Evidence of psychological and biological effects of structured Mindfulness-Based Interventions for cancer patients and survivors: A meta-review

Juliana Pedro, Sara Monteiro-Reis, Carina Carvalho-Maia, Rui Henrique, Carmen Jerónimo, Eunice R Silva, Juliana Pedro, Sara Monteiro-Reis, Carina Carvalho-Maia, Rui Henrique, Carmen Jerónimo, Eunice R Silva

Abstract

Objective: A large number of studies have been conducted exploring the effects of mindfulness programs on health outcomes, such as psychological and biological outcomes. However, there is substantial heterogeneity among studies and, consequently, in the systematic reviews/meta-analyses. Since clinical practice is massively informed by evidence on review studies, our main objective was to summarize the reported evidence regarding the effects of structured mindfulness-based programs on psychological, biological, and quality-of-life outcomes in cancer patients.

Methods: We conducted a meta-review, using a literature search from inception to June 2020 in several electronic databases using a combination of keywords including MBSR, MBCT, cancer, and meta-analysis OR "systematic review" (PROSPERO registration CRD42020186511).

Results: Ten studies met the eligibility criteria and were included. The main findings were beneficial small to medium effect sizes of Mindfulness-Based Stress Reduction (MBSR)/Mindfulness-Based Cognitive Therapy (MBCT)/Mindfulness-Based Cancer Recovery (MBCR) on psychological health, such as anxiety, depression, stress, and quality of life. A beneficial effect was found for biological outcomes, albeit based on a reduced number of studies. Studies were moderate homogenous regarding the intervention, population, and outcomes explored. Results on long-term follow-up seem to indicate that the effects tend not to be maintained, namely in shorter follow-ups (6 months).

Conclusions: This meta-review brings a broad perspective on the actual evidence regarding MBSR/MBCT/MBCR. We expect to contribute to future project design, focused on developing high-quality studies and exploring the moderating effects that might contribute to biased results, as well as exploring who might benefit more from MBSR/MBCT/MBCT interventions.

Keywords: MBCT; MBSR; anxiety; cancer; immune response; inflammatory-related markers; meta-review; mindfulness; oncology; psychological.

Conflict of interest statement

The authors reported no conflict of interest.

© 2021 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Study flow chart (Moher et al. 28 )

