Efficacy of a lovingkindness meditation intervention

Wren, A. A., et al. (2019). Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study. Supportive Care in Cancer, pp. 1-10. From Abstract.

Purpose: Despite more women undergoing treatment for breast cancer and increased survival rates, many women suffer from anxiety and physical symptoms (e.g., pain, fatigue) surrounding diagnosis and surgery. Research investigating the efficacy of psychosocial interventions for breast cancer patients during this period is limited. This randomized controlled pilot study examined the effect of a brief lovingkindness meditation intervention on these key outcomes.

Results: Multilevel modeling analyses demonstrated that lovingkindness meditation significantly improved pain, self-compassion, and heart rate over time compared to control conditions. There was a trend for anxiety. Music significantly improved pain compared to usual care.

Improving psychological well-being for adults with advanced cancer

Zimmermann, Fernanda F., et al. (2017). “The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: A systematic review. “Complementary Therapies in Clinical Practice.” Online Dec 12, 2017, https://doi.org/10.1016/j.ctcp.2017.12.014.

From the Abstract:

The acceptability and potential benefits of mindfulness-based interventions (MBIs) for the psychological well-being of people with advanced cancers were described, evaluated and synthesized.

The number of studies identified was notably small, MBIs showed benefits and acceptability, but logistical problems and limitations were reported.

Some adaptations to the MBIs must be considered given the target population’s needs, to allow patients to participate in this kind of treatment.

The ethical and methodological obstacles identified provide insights of what kind of MBIs may appropriately address this population needs.

Barriers to meditation among cancer family caregivers

Williams, A. L., Van Ness, P., Dixon, J., & McCorkle, R. (2012). Barriers to meditation by gender and age among cancer family caregivers. Nursing research, 61(1), 22.

From the Abstract. Despite solid basic science research supporting meditation’s physiologic benefits, meditation remains a marginalized practice for many Westerners; observational and descriptive studies indicate a spectrum of barriers to meditation practice.

A cross-sectional survey study was conducted of 150 family caregivers to adults with cancer visiting an outpatient chemotherapy center in Connecticut, United States. The primary outcome was the Determinants of Meditation Practice Inventory. Explanatory variables included demographic characteristics, Center for Epidemiologic Studies Depression scale, Big Five Inventory, and Caregiver Reactions Assessment. Participants included 98 women and 52 men. Age range was 18–84 years (M = 52.3 years).

The highest frequency of barriers for both genders related to misconceptions about meditation.

iPad-assisted meditation during chemotherapy infusion

Millegan, J., Manschot, B., Dispenzieri, M., Marks, B., Edwards, A., Raulston, V., … & Narro, M. (2015). Leveraging iPads to introduce meditation and reduce distress among cancer patients undergoing chemotherapy: a promising approach. Supportive Care in Cancer, 1-2. Abstract only.

Distress is common among cancer patients. Regular meditation practice has the potential to mitigate this distress and improve quality of life for this population. Introducing meditation to cancer patients can be particularly challenging given the demands on patients’ time from treatment and normal life events. This internal process improvement study examined the potential benefit of utilizing iPads during chemotherapy sessions to introduce meditation and reduce distress.

Patients undergoing chemotherapy infusion were offered iPads with various meditation videos and audio files during the session. Levels of distress were measured using the distress thermometer at the beginning of chemotherapy and at the conclusion of chemotherapy.

Seventy-three patients accepted the meditation iPads during the chemotherapy session. Among those who accepted the iPads, average distress dropped 46 % by the end of the session.

MBIs tailored to individuals with cancer

Rouleau, C. R. , Garland, S. N., & Carlson, L. E. (2015). The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer Management and Research, 7, 121-131. Full Text.

Abstract: Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness).

This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients – namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer.

Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic–pituitary–adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits.

We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes.

Mindfulness and disgust in colorectal cancer scenarios

Reynolds, L. M., Consedine, N. S., & McCambridge, S. A. (2014). Mindfulness and disgust in colorectal cancer scenarios: Non-judging and non-reacting components predict avoidance when it makes sense. Mindfulness, 1-11.

From the Abstract. Mindfulness facilitates greater tolerance of unpleasant emotion and may thus promote better decision making in health settings where emotional avoidance is common. Disgust’s elicitors are common in colorectal cancer (CRC) contexts and, because disgust evolved to minimise contamination risk through avoidance and withdrawal, decision making when disgusted is important.

