Breast Cancer Awareness Month: Mindfulness & Cancer

October is Breast Cancer Awareness Month

Written by Lauren Helm, M.A., B.C.B.

Cancer is incredibly common, and often leads to many difficult and frightening life changes. Studies have found that moderate to severe psychological distress occurs in 35-45% of all cancer patients (Carlson et al., 2004; Spiegel, 1996; Zabora, BrintzenhofeSzoc, Curbow, Hooker, & Piantadosi, 2001). Cancer is the most distressing diagnosis regardless of prognosis (Tacon & McComb, 2009), and anxiety can last even after treatment has been completed. Research has identified that cancer may lead to distress because of multiple factors, including the anticipation of suffering, and difficult treatment regimens (such as surgery, radiotherapy, chemotherapy, or hormone therapy). Some individuals experience great difficulty in coping with the life changes that cancer can bring about; in particular, the potential uncertainty and uncontrollability of illness is often formidable and distressing (Carlson, Ursuliak, Goodey, Angen, & Speca, 2001).  Additionally, when an individual is diagnosed with cancer, her quality of life may be profoundly impacted, and she may experience increases in stress, anxiety, depression, pain, fatigue, sleep problems, and nausea. The impact on one’s quality of life is not always easily “cured” by traditional Western medicine approaches. This is why some individuals with cancer also pursue supportive and complementary therapies, along with conventional medicine.

Some examples of supportive and complementary therapies for cancer patients include: support groups, interpersonal therapy, acupuncture, meditation, yoga, Tai Chi, hypnosis, massage, relaxation training, and mindfulness. When these therapies are used in conjunction with conventional medicine, studies have found that they may reduce stress, anxiety, depression, improve indicators of immune functioning, strengthen spirituality/religion, and improve coping skills, among other possible benefits.

Mindfulness is a potentially powerful tool that has been found to have a beneficial impact on the quality of life of individuals who are diagnosed with cancer. Mindfulness has been defined in many ways, but may be thought of as a “particular way of paying attention,” or “moment to moment” awareness where one adopts a non-judgmental, compassionate attitude towards one’s experience of the present moment. A mindful stance can be practiced by learning to accept, instead of resist or react to one’s thoughts, emotions, and physical sensations as they arise. It is all about changing the relationship to one’s thoughts and emotions so that a sense of equanimity is eventually achieved, even in the face of pain or distress (read more about mindfulness here).

Mindfulness has been embraced by patients and behavioral medicine practitioners alike (Baer, 2003; Bishop, 2002), in large part because of the positive physical and psychological changes that tend to result from the regular practice of mindfulness. A substantial body of empirical evidence supports the use of mindfulness with cancer patients (Carlson & Garland, 2005; Carlson, Speca, Patel, & Goodey, 2003; Carlson, Speca, Patel, & Goodey, 2004; Carlson et al., 2001; Speca, Carlson, Goodey, & Angen, 2000). Most of the literature supporting the use of mindfulness with cancer patients has examined Mindfulness Based Stress Reduction programs (a program developed by Dr. Jon-Kabat Zinn for those with chronic illness or pain that teaches patients how to practice mindfulness) since they are more frequently available in medical settings. Mindfulness has also been integrated into other psychological treatments , including Mindfulness-Based Cognitive Therapy (created by Zindel Segal, Mark Williams and John Teasdale to help prevent relapse for those with depression), Dialectical Behavior Therapy (created by Dr. Marsha Linehan in order to treat those with borderline personality disorder), and Acceptance and Commitment Therapy (developed by Dr. Steven Hayes and Dr. Kelly Wilson and is often used for those with anxiety – indeed, this evidence-based treatment is offered by therapists at CSAM!). Mindfulness is applicable for a wide range of problems.

Some of the benefits of mindfulness training may include:

• Improved general quality of life (Ledesma & Kumano, 2008)
• Improved markers of physical health (Ledesma & Kumano, 2008)
• Reduced anxiety and depression for patients, partners, and survivors (Ledesma & Kumano, 2008; Lengacher, Johnson-Mallard, Post-White, Moscoso, Jacobsen, Klein, Widen, Fitzgerald, Shelton, Barta, Goodman, Cox & Kip, 2009)
• Improved sleep (Carlson & Garland, 2005)
• Increased feelings of control, openness, personal growth, and spirituality and reduced feelings of isolation (Mackenzie, Carlson, Munoz, & Speca, 2007)
• Improved psychological health

Mackenzie, Carlson, Munoz, and Speca (2007) found that cancer patients who underwent mindfulness training through an MBSR program reported five major themes:

• Opening to change: Changes in how they think about and cope w/cancer and treatment
• Self-control:
  • An improved control of attention and behaviors, including a reduction of reactivity to stressors and learning when to take action vs. when to let go
  • An improved physical and mental self-regulation and self-discipline
  • Living better with cancer
• Shared experience:
  • Social support and camaraderie (sharing and listening; development of close and unique relationships; sense of community)
  • Reduced feelings of isolation, especially with cancer diagnosis
  • Instillation of hope (surrounded by other cancer survivors)
  • Improved coping skills (group problem solving, discovery of solutions together)
  • Meditation practice was reinforced
• Personal growth: 
  • Mindfulness provided comfort, meaning, and direction
  • Mindfulness increased willingness to learn from difficult life experiences, such as cancer
  • Shifting from negative to positive mindset; seeing cancer as a motivator to live a full life
  • “The way I look at cancer is that once you get through the awfulness it’s a very powerful motivator to live your life. I’m grateful I can come up here and be reminded of that.”
• Spirituality:
  • Exploration of spirituality (though a common theme that arose during interviews with study participants, though MBSR is secular)

In sum, the benefits of mindfulness are many, and can be potentially useful for those who suffer from cancer. If you or a loved one needs additional help in coping with the distress that cancer can bring, it may be worthwhile to learn more about additional resources that are available. Check out some of the resources below, or contact a qualified professional.

Breast Cancer Resources

Create an early detection plan: http://www.earlydetectionplan.org/

Beyond the Shock: http://www.nationalbreastcancer.org/nbcf-programs/beyond-the-shock

Anxiety and Breast Cancer: http://www.breastcancer.org/treatment/side_effects/anxiety

Tips on How to Combat Anxiety: http://www.breastcancercare.org.uk/news/vita-magazine/overcoming-anxiety#sthash.ku2X77DV.dpuf

If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

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