CommentaryPerspective

Mindfulness meditation improved quality of life in adolescents with cancer

A diagnosis of cancer is accompanied by a high degree of emotional stress.

Consequently, psychological interventions have become a vital and integral component of cancer care.

One example is mindfulness meditation, a form of meditation derived from the Buddhist practice of insight meditation. It is designed to develop the skill of paying attention to both inner and outer experiences with acceptance, patience and compassion. It focuses on experiencing life in a nonjudgmental way, in the moment.

Christine A. Zawistowski, MD

Christine A. Zawistowski

The practice strives to help patients develop stability, inner calmness and non-reactivity of the mind. In essence, it tries to train the person to not worry about what has happened in the past or what will happen in the future but to live in the present and accept what is happening.

‘A promising option’

Malboeuf-Hurtubise and colleagues evaluated mindfulness meditation as an intervention to improve the quality of life of teenagers with cancer. They presented their findings at the American Psychosomatic Society’s Annual Scientific Meeting in March.

The researchers enrolled 13 adolescents with cancer in the 8-week trial. Participants completed a questionnaire at baseline that assessed mood, quality of life and sleep. At that point, researchers assigned eight adolescents to weekly 90-minute meditation sessions, and the other five were assigned to a control group. After 8 weeks, participants completed the same questionnaire again.

The investigators analyzed differences in mood, sleep and quality-of-life scores for each participant and between each group to evaluate if mindfulness sessions had a greater effect than the simple passage of time. The results showed a significant improvement in all areas in the treatment group compared with the control group.

Teenagers who participated in the mindfulness group had lower depression scores after the eight sessions. These results were more pronounced in girls. Female participants slept better and developed greater mindfulness skills than male participants.

The small sample size precludes generalizations about the findings until further studies are done. The observed benefits observed with regard to mood and sleep also could be explained by the social support provided to the adolescents in the mindfulness meditation group. Despite this, mindfulness interventions appear to be a promising option to help teens with cancer deal with their psychological stressors.

Deeper benefits

Although the clinical benefits of this intervention are encouraging, there are data that suggest the benefits may extend deeper to a cellular level. There is a growing body of scientific research dedicated to understanding the physiologic and cellular responses induced by stress-reduction techniques.

A study by Kaliman and colleagues examined the effect of mindfulness meditation on gene expression. A group of experienced meditators practiced mindfulness for an 8-hour period. During that same time, another group of people engaged in non-meditative leisure activities in the same environment.

The researchers used polymerase chain reaction (PCR) analysis to measure gene expression in peripheral blood mononuclear cells of participants in both groups. The results showed a downregulation of genes involved in inflammation — histone deacetylase 2, 3 and 9, and pro-inflammatory genes RIPK2 and COX2 — with mindfulness meditation practice.

Although I am not familiar with mindfulness meditation, I have seen the positive clinical effects of other mind–body-based therapies in practice — such as guided imagery — and the data for mindfulness meditation look promising.

The growing body of research examining stress reduction techniques is exciting on many levels. It can identify new therapies that do not involve the research and development of new medications, a long and costly process. These therapies potentially could be economical to provide, as once someone masters meditation, the technique can be repeated as needed at no additional cost. This approach also avoids negative side effects and adverse events associated with medications or other therapies.

For adolescent patients with cancer, mindfulness meditation may be another therapy to add to their treatment plans that may have positive effects extending as far as the cellular level. I look forward to seeing where this research goes.

References:

Kaliman P. Psychoneuroendocrinology. 2014;40:96-107.

Malboeuf-Hurtubise C. Abstract #1075. Presented at: American Psychosomatic Society Annual Scientific Meeting; March 12-15, 2014; San Francisco.

For more information:

Christine A. Zawistowski, MD, is a pediatric palliative care and intensive care doctor at NYU Langone Medical Center in New York. She also is a HemOnc Today Editorial Board member. She can be reached at NYU Langone Medical Center, Department of Pediatrics, 462 First Ave., New York, NY 10016.

Disclosure: Zawistowski reports no relevant financial disclosures.

Perspective

  • Dr. Zawistowski attempts to address a very interesting topic and has written a clear commentary on this work. However, I confess to being rather disappointed at the very soft nature of the data provided. After so many years of attempting to study complementary and integrative medicine as applied to oncology, it really is time to stop the pseudo-science and to complete well-designed and well-powered studies that actually address statistical significance and the same design issues that apply to the assessment of any other novel therapeutic interventions. The study that Dr. Zawistowski mentions has a very small number of patients, for no particular reason, and the correlative gene expression work is dreadfully under-powered. If integrative medicine is to be part of our regular therapeutic armamentarium, its practitioners and supporters need to raise the bar and complete scientifically valid studies that are meaningful, and without rhetoric.
    • Derek Raghavan, MD, PhD, FACP, FRACP, FASCO
    • HemOnc Today Chief Medical Editor, Oncology
  • Disclosures: Raghavan reports no relevant financial disclosures.