References

    1. Williams JMG, Kabat‐Zinn J. Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemp Buddhism. 2011;12(1):1‐18.
    1. van Dam NT, van Vugt MK, Vago DR, et al. Mind the hype: a critical evaluation and prescriptive agenda for research on mindfulness and meditation. Persp Psychol Sci. 2018;13(1):36‐61.
    1. Rapgay L, Bystrisky A. Classical mindfulness: an introduction to its theory and practice for clinical application. Ann N Y Acad Sci. 2009;1172:148‐162.
    1. Cullen M. Mindfulness‐based interventions: an emerging phenomenon. Mindfulness (N Y). 2011;2(3):186‐193.
    1. Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Pract. 2003;10(2):125‐143.
    1. Shapero BG, Greenberg J, Pedrelli P, de Jong M, Desbordes G. Mindfulness‐based interventions in psychiatry. Focus (Madison). 2018;16(1):32‐39.
    1. Kabat‐Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Delacorte; 1990.
    1. Santorelli S, Meleo‐Meyer F, Koerbel L, Kabat‐Zinn J. Mindfulness‐based Stress Reduction (MBSR) Curriculum Guide. Center for Mindfulness in Medicine, Health Care & Society; 2017:1‐60.
    1. Ewais T, Begun J, Kenny M, et al. A systematic review and meta‐analysis of mindfulness based interventions and yoga in inflammatory bowel disease. J Psychosom Res. 2019;116:44‐53.
    1. Abbott RA, Whear R, Rodgers LR, et al. Effectiveness of mindfulness‐based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta‐analysis of randomised controlled trials. J Psychosom Res. 2014;76(5):341‐351.
    1. Rimes KA, Wingrove J. Mindfulness‐based cognitive therapy for people with chronic fatigue syndrome still experiencing excessive fatigue after cognitive behaviour therapy: a pilot randomized study. Clin Psychol Psychother. 2013;20(2):107‐117.
    1. Cillessen L, Johannsen M, Speckens AEM, Zachariae R. Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: a systematic review and meta‐analysis of randomized controlled trials. Psychooncoloy. 2019;28(12):2257‐2269.
    1. Segal Z, Williams J, Teasdale J. Mindfulness‐based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. GuilfordGuilford Press; 2002.
    1. Carlson LE, Speca M. Mindfulness‐based Cancer Recovery. New Harbinger; 2010.
    1. Zhang J, Xu R, Wang B, Wang J. Effects of mindfulness‐based therapy for patients with breast cancer: a systematic review and meta‐analysis. Complement Ther Med. 2016;26(35):1‐10.
    1. Van Der Lee ML, Garssen B. Mindfulness‐based cognitive therapy reduces chronic cancer‐related fatigue: a treatment study. Psychooncology. 2012;21(3):264‐272.
    1. Sanada K, Alda Díez M, Salas Valero M, et al. Effects of mindfulness‐based interventions on biomarkers in healthy and cancer populations: a systematic review. BMC Complement Altern Med. 2017;17(1):1‐13.
    1. Rouleau CR, Garland SN, Carlson LE. The impact of mindfulness‐based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer Manag Res. 2015;7:121‐131.
    1. Spiegel SA, Foulk D, Samuel A, Reducing DF. Diet and physical activity reducing overweight through a multidisciplinary school‐based intervention. 2006;14(1):88‐96.
    1. Pollock M, Fernandes RM, Becker LA, Pieper D, Hartling L. Chapter V: overviews of reviews. In: Higgins J, Thomas J, Chandle J, et al. eds. Cochrane Handbook for Systematic Reviews of Interventions, Version 6. Cochrane; 2020:1‐38.
    1. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta‐analysis protocols (PRISMA‐P) 2015 statement. Syst Rev. 2015;4(1):1‐9.
    1. Smith V, Devane D, Begley CM, et al. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011:1‐7.
    1. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10.
    1. Shea BJ, Hamel C, Wells GA, et al. AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews. J Clin Epidemiol. 2009;62(10):1013‐1020.
    1. Marcolino MS, Oliveira JAQ, D'Agostino M, Ribeiro AL, Alkmim MBM, Novillo‐Ortiz D. The impact of mHealth interventions: systematic review of systematic reviews. JMIR mHealth uHealth. 2018;6(1):e23.
    1. Francischetto EO, Damery S, Davies S, Combes G. Discharge interventions for older patients leaving hospital: protocol for a systematic meta‐review. Syst Rev. 2016;5(1):1‐8.
    1. Mays N, Pope C, Popay J. Systematically reviewing qualitative and quantitative evidence to inform management and policy making in the health field. J Heal Serv Res Policy. 2005;10(Suppl 1):6‐20.
    1. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009;6(7):873‐880. 10.1371/journal.pmed.1000097
    1. Zhang MF, Wen YS, Liu WY, Peng LF, Wu XD, Liu QW. Effectiveness of mindfulness‐based therapy for reducing anxiety and depression in patients with cancer. Medicine (Baltimore). 2015;94(45):e0897.
    1. Calero R, Cruzado JA. La intervención psicológica en mindfulness con pacientes supervivientes de cáncer de mama. Rev Sist Psicooncol. 2018;15(1):75‐88.
    1. Cramer H, Lauche R, Paul A, Dobos G. Mindfulness‐based stress reduction for breast cancer–a systematic review and meta‐analysis. Curr Oncol. 2012;19(5):e343‐e352.
    1. Ford CG, Vowles KE, Smith BW, Kinney AY. Mindfulness and meditative movement interventions for men living with cancer: a meta‐analysis. Ann Behav Med. 2020;54(5):360‐373.
    1. Haller H, Winkler MM, Klose P, Dobos G, Kümmel S, Cramer H. Mindfulness‐based interventions for women with breast cancer: an updated systematic review and meta‐analysis. Acta Oncol. 2017;56(12):1665‐1676.
    1. Piet J, Würtzen H, Zachariae R. The effect of mindfulness‐based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta‐analysis. J Consult Clin Psychol. 2012;80(6):1007‐1020.
    1. Schell LK, Monsef I, Wöckel A, Skoetz N. Mindfulness‐based stress reduction for women diagnosed with breast cancer. Cochrane Database Syst Rev. 2019;2019(3):CD011518.
    1. Xunlin N, Lau Y, Klainin‐Yobas P. The effectiveness of mindfulness‐based interventions among cancer patients and survivors: a systematic review and meta‐analysis. Support Care Cancer. 2020;28(4):1563‐1578.
    1. Zhang Q, Zhao H, Zheng Y. Effectiveness of mindfulness‐based stress reduction (MBSR) on symptom variables and health‐related quality of life in breast cancer patients—a systematic review and meta‐analysis. Support Care Cancer. 2019;27(3):771‐781.
    1. Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness‐based stress reduction for healthy individuals: a meta‐analysis. J Psychosom Res. 2015;78(6):519‐528.
    1. Alsubaie M, Abbott R, Dunn B, et al. Mechanisms of action in mindfulness‐based cognitive therapy (MBCT) and mindfulness‐based stress reduction (MBSR) in people with physical and/or psychological conditions: a systematic review. Clin Psychol Rev. 2017;55:74‐91.
    1. Simard S, Thewes B, Humphris G, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surv. 2013;7(3):300‐322.
    1. Herschbach P, Dinkel A. Fear of progression. Recent Results Cancer Res. 2014;197:11‐29.
    1. Luberto CM, Hall DL, Chad‐Friedman E, Park ER. Theoretical rationale and case illustration of mindfulness‐based cognitive therapy for fear of cancer recurrence. J Clin Psychol Med Settings. 2019;26(4):449‐460.
    1. Park S, Sato Y, Takita Y, et al. Mindfulness‐based cognitive therapy for psychological distress, fear of cancer recurrence, fatigue, spiritual well‐being, and quality of life in patients with breast cancer—a randomized controlled trial. J Pain Symptom Manag. 2020;60(2):381‐389.
    1. Ahmadiqaragezlou N, Boogar IR, Asadi J, Vojdani R. The effectiveness of mindfulness‐based stress reduction on fear of cancer recurrence in colorectal and breast cancer patients: a randomized controlled trial. Middle East J Cancer. 2020;11(2):216‐224.
    1. O'Connor MF, Bower JE, Cho HJ, et al. To assess, to control, to exclude: effects of biobehavioral factors on circulating inflammatory markers. Brain Behav Immun. 2009;23(7):887‐897.
    1. Perez‐Gracia JL, Sanmamed MF, Bosch A, et al. Strategies to design clinical studies to identify predictive biomarkers in cancer research. Cancer Treat Rev. 2017;53:79‐97.
    1. Wampold BE. How important are the common factors in psychotherapy? An update. World Psychiatry. 2015;14(3):270‐277.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel