Mindfulness practice reduces cortisol blunting during chemotherapy: A randomized controlled study of colorectal cancer patients

Cancer. 2017 Aug 15;123(16):3088-3096. doi: 10.1002/cncr.30698. Epub 2017 Apr 7.


Background: The objective of this randomized clinical experiment was to test the influence of a mindfulness meditation practice, when delivered during 1 session of active chemotherapy administration, on the acute salivary cortisol response as a marker of neuroendocrine system activity in cancer patients.

Methods: A mindfulness, attention-control, or resting exposure was assigned to 57 English- or Spanish-speaking colorectal cancer patients at 1 county oncology clinic and 1 university oncology clinic at the start of chemotherapy. Saliva samples were collected at the start of chemotherapy and at subsequent 20-minute intervals during the first 60 minutes of chemotherapy (4 samples in all). Self-reporting on biobehavioral assessments after chemotherapy included distress, fatigue, and mindfulness.

Results: An area-under-the-curve analysis (AUC) showed a relative increase in cortisol reactivity in the mindfulness group after adjustments for biological and clinical measures (β = 123.21; P = .03). More than twice as many patients in the mindfulness group versus the controls displayed a cortisol rise from the baseline to 20 minutes (69% vs 34%; P = .02). AUC values were uncorrelated with biobehavioral measure scores, although mindfulness scores were inversely correlated with fatigue (r = -0.46; P < .01) and distress scores (r = -0.54; P < .01).

Conclusions: Findings suggest that mindfulness practice during chemotherapy can reduce the blunting of neuroendocrine profiles typically observed in cancer patients. Implications include support for the use of mindfulness practice in integrative oncology. Cancer 2017;123:3088-96. © 2017 American Cancer Society.

Keywords: chemotherapy; colorectal; complementary medicine; cortisol; endocrine; integrative oncology; meditation; mindfulness.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Area Under Curve
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / psychology
  • Fatigue
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Male
  • Meditation / methods*
  • Middle Aged
  • Mindfulness / methods*
  • Saliva / chemistry
  • Stress, Psychological / metabolism
  • Stress, Psychological / psychology
  • Stress, Psychological / therapy*
  • Treatment Outcome


  • Antineoplastic Agents
  • Hydrocortisone