Mindfulness-Based Intervention May Improve QOL in Patients with Breast Cancer

Mindfulness-based intervention (MBI) may activate functional brain changes in networks related to attention and may have a positive effect on subjective measures of cognitive impairment in survivors of breast cancer, according to findings published in Cancer.

Given this, researchers suggested that MBI may help to decrease the stress of cancer-related cognitive impairment and can therefore indirectly improve quality of life in this patient population.

“There is increasing evidence that treatments for noncentral nervous system tumors can have both acute and long-term effects on cognitive functioning,” the authors wrote. “Women who are treated for breast cancer for example, regularly report problems with cognitive processes involving memory, attention, and executive functioning. These cognitive deficits can be a worrying side effect of cancer and its treatment and can have a serious effect on quality of life.”

In this cohort of 33 breast cancer survivors who reported cognitive impairment, participants were randomly assigned to either a mindfulness condition (n = 18) or a waitlist control condition (n = 15). Patients then completed questionnaires on cognitive impairment, emotional distress, and fatigue, as well as neuropsychological tests and resting-state functional magnetic resonance imaging before the start of MBI, immediately after the completion of an 8-week MBI program, and 3 months postintervention.

Patients in the mindfulness condition cohort were found to exhibit significantly higher connectivity between the dorsal and salience attention networks following the mindfulness intervention compared with those in the control condition cohort. Moreover, MBI participants also had reduced subjective cognitive impairment, emotional distress, and fatigue. However, no intervention effect was observed on neurocognitive tests.

“Our observation is in line with previous brain imaging studies showing an effect of mindfulness practice on attention-related networks,” the authors wrote. “Although several studies report increased activity in such networks after MBI, there is still large variation in studied subregions and the demonstrated effects across populations and tasks. To our knowledge, this is the first observation of an effect of MBI within the attention networks in patients with cognitive impairment.”

Notably, the researchers did not observe significant changes in mindfulness skills. Therefore, it was recommended that future studies attempt to replicate the results of the current study using an active control condition.

Importantly, the study was limited by a small sample size, the lack of an active control condition, and a possible selection bias due to the low participation rate and the high attrition rate, which may have affected the results. Furthermore, generalizability of the study is limited being that the population was comprised only of patients with breast cancer. In order to further refine the current understandings of changes in brain connectomics after MBI, the investigators indicated that ROI-independent, data-driven, multivariate network or graph analysis approaches could be used in future studies.

“Our results support a future replication of this study using a larger sample size and an active control condition,” the authors wrote. “Furthermore, the use of a blended-care program with only 4 face-to-face group sessions makes it feasible for participants who have a very busy life and could lead to future integration of the program into routine oncologic care. Because the intervention was led by a skilled facilitator, there is a potential effect of therapeutic alliance.”

Reference:

Van der Gucht K, Ahmadoun S, Melis M, et al. Effects of a Mindfulness-Based Intervention on Cancer-Related Cognitive Impairment: Results of a Randomized Controlled Functional Magnetic Resonance Imaging Pilot Study. Cancer. doi: 10.1002/cncr.33074.