Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques

Optimizing chemotherapy outcomes: The role of mindfulness in Epirubicin treatment for urinary tumors

This manuscript comments on the article published in a recent issue of World Journal of Psychology. We emphasize the potential of combining Epirubicin (EPI) chemotherapy with mindfulness-based interventions (MBIs) to optimize cancer care for urinary system tumors. The long-term use EPI is associated with depression and in short-term has shown side effects such as fatigue, nausea, and occasional abdominal pain, which can impact patient adherence. MBIs address the psychological burdens, such as depression and anxiety, that accompany cancer treatment, enhancing emotional well-being, immune function, and treatment adherence. Integration of MBIs alongside EPI offers improved clinical outcomes by lowering stress and reducing side effects, ultimately supporting both psychological and physical recovery. This comprehensive care model can potentially promote long-term health and quality of life for cancer patients.

Integrating Sleep Health Education in Cancer Care: Prevalence and Correlates of Insomnia Among Omani Patients Undergoing Chemotherapy

Insomnia is a prevalent and distressing symptom among cancer patients, adversely impacting quality of life (QOL). Factors such as treatment-related side effects, diagnosis-related stress, and coexisting conditions, including anxiety and depression, often exacerbate insomnia. In Oman, the prevalence and contributing factors of insomnia in cancer patients remain underexplored. Additionally, despite the well-documented impact of insomnia on cancer prognosis, sleep education remains an underutilized component of oncology care. This study is aimed at determining the prevalence of insomnia among Omani cancer patients receiving chemotherapy and at identifying associated factors, emphasizing the need for structured sleep education as an essential part of cancer supportive care. A cross-sectional study was conducted from October 2022 to March 2023 at the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman. Adult Omani cancer patients undergoing chemotherapy during the study period were recruited. Data were collected using Arabic versions of the Pittsburgh Sleep Quality Index (PSQI) and Edmonton Symptom Assessment System-Revised (ESAS-r). A total of 211 patients participated (response rate 85.1%). Most were female (65.9%), married (83.9%), and had stage IV cancer (55.0%). The mean age was 49.6 ± 11.7 years (range 19-81 years). Symptom burden, ranging from mild to severe, was reported by 30.8% of patients based on ESAS-r scores. Insomnia (PSQI score > 5) was identified in 55.0% of participants, with 34.1% reporting sleep disturbances after their diagnosis but prior to the initiation of chemotherapy. Insomnia was associated with pre-diagnosis sleeping problems (odds ratio (OR) = 3.04, p = 0.009), post-diagnosis but pre-chemotherapy sleep problems (OR = 7.34, p < 0.001), a history of smoking (OR = 4.00, p = 0.043), and symptom burden (OR = 3.78, p < 0.001). Multivariate analysis revealed that post-diagnosis/pre-chemotherapy sleep disturbances (OR = 4.09, p = 0.002) and symptom burden (OR = 3.02, p = 0.008) significantly increased the likelihood of insomnia. Insomnia is highly prevalent among Omani cancer patients undergoing chemotherapy, driven by high symptom burden and pre-existing sleep disturbances. Routine sleep assessments should be integrated into oncology care to identify at-risk patients and facilitate early intervention, ultimately improving sleep quality and enhancing QOL. Integrating structured sleep education into oncology training is crucial for effective cancer care. Approaches like CBT-I, digital tools, and hospital workshops equip providers and patients to manage sleep disturbances. Interprofessional education (IPE) boosts provider confidence, enhancing patient outcomes. Future efforts should focus on culturally tailored, evidence-based programs to support symptom management, treatment adherence, and survivorship.

Cancer and Stress: Understanding the Connections and Interventions

Stress is ubiquitous in our modern society and contributes to many disease states. This narrative review describes the effect of stress/distress on cancer development and progression. Seminal randomized controlled trials, systematic reviews/meta-analyses, and distress management guidelines from the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the Society for Integrative LinearOncology (SIO) are highlighted. We describe the physiological effects of distress, distress assessment, and management. Psychological treatments are summarized. Evidence-based lifestyle modifications and integrative therapies are reviewed in detail, including mindfulness-based techniques, yoga, guided imagery, breathing techniques, hypnosis, exercise, music therapy, qigong/Tai Chi, eye movement desensitization and reprocessing, and improving sleep and heart rate variability. Recognition and treatment of distress can improve quality of life. More research is needed to determine the effects of managing distress on cancer outcomes, as well as the best type and duration of intervention, noting that the benefits of interventions may be specific for patients with different cancer types.

Spiritual interventions: Improving the lives of colorectal cancer survivors-A systematic literature review

AIM

To systematically review the types of spiritual interventions available for colorectal cancer survivors and determine if they improve their lives.

DESIGN

Systematic review.

