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The effectiveness of mindfulness-based interventions among cancer patients and survivors: a systematic review and meta-analysis

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Abstract

Purpose

Cancer is one of the leading causes of morbidity and mortality worldwide. Cancer negatively affects individuals’ quality of life and overall health. Mindfulness-based interventions appear to be promising in the reduction of cancer-related and treatment-related symptoms. This review aimed to systematically summarize and synthesize the best available evidence concerning the effectiveness of mindfulness-based interventions on anxiety, depression, quality of life, fatigue, stress, posttraumatic growth, and mindfulness among adult cancer patients and survivors.

Methods

A literature search was conducted across 10 electronic databases. Only randomized controlled trials were eligible. Two reviewers independently screened the studies, extracted data, and performed quality assessment using the Cochrane risk of bias assessment tool. Meta-analyses were conducted using review manager software, and standardized mean difference (SMD) was used to determine intervention effects. Subgroup analyses were performed for cancer type, gender, and interventions. Heterogeneity was examined using the Chi2 and I2 statistics.

Results

Twenty-nine studies were included with a total of 3476 participants. Those who received mindfulness-based interventions reported significantly lower anxiety, depression, fatigue, and stress and greater quality of life, posttraumatic growth, and mindfulness than respondents in control groups. Mindfulness-based art therapy (MBAT) produced the strongest intervention effect on anxiety (SMD = − 2.48) and depression (SMD = − 2.21), followed by mindfulness-based stress reduction program (MBSR) and mindfulness-based care recovery (MBCR). The interventions were effective across different cancer types.

Conclusion

Mindfulness-based interventions can be used as an adjuvant therapy for the management of cancer-related symptoms among cancer patients and survivors.

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Abbreviations

ACT:

acceptance commitment therapy

BCSG:

breast cancer support group

CBT-I:

cognitive behavioral therapy for insomnia

ES:

education and support

MBAT:

mindfulness-based art therapy

MBCT:

Mindfulness-Based Cognitive Therapy

MBCR:

Mindfulness-Based Cancer Recovery

MBSR:

Mindfulness-Based Stress Reduction

MBSR(BC):

mindfulness-based stress reduction (breast cancer)

NEP:

Nutrition Education Program

SNAP:

Stanford Nutritional Action Program

UC:

usual care

WLC:

wait-listed control

NR:

not reported

QoL:

quality of life

UK:

United Kingdoms

USA:

United States of America

CEC:

Courtauld Emotional Control scale

CES-D:

Center for Epidemiologic Studies Depression Scale

CPTGI:

Chinese Post-Traumatic Growth Inventory

CPSS:

Chinese Perceived Stress Scale

C-SOSI:

Calgary Symptoms of Stress Inventory

EORTC QLQ-C30:

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire

FACIT-F:

Functional Assessment of Chronic Illness Therapy-Fatigue

FACIT-Sp:

Functional Assessment of Chronic Illness Therapy-Spirituality

FACT-B:

Functional Assessment of Cancer Therapy-Breast

FACT-C:

Functional Assessment of Cancer Therapy-Colorectal

FACT-G:

Functional Assessment of Cancer Therapy-General

FACT-P:

Functional Assessment of Cancer Therapy-Prostate

FFMQ:

Five Facet Mindfulness Questionnaire

FMI:

Freiburg Mindfulness Inventory

FSI:

Fatigue Symptom Inventory

GAD-7:

Generalized Anxiety Disorder Assessment

GSI:

Global Severity Index

HADS:

Hospital Anxiety and Depression Scale

HAM-A:

Hamilton Anxiety Rating Scale

HAM-D:

Hamilton Depression Rating Scale

KIMS:

Kentucky Inventory of Mindfulness Skills

MAAS:

Mindful Attention Awareness Scale

MAX-PC:

Memorial Anxiety Scale for Prostate Cancer

PAI:

Personality Assessment Inventory

PHQ-8:

Patient Health Questionnaire Depression-8 scale

PGH-10:

PROMIS Global Health-10

POMS:

Profile of Mood States

PSS:

Perceived Stress Scale

PTGI:

Posttraumatic Growth Inventory

SCL-90-R:

Symptom Checklist-90-Revised

SF-36:

Short Form-36 Health Survey

SOSI:

symptoms of stress inventory

STAI:

State-Trait Anxiety Inventory

WHO-5:

World Health Organization-5 Well-Being Index

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Authors and Affiliations

  1. Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    NG Xunlin

  2. Alice Lee Centre for Nursing Studies, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore

    Ying Lau & Piyanee Klainin-Yobas

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  1. NG Xunlin
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  2. Ying Lau
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  3. Piyanee Klainin-Yobas
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Correspondence to Piyanee Klainin-Yobas.

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Fig. 4
figure 4

Funnel plots for anxiety, depression, and QoL outcomes

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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 28, 1563–1578 (2020). https://doi.org/10.1007/s00520-019-05219-9

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