The current report investigated whether specific components of dispositional mindfulness predict elicited disgust and avoidance behaviours in scenarios based around CRC screening and treatment. After completing trait mindfulness measures, 80 healthy volunteers were block randomised (by gender) to disgust or control conditions before completing tasks assessing immediate avoidance of a disgust elicitor (stoma bag) and anticipated avoidance of a hypothetical CRC drug with disgusting side effects.

In total, these findings suggest persons with low mindfulness may fail to attend to emotional experience when making decisions while those higher in non-react and non-judge components may use their disgust to inform both current and future behaviour. Mindfulness training may promote more integrated decision-making skills in CRC contexts where disgust is a factor.

Effect of MBSR on spirituality and post-traumatic growth

Labelle, L. E., et al. (2014). Does self-report mindfulness mediate the effect of Mindfulness-Based Stress Reduction (MBSR) on spirituality and posttraumatic growth in cancer patients?. The Journal of Positive Psychology, (ahead-of-print), 1-14.

From the Abstract. This longitudinal waitlist-controlled study evaluated the effects of Mindfulness-Based Stress Reduction (MBSR) on spirituality, posttraumatic growth (PTG), and mindfulness in cancer patients. The study also assessed whether increased mindfulness mediated the effects of MBSR on spirituality and PTG.

Patients were either registered for immediate participation in MBSR (n = 135), or were naturally waiting for the next program (n = 76). Participants completed questionnaires pre-, mid-, and post-MBSR, or waiting period.

MBSR participants demonstrated increased spirituality, PTG, and mindfulness, relative to controls. Change in all mindfulness facets mediated the effect of MBSR on spirituality and PTG. The development of mindfulness skills through MBSR may facilitate a sense of meaning, peacefulness, connectedness, and personal growth in cancer patients. This investigation contributes to an emerging focus on determining ‘how’ mindfulness-based interventions work.

Single-session meditation in oncology outpatient clinic

Chaoul, A., et al. (2014). An Analysis of Meditation Consultations in an Integrative Oncology Outpatient Clinic. The Journal of Alternative and Complementary Medicine, 20(5), A86-A86.

From the Abstract. The majority of cancer patients use some complementary medicine modality. Mind-body practices, and especially meditation, are amongst the most utilized. Research shows that they help cancer patients manage psychological distress and control symptoms such as pain, nausea, and sleep disturbances. However, the effects of a single meditation session on self-reported symptoms, including physical, psychological and symptom distress in an outpatient setting, are largely unknown.

All patients [received] an individual meditation consultation (60 minute initial visits, and 30 minute follow-up visits). Our analysis included 81 meditation visits for 121 participants over 32 months. The [results] revealed a significant reduction from pre- to post-meditation session in physical, psychological, and symptom distress component scores. The greatest mean reductions for individual symptoms were for: Anxiety, Fatigue, Distress, Well Being, Sleep, and Pain; all changes reaching statistically and clinically significant thresholds.

Further research with a larger sample size is needed to better understand the symptoms that meditation can help control and the frequency of self-practice outside of the clinic to help maintain the long-term benefits.

Pranic meditation: significant benefits for cancer patients

Castellar, J. I., Fernandes, C. A., & Tosta, C. E. (2014). Beneficial Effects of Pranic Meditation on the Mental Health and Quality of Life of Breast Cancer Survivors. Integrative Cancer Therapies, 1534735414534730.

From the Abstract. Breast cancer survivors frequently present long-lasting impairments, caused either by the disease or its treatment, capable of compromising their emotional health and quality of life. Meditation appears to be a valuable complementary measure for overcoming some of these impairments. The purpose of the present investigation was to assess the effect of pranic meditation on the quality of life and mental health of breast cancer survivors.

The subjects were 75 women submitted either to breast cancer therapy or to posttherapy control who agreed to practice pranic meditation for 20 minutes, twice a day, during 8 weeks, after receiving a formal training. After 8 weeks … the results of this pilot study showed that breast cancer survivors presented significant benefits related to their mental health and quality of life scores after a short period of practice of pranic meditation, consisting of simple and easy-to-learn exercises.

However, because of the limitations of the study, further research is required using a more rigorous experimental design to ascertain whether pranic meditation may be an acceptable adjunct therapy for cancer patients.

For women with cancer recurrence

Thornton, L. M., et al. (2014). Test of Mindfulness and Hope Components in a Psychological Intervention for Women With Cancer Recurrence. Journal of consulting and clinical psychology. Epubl ahead of publication.

From the Abstract. Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and bio-behavioral components.

Method: An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included.

Results: Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety.

Conclusions: The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent.