SAN ANTONIO — The mindfulness-based stress reduction program developed by Jonathan Kabat-Zinn, Ph.D., appears to be beneficial to patients with early-stage breast cancer in the immediate posttreatment period as they transition to survivorship, Cecile Lengacher, Ph.D., reported at a breast cancer symposium sponsored by the Cancer Therapy and Research Center.
This transition is an underappreciated period of high risk for emotional distress. Many patients experience fear of recurrence while also coming to grips with changes in body image, concern for their children and other family members, and difficulties reintegrating into work and family roles, explained Dr. Lengacher of the Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa.
Because few clinical interventions addressing this challenging period are available to offer patients, Dr. Lengacher and her coworkers decided to do a nonrandomized pilot feasibility study of mindfulness-based stress reduction, the structured program developed by Dr. Kabat-Zinn of the University of Massachusetts, Worcester.
The program is designed to teach patients to self-regulate their arousal to stress through awareness of their thoughts and feelings during stressful circumstances. The program emphasizes regular practice of four meditation techniques: sitting meditation, body scan, gentle hatha yoga, and walking meditation. The formal program entails eight 2-hour weekly group sessions, along with a minimum of 45 minutes per day 6 days per week practicing the various forms of meditation individually outside of class.
Investigators offered the program to 58 women who had undergone lumpectomy plus radiotherapy and/or chemotherapy. Thirty-one agreed to attend an orientation session. Nineteen of the 31 consented to participate in the program, and 17 completed the classes.
Compliance was excellent. Thirteen of the 17 patients kept a practice diary as requested. Diary entries showed they averaged 372 minutes per week in sitting meditation, 212 doing the body scan, 139 in walking meditation, and 123 minutes doing yoga.
Fifteen of the 17 patients reported that they found the program beneficial, and 13 said they had a greater ability to handle stress and improved coping skills. Serial measures of anxiety, depression, and pain were obtained, but the results haven't yet been analyzed.
Patients reportedly found the 8-week course too great a time burden, though, so investigators have condensed it to 6 weeks. The shorter version has been very well accepted; all but 1 of the 50 patients who have enrolled since the switch was made have completed the program.
A randomized trial is planned.