Abstract and key points
- Mindfulness-based clinical interventions encompass multi-component mind-body modalities (mindfulness meditation, Yoga, psycho-education) aimed at reducing emotional distress, mood disturbances and fatigue and improving quality of life.
- Existing evidence suggests that mindfulness-based clinical interventions may improve psychosocial adjustment, especially concerning the reduction of anxiety and depression. Effects on physical health need to be evaluated in future research.
- While generally considered safe, the safety of mindfulness-based clinical interventions has not been rigorously assessed.
Mindfulness-based clinical interventions are mind-body modalities that may encompass multiple components: psycho-educational elements, mindfulness meditation exercises, cognitive-behavioral interventions and movement exercises. Core practices are: sitting meditation (breath awareness, focused attention), body scan (awareness of sensations in the body, 45 minute exercise), Hatha Yoga (mindful movement), walking meditation and insight meditation. The two most used mindfulness-based clinical interventions in oncology are: mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).
Evidence can be drawn from the analysis of seven systematic reviews including 39 individual randomized controlled trials, six non-randomized controlled trials and 24 uncontrolled trials, as well as a further 10 RCTs published after these systematic reviews. One overview of systematic reviews and meta-analyses of RCTs is included as well.
An overall summary of results shows that the two most widely used mindfulness-based clinical interventions – mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) – have positive short-term and probably also medium-term effects on psychological function, in particular on anxiety and depression of breast cancer patients. Similar results are reported in the general cancer population but only a small number of trials are available. All reported effects are however small and prone to potential methodological bias. Evidence for MBSR and MBCT on physical health is lacking which prevents any conclusions to be drawn. Only for fatigue, some trials suggest effects of MBSR over and above those of usual care. For sleep problems, specialized cognitive-behavioral therapy for insomnia seems to be superior to MBSR.
While MBSR and MBCT are generally considered to be safe in supportive cancer care, no rigorous assessment of the safety of mindfulness-based approaches in cancer patients is available.
|Citation||Holger Cramer, Ann-Christine Moenaert, CAM-Cancer Consortium. Mindfulness [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Mindfulness. October 24, 2016.|
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