Effect of mindfulness training on quality of life and distress in early breast cancer patients treated with endocrine therapy

Background

Endocrine therapy (ET) prescribed in breast cancer can cause side effects that mimic menopausal symptoms and can thereby affect patients' quality of life. Mindfulness-Based Stress Reduction (MBSR) is a structured group intervention based on meditation and its application in daily life. It has been shown effective in improving quality of life (QoL) and reducing psychological distress in cancer patients but not specifically in patients receiving ET, which was the aim of this study.

Methods

Newly diagnosed breast cancer patients scheduled for (any) ET and/ or radio- but no chemotherapy were recruited to participate in a standardized, 8-week MBSR program provided by a certified trainer (one 3h-session/ week). Clinical outcomes were general QoL and distress measured through the short World Health Organisation Quality of Life scale (WHOQOL-Bref) and the short revised Depression Anxiety Stress Scales (DASS-21-R) before the start, at the end, and 6 months after the end of MBSR.

Results

Twenty breast cancer patients, all receiving tamoxifen (11 had also radiotherapy), completed the study. Mean age was 57.5 ± 7.4 years. At the start of MBSR, 11 were postmenopausal, mean time since diagnosis was 157 ± 65 days and mean time on ET was 99 ± 68 days. As shown in Table 1, the WHOQOL-Bref total score did not improve after MBSR. In contrast, there was a significant decrease of the DASS-21-R total score, though only the comparison of scores before the start vs after 6 months reached significance (p = 0.023, two-tailed paired Wilcoxon tests; scores before vs after MBSR: p = 0.186).

Mean scores for global QOL and psychological distress of patients treated with tamoxifen receiving MBSR

Conclusions

MBSR did not improve global QoL in breast cancer patients treated with tamoxifen. Given their rather high QoL MBSR might not have been offered at an appropriate time. Still, MBSR was beneficial as it significantly lowered their psychological distress (up to at least 6 months).

Clinical trial identification

Legal entity responsible for the study

Jeroen Mebis

Funding

VZW Think Pink

Disclosure

All authors have declared no conflicts of interest.