DATA SOURCE

A thorough literature search was conducted in July 2023 using PRIMO, PubMed/Medline, Cochrane, CINAHL, Scopus, and EMBASE.

REVIEW METHODS

As an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, the Synthesis Without Meta-Analysis reporting guideline was employed. A narrative synthesis was used to analyse the data.

RESULTS

Thirty-five articles were analysed for this study. The findings suggest that psychoeducational intervention, cognitive behavioural therapy intervention, mindfulness intervention, social intervention, and spiritual counselling improved CRC survivor's coping skills, boosted self-esteem, lessened anxiety, instilled hope, enhanced daily functioning, improved survival rates, improved neurological functional status and quality of life (QoL).

CONCLUSION

There is proof that spiritual interventions help CRC patients and improve their QoL. It has been discovered that spiritual intervention is helpful in the diagnosis, management, and treatment of CRC conditions.

IMPACT

CRC survivors may have impairments in their physical ability and daily functioning as a result of many symptoms, such as pain, bowel dysfunction, and exhaustion. Furthermore, individuals may encounter difficulties in several aspects of their psychological, emotional, social, and role functioning due to the presence of dread symptoms. Therefore, these study will help CRC survivors To implement spiritual interventions in the management of their long-term care. To cultivate problem-solving abilities, foster self-assurance, and enhance self-awareness. To alleviate symptoms, enhance everyday functioning, and improve QoL.

NO INDUCEMENT

No financial incentives were used to compensate patients or members of the public for this review.

Design of a mindfulness intervention to reduce risk factors for colorectal cancer among at-risk Black women in Chicago

Chronic stress can directly and indirectly promote carcinogenesis through immune, metabolic, and microbial pathways. Our overarching hypothesis is that reducing chronic stress will have important implications for colorectal cancer (CRC) risk reduction among vulnerable and high-risk populations. A promising approach for reducing chronic stress is mindfulness. Mindfulness is a meditation-based technique that achieves a state of mind that is used to experience higher awareness or consciousness. Existing small studies suggest mindfulness can positively regulate stress response in a way that translates to anticancer effects, including reduced systemic inflammation. We propose to evaluate an 8-wk mindfulness intervention delivered in a hybrid format (synchronous and asynchronous sessions) among 40 Black women at elevated risk of CRC who reside in vulnerable communities and who report moderate to high perceived stress. At baseline and postintervention, participants will provide blood, hair, and stool; undergo body composition analysis; and complete mood and lifestyle-related surveys. The specific aims are to assess the feasibility and acceptability of the intervention and explore changes on stress, weight, fasting glucose, inflammation markers, and the gut microbiota-risk markers and risk pathways associated with CRC. The data generated through this project will inform if mindfulness is a feasible option for CRC risk reduction among high-risk individuals.NEW & NOTEWORTHY We propose to evaluate an 8-wk mindfulness intervention delivered in a hybrid format (synchronous and asynchronous sessions) among 40 Black women at elevated risk of CRC who reside in vulnerable communities and who report moderate to high perceived stress. The specific aims are to assess the feasibility and acceptability of the intervention and explore changes on stress, weight, fasting glucose, inflammation markers, and the gut microbiota-risk markers and risk pathways associated with CRC.

Assessment of Prognostic Indicators and Survival-Based Impact of Holistic Approach in Oral Cancer Patients: An Observational Study

INTRODUCTION

Oral cancer is recognized as the sixth most common type of cancer globally. Instances have been recorded demonstrating an increase in its incidence, particularly in the territories of southern Asia, with a significant emphasis on India. Thus, the objectives of this investigation were to assess the efficacy of a holistic approach on the life expectancies of patients diagnosed with oral cancer, and to assess the prognostic indicators in such patients.

MATERIAL AND METHODS

A retrospective study was conducted on medical records of 60 clinically and histopathologically confirmed cases of oral squamous cell carcinoma (OSCC) who received complete surgical intervention or radiation therapy or a combination of both modalities depending on stage of OSCC from January 2015 to December 2016. After completion of their treatment, 30 patients underwent Cancer Care program of Annabhai Chudamani Patil Memorial Medical College which consisted of yoga sessions, meditation, psychological counselling, nutritional counselling, emotional and social support (embracing a holistic approach, group 1) and 30 patients did not enroll in the Cancer Care initiative (not opting for holistic approach, group 2). The program was conducted for 21 days every six months for two years. Data pertaining to demographic characteristics, stage of OSCC, modalities of treatment administered, histopathological characteristics of the neoplasm, as well as the clinical outcome (Survival/Deceased) post a five-year duration subsequent to the primary diagnosis were extracted from the medical records to assess the role of holistic approach and various factors on the overall survival (OS) of the patients in both the groups. The data collected was subsequently subjected to a thorough statistical analysis.

RESULTS

The mean age of the patients was 44.33±8.66 years (95% CI: 39.53-49.13) in group 1, and 51.20±9.99 years (95% CI: 39.53-49.13) in group 2. The mean survival time for group 1 was 81.60±5.02 months (95% CI: 78.817-84.383), and 66.00±20.29 months (95% CI: 54.761-77.239) in group 2 with statistically significant difference between the groups (p=0.007). Group 2 showed a 1.31 relative risk of mortality to group 1. The probability of death in group 2 was 1.39 times more than in group 1. Cox regression analysis revealed group 2 was significantly associated with the risk of OSCC in this analysis. Other variables were not significantly associated with the risk of the OSCC in this analysis.

CONCLUSION

The current research indicated that employing a holistic strategy proves to be a successful approach in increasing the OS of patients with OSCC.

Trait Mindfulness and Social Support Predict Lower Perceived Stress Burden in Patients Undergoing Radiation Therapy

Purpose

Cancer diagnosis and treatment, including radiation therapy (RT), cause significant patient stress. Mindfulness and social support have been shown to help manage the psychological effects of cancer treatment. The objective of our study was to determine the sociodemographic and clinical factors associated with stress burden in patients receiving RT.

Methods and Materials

Patients receiving RT for cancer at a single institution were given a 3-section survey to complete during the first on-treatment visit. The survey included the Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale, which were used to measure stress, social support, and trait mindfulness, respectively. Linear regression analysis was performed to determine associations between perceived stress and age, patient sex, race and ethnicity, treatment intent, disease site, trait mindfulness, and social support. Factors significant in univariable analysis were analyzed with a multivariable analysis.

Results

A total of 93 patients undergoing RT at a tertiary care academic institution were recruited from July to September 2019. Median scores for Perceived Stress Scale, Medical Outcomes Study Social Support Survey, and Mindfulness Attention Awareness Scale were 14.6 (range, 0-31; SD, 6.9), 4.2 (range, 1-5; SD, 1.0), and 5.1 (range, 3.1-6.0; SD, 0.8), respectively. On univariable analysis, mindfulness and social support were associated with decreased stress burden, and female sex and palliative intent were associated with increased stress burden. These factors all maintained significance in multivariable analysis.

Conclusions

These results suggest measures to improve mindfulness and perceived social support, such as mindfulness meditation and psychoeducational approaches, may lessen the stress burden and improve quality of life for patients undergoing RT. Future studies should analyze the longitudinal impact of individual patient characteristics, including patient sex and treatment intent, to better understand their effects on psychological maladjustment during cancer care.

The Impact of Chronic Diseases on Mental Health: An Overview and Recommendations for Care Programs

PURPOSE OF REVIEW

The current achievement of medical advancement is noteworthy; however, the occurrence of chronic diseases is increasing day by day, with a significant percentage of affected people are suffering from a mental health crisis. This article aims to present a thorough yet brief review of methods that can be employed to build the emotional wellness of chronic patients.

RECENT FINDINGS

The mental health care strategies include resilience-building, coping skills training, professional counseling, and lifestyle adaptations. Additionally, the article highlights the efficacy of several modern interventions, such as mindfulness-based therapies, cognitive behavioral therapy, eye movement desensitization, and recovery from stress therapy. The global burden of chronic illness emphasizes the pressing need to mitigate mental health problems among chronic patients. By providing actionable insights, our study clears the path for targeted interventions and holistic approaches for chronic disease patients. Moreover, the article suggests to policymakers and clinicians the need for collaboration and multifaceted interventions.

Advances in the care of breast cancer survivors

Breast cancer survivors may experience significant after effects from diagnoses of breast cancer and cancer directed therapies. This review synthesizes the evidence about optimal management of the sequelae of a diagnosis of breast cancer. It describes the side effects of chemotherapy and endocrine therapy and evidence based strategies for management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. In addition, this review examines models of survivorship care and ways in which digital tools may facilitate communication between clinicians and patients. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life.

Shared meditation involving cancer patients, health professionals and third persons is relevant and improves well-being: IMPLIC pilot study

BACKGROUND

Alleviating suffering and improving quality of life are universally shared goals. In this context, we implemented a pilot study to assess the feasibility and acceptability of a mindfulness intervention in the form of meditation involving together cancer patients, health professionals, and third persons.

METHODS

Two groups of 15 participants equally composed of patients, health professionals and third persons were constituted. A dedicated programme on mindfulness and compassion was constructed, including 12 weekly sessions of 1.5 h and a half-day retreat. Adherence and satisfaction with the programme were evaluated. All participants completed questionnaires on perceived stress, quality of life, mindfulness, empathy, and self-efficacy. Burnout was assessed in health professionals.

