Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT)
- 2k Downloads
To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0–III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
KeywordsFear of recurrence Cancer Mindfulness-based stress reduction (MBSR) Oncology
Supported by the National Institutes of Health, National Cancer Institute: grant number R21CA109168.
Conflict of interest
The authors have no conflicts to report.
- Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010). The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. Journal of Psychosomatic Research, 68, 539–544. doi: 10.1016/j.jpsychores.2009.10.005 PubMedCrossRefGoogle Scholar
- Brown, K. W., & Cordon, S. (2009). Toward a phenomenology of mindfulness: Subjective experience and emotional correlates. In F. Didonna (Ed.), Clinical handbook of mindfulness. New York: Springer Science.Google Scholar
- Chambers, S. K., Foley, E., Galt, E., Ferguson, M., & Clutton, S. (2012). Mindfulness groups for men with advanced prostate cancer: A pilot study to assess feasibility and effectiveness and the role of peer support. Supportive Care in Cancer, 20, 1183–1192. doi: 10.1007/s00520-011-1195-8 PubMedCrossRefGoogle Scholar
- Costanzo, E. S., Lutgendorf, S. K., Mattes, M. L., Trehan, S., Robinson, C. B., Tewfik, F., et al. (2007). Adjusting to life after treatment: Distress and quality of life following treatment for breast cancer. British Journal of Cancer, 97, 1625–1631. doi: 10.1038/sj.bjc.6604091 PubMedCentralPubMedCrossRefGoogle Scholar
- Cullen, M. (2006). Mindfulness: The heart of Buddhist meditation? A conversation with Jan Chozen Bays, Joseph Goldstein, Jan Kabat-Zinn, and Alan Wallace. Inquiring Mind, 22, 4–7.Google Scholar
- Curran, D., van Dongen, J. P., Aaronson, N. K., Kiebert, G., Fentiman, I. S., Mignolet, F., et al. (1998). Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: Results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). European Journal of Cancer, 34, 307–314.PubMedCrossRefGoogle Scholar
- Hawkins, N. A., Smith, T., Zhao, L., Rodriguez, J., Berkowitz, Z., & Stein, K. D. (2010). Health-related behavior change after cancer: Results of the American cancer society’s studies of cancer survivors (SCS). Journal of Cancer Survivorship, 4, 20–32. doi: 10.1007/s11764-009-0104-3 PubMedCrossRefGoogle Scholar
- Kabat-Zinn, J. (1990). Full-catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Bantam Doubleday Dell Publishing.Google Scholar
- Lengacher, C. A., Johnson-Mallard, V., Post-White, J., Moscoso, M. S., Jacobsen, P. B., Klein, T. W., et al. (2009). Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology, 18, 1261–1272. doi: 10.1002/pon.1529 PubMedCrossRefGoogle Scholar
- National Cancer Institute. (2010). Surveillance epidemiology and end results: Cancer statistics from http://seer.cancer.gov/statistics/
- Nyklicek, I., & Kuijpers, K. F. (2008). Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Annals of Behavioral Medicine, 35, 331–340. doi: 10.1007/s12160-008-9030-2 PubMedCentralPubMedCrossRefGoogle Scholar
- Oxlad, M., Wade, T. D., Hallsworth, L., & Koczwara, B. (2008). ‘I’m living with a chronic illness, not… dying with cancer’: A qualitative study of Australian women’s self-identified concerns and needs following primary treatment for breast cancer. European Journal of Cancer Care (English Language Edition), 17, 157–166. doi: 10.1111/j.1365-2354.2007.00828.x CrossRefGoogle Scholar
- Spielberger, C. D., Gorsuch, R. L., & Luschene, R. E. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists.Google Scholar
- van den Beuken-van Everdingen, M. H., Peters, M. L., de Rijke, J. M., Schouten, H. C., van Kleef, M., & Patijn, J. (2008). Concerns of former breast cancer patients about disease recurrence: A validation and prevalence study. Psychooncology, 17, 1137–1145. doi: 10.1002/pon.1340 PubMedCrossRefGoogle Scholar
- Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 survey manual and interpretation guide. Boston: New England Medical Center, The Health Institute.Google Scholar