Mindfulness-based Stress Reduction Reduces Cognitive Deficits in Survivors of Breast and Colorectal Cancers

Participation in a mindfulness-based stress reduction (MBSR) program yields robust and sustained improvement in cancer-related cognitive impairment. These findings were published in the Journal of Cancer Survivorship (doi:10.1007/s11764-015-0494-3).

Cancer-related cognitive impairment is a prevalent and potentially debilitating condition that affects attention, memory, and executive function in survivors. Sometimes referred to as chemo brain or postcancer cognitive fuzziness, the condition is common among survivors and known to disrupt social relationships, work ability, self-confidence, and quality of life. However, clinicians have few treatment options to offer. Cognitive deficits have been reported to persist for more than a decade after cancer treatment for many survivors.

This research, from the Regenstrief Institute and Indiana University (IU) School of Medicine, both in Indianapolis, is the first randomized clinical trial to evaluate the effects of MBSR on fatigued breast and colorectal cancer survivors, the majority of whom received chemotherapy.

In the study, participants who practiced MBSR reported significantly greater improvement in their ability to pay attention, and made fewer mistakes on difficult cognitive tasks compared with those in the control group, who received patient education materials and supportive counseling. Both groups attended 2-hour classes led by skilled facilitators for 8 weeks.

Retention rates in the trial exceeded 95%, strongly suggesting that participants found the program to be worthwhile. Previous studies by the Regenstrief-IU research group demonstrated MBSR to have a positive impact on post cancer fatigue, depression, and sleep disturbance.

Mindfulness training is thought to improve cognitive functioning through mechanisms of focused attention and nonreactive coping with one's internal experiences, such as thoughts, feelings, and bodily sensations. Programs in MBSR include a variety of meditation and yoga practices and other elements. These programs typically cost $200 to $800 for an 8-week program, and are widely available in communities and on the Internet.

Those who participated in the MBSR arm of the study reported significant engagement with high rates of self-reported home practice of mindfulness techniques during the study. The majority continued to practice mindfulness throughout the 6-month period following conclusion of the program.

"More people than ever are surviving cancer due to the development of targeted and effective treatments," said Shelley Johns, PsyD, the clinical health psychologist and health services researcher who led the Regenstrief-IU study. "Yet many cancer survivors are living with difficult and persistent side effects of these treatments, which can be incapacitating.

"Mindfulness meditation practices enable cancer survivors to better manage cancer-related cognitive impairment, reported by approximately 35% of cancer survivors who have completed treatment," said Johns, who is a Regenstrief Institute investigator and assistant professor of medicine at the IU School of Medicine. "MBSR provides a creative solution for survivors whose social and occupational functioning may have been negatively impacted by cognitive difficulties."

Although some oncologists provide patients with information on cancer-related cognitive impairment, many clinicians do not address this symptom due to a lack of evidence-based treatments for the condition, explained Johns.

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