, VEGFR, panCK, and other signal transduction pathway protein expression and their levels of activation in 500 GC patients. Conclusions: The treatment of recurrent or metastatic GC may be optimized by functional profiling of GC. In addition, the incidence of alteration in transduction pathway proteins may guide oncologists for further clinical development of targeted therapies or combined therapies. No significant financial relationships to disclose.

Role of Massage Therapy in Cancer Care

The care of patients with cancer not only involves dealing with its symptoms but also with complicated information and uncertainty; isolation; and fear of disease progression, disease recurrence, and death. Patients whose treatments require them to go without human contact can find a lack of touch to be an especially distressing factor. Massage therapy is often used to address these patients' need for human contact, and findings support the positive value of massage in cancer care. Several reviews of the scientific literature have attributed numerous positive effects to massage, including improvements in the quality of patients' relaxation, sleep, and immune system responses and in the relief of their fatigue, pain, anxiety, and nausea. On the basis of these reviews, some large cancer centers in the United States have started to integrate massage therapy into conventional settings. In this paper, we recognize the importance of touch, review findings regarding massage for cancer patients, describe the massage therapy program in one of these centers, and outline future challenges and implications for the effective integration of massage therapy in large and small cancer centers.

Creativity, identity and healing: participants' accounts of music therapy in cancer care

This article reports on findings from a study of the accounts of people participating in music therapy as part of a programme of complementary and alternative medicine (CAM) in supportive cancer care. The article outlines the perceived effects of music therapy, which shares many characteristics with CAM therapies as well as offering a distinct contribution as a creative therapy. Hence in this article we draw on theories and writings from the sociology of CAM as well as those relating to music, healing and aesthetics in order to explore participants' accounts. The importance of identity and the role of creativity in processes of individuation are key themes emerging from the analysis. While music and creativity are often seen uncritically as resources for health and well-being, we draw attention to the challenges and complexity of diverse responses to music, framed by personal biographies that are in turn often situated within socially constructed notions of aesthetics. We argue that in research on music therapy, as well as other CAM therapies, issues of identity can be key to an understanding of questions of therapeutic impact.

Qigong for cancer treatment: A systematic review of controlled clinical trials

Qigong is a mind-body integrative exercise or intervention from traditional Chinese medicine used to prevent and cure ailments, to improve health and energy levels through regular practice. The aim of this systematic review is to summarize and critically evaluate the effectiveness of qigong used as a stand-alone or additional therapy in cancer care. We have searched the literature using the following databases from their respective inceptions through November 2006: MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library 2006, Issue 4, four Korean Medical Databases, Qigong and Energy Medicine Database from Qigong Institute and four Chinese Databases. Randomised and non-randomised clinical trials including patients with cancer or past experience of cancer receiving single or combined qigong interventions were included. All clinical endpoints were considered. The methodological quality of the trials was assessed using the Jadad score. Nine studies met our inclusion criteria (four were randomised trials and five were non-randomised studies). Eight of these trials tested internal qigong and one trial did not reported details. The methodological quality of these studies varies greatly and was generally poor. All trials related to palliative/supportive cancer care and none to qigong as a curative treatment. Two trials suggested effectiveness in prolonging life of cancer patients and one failed to do so. We conclude that the effectiveness of qigong in cancer care is not yet supported by the evidence from rigorous clinical trials.

Efficacy of homeopathic therapy in cancer treatment

Many cancer patients use homeopathic approaches to increase their body's ability to fight cancer, improve their physical and emotional well-being, and alleviate their pain resulting from the disease or conventional treatments. Homeopathy is highly controversial as there is no plausible mode of action for these highly diluted remedies. The aim of this systematic review is to summarize and critically evaluate the efficacy of homeopathic remedies used as a sole or additional therapy in cancer care. We have searched the literature using the databases: Amed (from 1985); CINHAL (from 1982); EMBASE (from 1974); Medline (from 1951); and CAMbase (from 1998). Randomised and non-randomised controlled clinical trials including patients with cancer or past experience of cancer receiving single or combined homeopathic interventions were included. The methodological quality of the trials was assessed by Jadad score. Six studies met our inclusion criteria (five were randomised clinical trials and one was a non-randomised study); but the methodological quality was variable including some high standard studies. Our analysis of published literature on homeopathy found insufficient evidence to support clinical efficacy of homeopathic therapy in cancer care.

Music and healing in cancer care: A survey of supportive care providers

This paper explores the role of music activity and music therapy in health care drawing on a survey of UK cancer care providers offering music interventions and music therapy. The survey examined the extent and type of music provision and explored providers’ views about the role and contribution of music and music therapy in healing. As well as music, the survey organisations offered a range of supportive therapies including complementary and alternative therapies (CAM) and creative therapies such as art therapy. The results provide insight into the way in which music and creative therapies are viewed by those responsible for care provision in this sector. The data point towards some of the challenges facing music therapists in the changing world of cancer care. These include responding to changes arising from developments in treatment and the organisation of care as well as increased collaboration with a diverse range of supportive care practitioners. These include providers of music and arts for health activity as well as complementary and alternative therapy practitioners who are increasingly involved in cancer care provision. We discuss the implications of these changes for the development of music therapy in cancer care.

Mindfulness‐Based Stress Reduction as supportive therapy in cancer care: systematic review

This paper reports a systematic review and critical appraisal of the evidence on the effectiveness of Mindfulness-Based Stress Reduction for cancer supportive care. The experience of cancer can have a negative impact on both psychological and physical health and on quality of life. Mindfulness-Based Stress Reduction is a therapy package that has been used with patients with a variety of conditions. In order to draw conclusions on its effectiveness for cancer patients, the evidence requires systematic assessment. A comprehensive search of major biomedical and specialist complementary medicine databases was conducted. Additionally, efforts were made to identify unpublished and ongoing research. Relevant research was categorized by study type and appraised according to study design. Clinical commentaries were obtained for each study and included in the review. Three randomized controlled clinical trials and seven uncontrolled clinical trials were found. A lack of relevant qualitative research studies was identified. Studies report positive results, including improvements in mood, sleep quality and reductions in stress. A dose-response effect has been observed between practice of Mindfulness-Based Stress Reduction and improved outcome. A number of methodological limitations were identified. Modifications to the traditional Mindfulness-Based Stress Reduction programme make comparison between studies difficult and a lack of controlled studies precludes any firm conclusion on efficacy. Mindfulness-Based Stress Reduction has potential as a clinically valuable self-administered intervention for cancer patients. Further research into its efficacy, feasibility and safety for cancer patients in the nursing context is recommended.