Cancer patients may benefit from mindfulness-based therapy

Mindfulness-based therapy may help ease anxiety and depression in some patients with cancer, a small research review suggests.

As medical advances have helped transform cancer from a death sentence to a chronic disease for many patients, more attention is being paid to the physical and mental health problems that can linger even after tumors subside.

Depression and anxiety, common in terminal cancer patients and people with persistent pain, can also affect patients who have a better prognosis but fear treatment may fail.

"Anxiety and depression are common reactions to learning of a cancer diagnosis, as people inevitably think of the possibility of their own death, even if the prognosis is good," Linda Carlson, a psychology and oncology researcher at the University of Calgary, who wasn't involved in the study, said by email.

While approaches to mindfulness-based therapy vary, this type of treatment typically involves a combination of counseling as well as education in relaxation and stress-relief techniques such as yoga or medication. Originally devised to ease chronic depression, it's also commonly used to address anxiety and to help patients cope with mental health problems tied to conditions ranging from cancer to high blood pressure to chronic pain.

To learn more about how a mindfulness approach may work in oncology, researchers analyzed data from seven previously published studies that included 469 cancer patients who received this type of therapy and 419 who didn't.

Overall, mindfulness-based therapy is effective for reducing anxiety and depression, but the impact may depend on the exact type of treatment provided and the effect may not last longer than 12 weeks, the researchers conclude.

Most of the studies involved women with breast cancer. The people in the studies were typically around 50 years old and there were few differences in education, marital status or employment status.

In six of the studies included in the analysis, treatment lasted for eight weeks, while one study included seven weeks of therapy.

When the researchers pooled the data from all the studies, mindfulness-based therapy was linked to a 25% greater decline in anxiety and a 10% bigger decline in symptoms of depression, compared to usual care, Mei-Fen Zhang of Sun Yat-Sen University in China and colleagues report in the November issue of the journal Medicine.

One shortcoming of the analysis is that only two studies incorporated assessments of benefits beyond 12 weeks, the researchers note. There was also little consistency in the types of mindfulness therapy used and insufficient data to assess whether people were also treated with medications to ease anxiety or depression.

To be effective, mindfulness-based therapy techniques need to be practiced on an ongoing basis, noted Rebecca Lehto, a researcher at Michigan State University College of Nursing in East Lansing who wasn't involved in the study.

Six to eight week programs may help patients learn skills to practice mindfulness-based techniques on their own, but people may stop doing this once they no longer have motivation from an instructor, Lehto said by email.

"It is critically important that all cancer patients with mental health difficulties are thoroughly evaluated by a professional provider to determine their individualized needs with sustained follow-up over time," Lehto said.

SOURCE: http://bit.ly/1OzYAFa

Medicine 2015.