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Analysis Suggests Mindfulness Improves Mental Health After Breast Cancer

An analysis of nine studies shows benefit of using mindfulness-based stress reduction

September 16, 2013

Written By Josh Fernandez, Writer and Web Content Coordinator
Reviewed By Michael J. Baime, MD

A type of mindfulness meditation has a moderate to large positive impact on the mental health of women affected by breast cancer, a recent analysis published in Psycho-Oncology suggests. 

Researchers examined data from several published studies to determine the effectiveness of mindfulness-based stress reduction (MBSR)—a kind of focused, non-judgmental attention on the present—at reducing stress, anxiety, and depression in persons diagnosed with breast cancer.

Background and Reason for the Analysis

Results from several studies suggest that the rates of anxiety and depression in women with breast cancer are about 16 percent and between 11 – 20 percent, respectively. According to an article in the February 2013 issue of Journal of the National Cancer Institute, nearly 25 percent of women newly diagnosed develop symptoms of post-traumatic stress disorder (PTSD).

While medicine and psychotherapy are commonly prescribed treatments for anxiety and depression, there is growing interest in the mental health benefits of regular mindfulness practice.

The first MBSR program was developed in 1979 by Jon Kabat-Zinn, MD, of the Center for Mindfulness at the University of Massachusetts Medical School. Since then, other university hospitals have begun offering MBSR classes consisting of 8 weeks of group sessions during which individuals are trained to be fully mindful, or aware, of feelings in the present moment through focused attention. Instead of avoiding negative sensations and feelings, they learn to be with them. Equal attention is given to positive feelings that arise during meditation. 

The authors wanted to investigate data from published studies on MBSR to determine its effectiveness at alleviating anxiety, depression and stress for women affected by breast cancer. 

Structure of the Analysis

Of the 33 studies the authors found, only nine were used in the analysis because they focused on the effect of MBSR on women with breast cancer. 

The nine studies included

  • two randomized controlled trials, meaning each trial randomly assigned some participants to use MBSR, while others were randomly assigned a different mental health intervention.
  • one quasi-experimental case-control study, or a study of the cause-effect relationship between mental distress and MBSR as an intervention, in which researchers did not have full control over elements that may influence the outcome.
  • six single-group studies that assessed the mental distress of women with breast cancer before and after they used MBSR.

The authors measured how effective the practice was at improving the mental health of the participants by averaging the effect size—in this study, the magnitude or strength of MBSR practice on reducing anxiety, depression, and stress.

Effect size was measured as follows:

  • less than 0.1 – trivial effect
  • 0.1 to 0.3 – small positive effect
  • 0.3 to 0.5 – moderate positive effect
  • 0.5 or higher – large positive effect

Findings

Of the nine studies, only three looked at all three mental health issues. Four studies measured anxiety, seven reported data on depression and eight examined stress.

MBSR had a large positive effect on reducing anxiety (0.73) within four studies, depression (0.56) within seven studies, and stress (0.71) within eight studies of women with breast cancer.

Limitations

The authors mention a few limitations of their analysis:

  • A relatively small group of people participated in the few studies analyzed.
  • There was variation in the design of the trials across studies.
  • Most of the studies were non-randomized trials—allowing for the possibility of bias in outcomes—and showed large effect sizes. It is possible that the effect sizes would be smaller if more randomized controlled trials were included in the multi-study analysis.

These factors make the conclusions of this analysis less powerful. However, it is unlikely that the overall results would change dramatically with further study. 

What This Means for You

Despite these limitations, this analysis showed that MBSR is likely to have meaningful positive impact on improving the mental health of women with breast cancer. 

If you are struggling with anxiety, depression or stress, MBSR may be a practice worth trying. Talk with your healthcare providers to learn how you can get involved in a MBSR program during or after your treatment for breast cancer. 

Check out Living Beyond Breast Cancer's podcasts and transcripts for  managing anxiety and depression after breast cancer and using mindfulness meditation to control worry.

Learn more about MBSR at the website of the University of Massachusetts Medical School Center for Mindfulness.

Zainal, N. Z., Booth, S. and Huppert, F. A. The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psycho-Oncology; 2013; 22: 1,457-1,465.

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