Meditation Has Many Benefits for Patients With Cancer
By Jyothirmai Gubili, MS, Donna Wilson, RN, MSN, RRT, and Jun J. Mao, MD, MSCE
Meditation is a healing practice that involves focusing attention, regulating breathing, and developing a nonjudgmental awareness of one’s thoughts and feelings. It aims to improve emotional regulation and overall well-being. Data from the 2012 National Health Interview Survey indicate that 18 million adults and 927,000 children (https://www.ncbi.nlm.nih.gov/pubmed/25671660) practice meditation. Meditation encompasses repeating words with phonetic significance as in mantram meditation; paying attention or continually returning to the present moment as in mindfulness meditation; or practicing specific movements as in tai chi and qigong.
Over the past few decades, researchers have focused on mindfulness-based stress reduction (MBSR), an approach consisting of a well-defined eight-week curriculum. It emphasizes sitting meditation and mindful movement that reorients the mind to sense the connection with body and breath. MBSR also provides practitioners insights into the nature of their own stress reactivity and increasing awareness towards their coping mechanisms. The effectiveness of MBSR for managing chronic pain, depression and anxiety, insomnia, diabetes, coronary heart disease, and irritable bowel syndrome is well documented (https://www.ncbi.nlm.nih.gov/pubmed/23762768).
MBSR for Patients With Cancer
The effectiveness of MBSR in controlling cancer and its treatment-related symptoms has been validated in many randomized clinical trials. It was shown to reduce psychological distress (https://www.ncbi.nlm.nih.gov/pubmed/28337821) in patients with lung cancer, improve mood and general well-being (https://www.ncbi.nlm.nih.gov/pubmed/22505593) in patients with different cancer diagnoses, and improve psychological functioning and mindfulness (https://www.ncbi.nlm.nih.gov/pubmed/19918956) in partners of patients with cancer.
Studies in patients with breast cancer reported improvements in anxiety, depression, and long-term emotional and physical adverse effects (https://www.ncbi.nlm.nih.gov/pubmed/22430268) associated with medical and endocrine treatments and quality of sleep (https://www.ncbi.nlm.nih.gov/pubmed/23265707) following MBSR practice. Notably, Reich et al. (2017) showed (https://www.ncbi.nlm.nih.gov/pubmed/27720794) that the salutary effects of MBSR are sustained over several weeks after practice.
In addition, reductions were observed in anxiety, fear of recurrence, and physical symptoms of fatigue severity and fatigue interference (https://www.ncbi.nlm.nih.gov/pubmed/27247219) in breast cancer survivors who practiced MBSR, along with improvements in cancer-related cognitive impairment (https://www.ncbi.nlm.nih.gov/pubmed/26586494). And a six-week mindful-awareness practice was reported to have short-term efficacy in lowering stress, behavioral symptoms, and proinflammatory signaling (https://www.ncbi.nlm.nih.gov/pubmed/25537522) in younger breast cancer survivors. Noteworthy also is a study involving mindfulness-based cancer recovery (MBCR) that focuses on training in mindfulness meditation and gentle yoga. Data indicate that compared to supportive expressive group therapy that focuses on emotional expression and group support, MBCR was superior in improving stress levels, quality of life and social support (https://www.ncbi.nlm.nih.gov/pubmed/23918953) in breast cancer survivors.
Furthermore, MBSR may be useful in pediatric patients as well. A review of mind-body therapy trials that included MBSR showed increased optimism and self-confidence in coping skills (https://www.ncbi.nlm.nih.gov/pubmed/23578913) in a pediatric oncology population.
How MBSR May Work
Mechanistic studies thus far suggest that meditation likely influences changes (https://www.ncbi.nlm.nih.gov/pubmed/25783612) in the structural and functional aspects of brain that are involved in regulating attention, emotion and self-awareness. In a randomized study (https://www.ncbi.nlm.nih.gov/pubmed/20633873), mindful breathing exercise increased “decentering” from internal experiences and decreased reactivity to repetitive thoughts. MBSR may also exert immunomodulatory effects (https://www.ncbi.nlm.nih.gov/pubmed/12883107) by reducing the ratio of T1 proinflammatory to T2 anti-inflammatory lymphocytes. It also increases telomerase activity (https://www.ncbi.nlm.nih.gov/pubmed/24486564), a known marker of cellular aging and psychological status.
Recommending MBSR for Your Patients
Oncology nurses or advanced practice nurses should be aware of current evidence that supports the use of meditation for alleviating psychological and physical symptoms in patients with cancer and survivors. It is recommended by the Society of Integrative Oncology as part of an interprofessional approach (https://www.ncbi.nlm.nih.gov/pubmed/25749602) to improve the quality of life of patients with breast cancer. MBSR also was recently shown to be cost effective (https://www.ncbi.nlm.nih.gov/pubmed/26477119) when compared with other interventions in a study of breast cancer survivors. When working with patients or families who experience distress associated with cancer diagnosis or treatment, oncology nurses can rely on meditation as one of the tools to help individuals find peace and restore a sense of wellness.