Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors.
Study Goal
The researchers aimed to compare the efficacy of mindfulness-based stress reduction (MBSR) versus psychoeducation/support groups (PES) in reducing cancer-related fatigue (CRF) and associated symptoms in cancer survivors.
Results Summary
MBSR showed a trend toward reducing CRF interference and significantly improved vitality and pain reduction compared to PES at post-intervention. Both interventions led to moderate-to-large within-group improvements in fatigue, depression, anxiety, and sleep.
Population
Breast (n=60) and colorectal (n=11) cancer survivors (stage 0-III) with clinically significant CRF after completing chemotherapy and/or radiation therapy.
Effective Dosage
Not specified
Duration
Not specified (assessed at baseline, post-intervention, and 6-month follow-up)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based stress reduction (MBSR) | decrease | CRF interference | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | d = -0.46, p = 0.073 | trend favoring | #1 |
mindfulness-based stress reduction (MBSR) | increase | vitality | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | d = 0.53, p = 0.003 | significantly greater improvement | #2 |
mindfulness-based stress reduction (MBSR) | increase | CRF global improvement | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | χ2 (1) = 4.1765, p = 0.041 | more likely to report CRF as moderately to completely improved | #3 |
mindfulness-based stress reduction (MBSR) | decrease | pain | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | d = 0.53, p = 0.014 | significantly greater reductions | #4 |
mindfulness-based stress reduction (MBSR) | improvement | all fatigue outcomes, depression, anxiety, and sleep | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | moderate-to-large and significant | produced moderate-to-large and significant within-group improvements | #5 |
psychoeducation/support groups (PES) | improvement | all fatigue outcomes, depression, anxiety, and sleep | Breast and colorectal cancer survivors (stage 0-III) with clinically significant CRF | moderate-to-large and significant | produced moderate-to-large and significant within-group improvements | #6 |
PURPOSE: Cancer-related fatigue (CRF) is a disruptive symptom for many survivors. Despite promising evidence for efficacy of mindfulness-based stress reduction (MBSR) in reducing CRF, no trials comparing it to an active comparator for fatigued survivors have been published. The purpose of this trial was to compare MBSR to psychoeducation for CRF and associated symptoms. METHODS: Breast (n = 60) and colorectal (n = 11) cancer survivors (stage 0-III) with clinically significant CRF after completing chemotherapy and/or radiation therapy an average of 28 months prior to enrollment were randomized to MBSR or psychoeducation/support groups (PES). MBSR focused on mindfulness training; PES focused on CRF self-management. Outcomes included CRF interference (primary), CRF severity and global improvement, vitality, depression, anxiety, sleep disturbance, and pain. Outcomes were assessed at baseline (T1), post-intervention (T2), and 6-month follow-up (T3) using intent-to-treat analysis. RESULTS: Between-group differences in CRF interference were not significant at any time point; however, there was a trend favoring MBSR (d = -0.46, p = 0.073) at T2. MBSR participants reported significantly greater improvement in vitality (d = 0.53, p = 0.003) and were more likely to report CRF as moderately to completely improved compared to the PES group (χ2 (1) = 4.1765, p = 0.041) at T2. MBSR participants also reported significantly greater reductions in pain at T2 (d = 0.53, p = 0.014). In addition, both MBSR and PES produced moderate-to-large and significant within-group improvements in all fatigue outcomes, depression, anxiety, and sleep at T2 and T3 compared to T1. CONCLUSION: MBSR and PES appear efficacious for CRF and related symptoms. Larger trials including a usual care arm are warranted. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01724333.