Effects of Mindfulness-based Stress Reduction on Cancer-related Fatigue in Patients with Breast Cancer: a Meta-analysis of Randomized Controlled Trials

Overview

Journal Front Oncol

Specialty Oncology

Date 2024 Oct 18

PMID 39421452

Authors

XiaoQian Lan

Hongmei Xie

Lan Fu

Wentao Peng

Affiliations

Soon will be listed here.

Abstract

Introduction: Mindfulness-based stress reduction (MBSR) has been widely used for improving psychological symptoms and sleep quality in breast cancer patients and has a positive impact on posttraumatic growth and immunology. Moreover, MBSR is increasingly being used in cancer-related fatigue (CRF) intervention studies for breast cancer patients, but conflicting results also exist.

Objective: This study aimed to evaluate the effect of MBSR on CRF in patients with breast cancer.

Methods: A comprehensive computer search of the Pubmed, Cochrane Library, Embase, Web of Science, China Biomedical Document Service System, China Knowledge Infrastructure Engineering, Wanfang Data Knowledge Service Platform, and VIP databases was performed. Randomized controlled trials (RCTs) published before April 10, 2023, were identified. The primary outcome was cancer-related fatigue associated with breast cancer. Two researchers independently screened the studies, extracted the data, and evaluated the methodological quality of the studies according to the inclusion and exclusion criteria. The Meta-analysis of the outcome indicators was performed using STATA 16.0 software.

Results: A total of 13 studies were included, including 1992 patients (997 patients in the MBSR group and 1015 patients in the control group). Compared with conventional care, MBSR significantly alleviated the symptoms of CRF in breast cancer patients (SMD=-0.32, 95% CI [-0.42, -0.22], z=6.54, p<.01). Under the supervision of experts, the 8-week MBSR had a great influence on CRF, especially in the Asian population.

Conclusions: MBSR is effective in the treatment of CRF induced by breast cancer, and no obvious adverse effects occur; thus, MBSR can be recommended as a beneficial adjuvant therapy for treating CRF in breast cancer patients.

Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021245365.

References

Franzoi M, Agostinetto E, Perachino M, Del Mastro L, de Azambuja E, Vaz-Luis I . Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer. Lancet Oncol. 2021; 22(7):e303-e313. DOI: 10.1016/S1470-2045(20)30666-5. View

Maass S, Brandenbarg D, Boerman L, Verhaak P, de Bock G, Berendsen A . Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study. Cancers (Basel). 2021; 13(6). PMC: 8001130. DOI: 10.3390/cancers13061301. View

Rahmani S, Talepasand S . The effect of group mindfulness - based stress reduction program and conscious yoga on the fatigue severity and global and specific life quality in women with breast cancer. Med J Islam Repub Iran. 2015; 29:175. PMC: 4431452. View

Hoffman C, Ersser S, Hopkinson J, Nicholls P, Harrington J, Thomas P . Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012; 30(12):1335-42. DOI: 10.1200/JCO.2010.34.0331. View

Witek Janusek L, Tell D, Mathews H . Mindfulness based stress reduction provides psychological benefit and restores immune function of women newly diagnosed with breast cancer: A randomized trial with active control. Brain Behav Immun. 2019; 80:358-373. DOI: 10.1016/j.bbi.2019.04.012. View

Lengacher C, Reich R, Paterson C, Ramesar S, Park J, Alinat C . Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial. J Clin Oncol. 2016; 34(24):2827-34. PMC: 5012660. DOI: 10.1200/JCO.2015.65.7874. View

Adam S, van de Poll-Franse L, Mols F, Ezendam N, de Hingh I, Arndt V . The association of cancer-related fatigue with all-cause mortality of colorectal and endometrial cancer survivors: Results from the population-based PROFILES registry. Cancer Med. 2019; 8(6):3227-3236. PMC: 6558477. DOI: 10.1002/cam4.2166. View

Lengacher C, Reich R, Paterson C, Shelton M, Shivers S, Ramesar S . A Large Randomized Trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for Breast Cancer (BC) Survivors on Salivary Cortisol and IL-6. Biol Res Nurs. 2018; 21(1):39-49. PMC: 6700883. DOI: 10.1177/1099800418789777. View

Reich R, Lengacher C, Alinat C, Kip K, Paterson C, Ramesar S . Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. J Pain Symptom Manage. 2016; 53(1):85-95. PMC: 7771358. DOI: 10.1016/j.jpainsymman.2016.08.005. View

10.

Haller H, Winkler M, Klose P, Dobos G, Kummel S, Cramer H . Mindfulness-based interventions for women with breast cancer: an updated systematic review and meta-analysis. Acta Oncol. 2017; 56(12):1665-1676. DOI: 10.1080/0284186X.2017.1342862. View

11.

Abrahams H, Gielissen M, Schmits I, Verhagen C, Rovers M, Knoop H . Risk factors, prevalence, and course of severe fatigue after breast cancer treatment: a meta-analysis involving 12 327 breast cancer survivors. Ann Oncol. 2016; 27(6):965-974. DOI: 10.1093/annonc/mdw099. View

12.

Carlson L, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E . Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer. J Clin Oncol. 2013; 31(25):3119-26. DOI: 10.1200/JCO.2012.47.5210. View

13.

Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P . Breast cancer. Nat Rev Dis Primers. 2019; 5(1):66. DOI: 10.1038/s41572-019-0111-2. View

14.

Behringer K, Goergen H, Muller H, Thielen I, Brillant C, Kreissl S . Cancer-Related Fatigue in Patients With and Survivors of Hodgkin Lymphoma: The Impact on Treatment Outcome and Social Reintegration. J Clin Oncol. 2016; 34(36):4329-4337. DOI: 10.1200/JCO.2016.67.7450. View

15.

Ma Y, He B, Jiang M, Yang Y, Wang C, Huang C . Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. Int J Nurs Stud. 2020; 111:103707. DOI: 10.1016/j.ijnurstu.2020.103707. View

16.

Johns S, Tarver W, Secinti E, Mosher C, Stutz P, Carnahan J . Effects of mindfulness-based interventions on fatigue in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Oncol Hematol. 2021; 160:103290. PMC: 8200642. DOI: 10.1016/j.critrevonc.2021.103290. View

17.

Xie C, Dong B, Wang L, Jing X, Wu Y, Lin L . Mindfulness-based stress reduction can alleviate cancer- related fatigue: A meta-analysis. J Psychosom Res. 2020; 130:109916. DOI: 10.1016/j.jpsychores.2019.109916. View

18.

Mao H, Bao T, Shen X, Li Q, Seluzicki C, Im E . Prevalence and risk factors for fatigue among breast cancer survivors on aromatase inhibitors. Eur J Cancer. 2018; 101:47-54. PMC: 6148367. DOI: 10.1016/j.ejca.2018.06.009. View

19.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

20.

Ebede C, Jang Y, Escalante C . Cancer-Related Fatigue in Cancer Survivorship. Med Clin North Am. 2017; 101(6):1085-1097. DOI: 10.1016/j.mcna.2017.06.007. View