RESULTS

Shared meditation was feasible as 70% of participants attended ≥ 80% of the 13 meditation sessions. Satisfaction with the programme was high (median satisfaction score: 9.1 out of 10) and all participants expressed positive attitudes towards shared meditation and a benefit on their global quality of life. Participants reported significant improvement in stress (p < 0.001), global quality of life (p = 0.004), self-efficacy (p < 0.001), and mindfulness skills (p < 0.001) from baseline to post-programme.

CONCLUSIONS

This study demonstrated the feasibility of a shared dedicated meditation programme in terms of participation and acceptability of participants. The measured benefits observed among participants furthermore justify the interest of a subsequent randomized study aiming to demonstrate the potential added value of shared meditation by promoting bridge-building between cancer patients, health professionals and others.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT04410185 . Registered on June 1, 2020.

Existential Insights in Cancer: Meaning in Life Adaptability

Previous research demonstrated that the cancer diagnosis and treatment evoke existential concerns, especially ones related to meaning in life and meaning-making processes. The cancer experience is a vital challenge that often entails changes in what is personally important in life. Firstly, this paper collects evidence supporting that meaning adaptability, the way people adapt their meaning in life to the cancer experience, is a central element in the mental health of cancer patients. Various theories that could account for this meaning adaptability are introduced. Secondly, the paper provides a compilation of studies showing how people change what is significant in their lives within the course of cancer. Finally, the paper presents the available psychological therapies directed to facilitate meaning adaptability in this population. Meaning-centered interventions have been demonstrated to be effective in alleviating the suffering related to the cancer experience and promoting personal growth.

A Transcriptomic Analysis of Head and Neck Squamous Cell Carcinomas for Prognostic Indications

Survival analysis of the Cancer Genome Atlas (TCGA) dataset is a well-known method for discovering gene expression-based prognostic biomarkers of head and neck squamous cell carcinoma (HNSCC). A cutoff point is usually used in survival analysis for patient dichotomization when using continuous gene expression values. There is some optimization software for cutoff determination. However, the software's predetermined cutoffs are usually set at the medians or quantiles of gene expression values. There are also few clinicopathological features available in pre-processed datasets. We applied an in-house workflow, including data retrieving and pre-processing, feature selection, sliding-window cutoff selection, Kaplan-Meier survival analysis, and Cox proportional hazard modeling for biomarker discovery. In our approach for the TCGA HNSCC cohort, we scanned human protein-coding genes to find optimal cutoff values. After adjustments with confounders, clinical tumor stage and surgical margin involvement were found to be independent risk factors for prognosis. According to the results tables that show hazard ratios with Bonferroni-adjusted p values under the optimal cutoff, three biomarker candidates, CAMK2N1, CALML5, and FCGBP, are significantly associated with overall survival. We validated this discovery by using the another independent HNSCC dataset (GSE65858). Thus, we suggest that transcriptomic analysis could help with biomarker discovery. Moreover, the robustness of the biomarkers we identified should be ensured through several additional tests with independent datasets.

Mindfulness meditation program for the elderly in Korea: A preliminary review for planning the program

BACKGROUND

The significance of mindfulness meditation (MM) has increased in recent years in both clinical settings and public health. However, ways to implement MM as a disease prevention or treatment method in the elderly is still a major challenge. A comprehensive analysis of previous studies on MM programs for the elderly in Korea will help build future integrated care programs that incorporate MM.

METHODS

Seven international and Korean domestic electronic databases were searched to collect relevant clinical studies until May 30, 2020.

RESULTS

Sixteen articles with twelve clinical studies were included in this review. The MM program was generally offered once a week over eight weeks with a duration of between 60 and 90 min per session. The main reason for participants' drop out was poor program compliance attributed to conflicting schedules, physical illness, or a change of mind. The program results were either positive or mixed, but the mindfulness level of the participants was improved.

CONCLUSIONS

This review summarizes information obtained from previously published studies in Korea, on the design considerations, characteristics, and preliminary effectiveness of the MM program for the elderly. The findings can be used as preliminary data by future practitioners and/or researchers to design MM programs targeted toward the elderly; it could also help policymakers integrate MM-based strategies into integrated care programs to promote their mental health and well-being.

Promoting Mindfulness in African American Communities

African Americans report higher rates of chronic stress compared to non-Hispanic Whites. Consequently, chronic stress contributes to disproportionately higher rates of poor health outcomes among African Americans. Mindfulness meditation is a well-established and studied strategy to reduce stress and potentially improve health outcomes. However, the practice of mindfulness meditation is largely underutilized in African American communities despite its potential health benefits. In this commentary, we will discuss the relevance of mindfulness interventions, limited research available, reasons for low representation, and cultural adaptations for mindfulness meditation in African American communities. We also provide additional strategies to guide future mindfulness research that target African Americans.