Randomized controlled pilot study of mindfulness-based stress reduction for persistently fatigued cancer survivors

Psychooncology. 2015 Aug;24(8):885-93. doi: 10.1002/pon.3648. Epub 2014 Aug 17.

Abstract

Objective: Cancer-related fatigue (CRF) is one of the most common, persistent, and disabling symptoms associated with cancer and its treatment. Evidence-based treatments that are acceptable to patients are critically needed. This study examined the efficacy of mindfulness-based stress reduction (MBSR) for CRF and related symptoms.

Method: A sample of 35 cancer survivors with clinically significant CRF was randomly assigned to a 7-week MBSR-based intervention or wait-list control group. The intervention group received training in mindfulness meditation, yoga, and self-regulatory responses to stress. Fatigue interference (primary outcome) and a variety of secondary outcomes (e.g., fatigue severity, vitality, disability, depression, anxiety, and sleep disturbance) were assessed at baseline, post-intervention, and 1-month follow-up. Bonferroni correction was employed to account for multiple comparisons. Controls received the intervention after the 1-month follow-up. Participants in both groups were followed for 6 months after completing their respective MBSR courses to assess maintenance of effects.

Results: Compared to controls, the MBSR group reported large post-intervention reductions as assessed by effect sizes (d) in the primary outcome, fatigue interference (d = -1.43, p < 0.001), along with fatigue severity (d = -1.55, p < 0.001), vitality (d = 1.29, p < 0.001), depression (d = -1.30, p < 0.001), and sleep disturbance (d = -0.74, p = 0.001). Results were maintained or strengthened at 1-month follow-up, the point at which significant improvements in disability (d = -1.22, p < 0.002) and anxiety (d = -0.98, p = 0.002) occurred. Improvements in all outcomes were maintained 6 months after completing the course. MBSR adherence was high, with 90% attendance across groups and high rates of participant-reported home practice of mindfulness.

Conclusions: Mindfulness-based stress reduction is a promising treatment for CRF and associated symptoms.

Keywords: MBSR; cancer; cancer-related fatigue; meditation; mindfulness; oncology.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / etiology
  • Anxiety / therapy
  • Depression / etiology
  • Depression / therapy
  • Disabled Persons
  • Fatigue / etiology*
  • Fatigue / prevention & control*
  • Fatigue / psychology
  • Female
  • Humans
  • Male
  • Meditation
  • Middle Aged
  • Mindfulness*
  • Neoplasms / complications*
  • Neoplasms / psychology*
  • Pilot Projects
  • Sample Size
  • Selection Bias
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / therapy
  • Stress, Psychological / etiology
  • Stress, Psychological / prevention & control
  • Stress, Psychological / therapy*
  • Survivors / psychology*
  • Treatment Outcome
  • Waiting Lists
  • Yoga