Mindfulness-Based Stress Reduction Diminishes Chemo Brain

“Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors, according to a new study from the Regenstrief Institute and Indiana University School of Medicine.

“Although cancer-related cognitive impairment, sometimes referred to as chemo brain or post-cancer cognitive fuzziness, is common among survivors—disrupting social relationships, work ability, self-confidence, and quality of life—clinicians have few treatment options to offer. Cognitive deficits have been seen to persist for more than a decade following cancer treatment for many survivors.

” ‘Randomized Controlled Pilot Trial of Mindfulness-based Stress Reduction for Breast and Colorectal Cancer Survivors: Effects on Cancer-related Cognitive Impairment,’ published online in advance of print in the Journal of Cancer Survivorship, is the first randomized clinical trial to evaluate the effects of mindfulness-based stress reduction, known as MBSR, on fatigued breast and colorectal cancer survivors, the majority of whom had been treated with chemotherapy.”

Clinical Trial Reduces Stress of Cancer Caregivers

“Stem cell transplant is essential in the care of many blood cancers, but leaves patients requiring in-home care for months after. Frequently the role of caregiver falls to family or other committed members of the patient’s support network. Previous work shows dramatically increased stress in cancer caregivers, directly impacting the caregiver and indirectly impacting the cancer patient via reduced quality of care. A randomized control trial funded by the National Cancer Institute by members of the University of Colorado Cancer Center, published in the journal Bone Marrow Transplantation, demonstrates an intervention that successfully reduces the stress of caregivers in the context of cancer patients treated with stem cell transplantation.

” ‘The first 100 days after a stem cell transplant is a critical period for patients in which caregivers are called upon to deliver around-the-clock care, providing support for patients’ everyday needs and also patients’ emotional health. But who takes care of the caregivers?’ says Mark Laudenslager, PhD, investigator at the CU Cancer Center, director of the Behavioral and Endocrinology Laboratory at the CU School of Medicine, and the paper’s first author.”

Stress Management Techniques Improve Long-Term Mood and Quality of Life

“A new study shows that providing women with skills to manage stress early in their breast cancer treatment can improve their mood and quality of life many years later. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings suggest that women given the opportunity to learn stress management techniques during treatment may benefit well into survivorship.

“At the turn of the century, 240 women with a recent breast cancer diagnosis participated in a randomized trial that tested the effects of a stress management intervention developed by Michael Antoni, Ph.D., professor of psychology in the University of Miami (UM) College of Arts & Sciences. Dr. Antoni and his team in the Department of Psychology found that, compared with patients who received a one-day seminar of education about breast cancer, patients who learned relaxation techniques and new coping skills in a supportive group over 10 weeks experienced improved quality of life and less depressive symptoms during the first year of treatment.

“In their latest report, the researchers found that the women who received the stress management intervention had persistently less depressive symptoms and better quality of life up to 15 years later.

Delayed Breast Reconstruction after Mastectomy May Be More Stressful than Mastectomy Alone

The gist: Women who do not have breast reconstruction after mastectomy may have less cancer-related distress than women who start breast reconstruction more than one year after mastectomy. Women who have mastectomies have three choices: no reconstruction, immediate reconstruction started during the mastectomy surgery, or delayed breast reconstruction. Researchers recently compared women who had no breast reconstruction with women who started reconstruction more than one year after mastectomy. The women who had delayed breast reconstruction had higher levels of distress and obsessiveness than women who did not have reconstruction. 

“In women who have undergone mastectomy, those who underwent delayed breast reconstruction experienced greater cancer-related distress over the long term compared with women who underwent mastectomy alone, according to a prospective study by Metcalfe et al in the Journal of Surgical Oncology

“Metcalfe and colleagues conducted a prospective study to examine the psychosocial outcomes in women who had mastectomy alone compared to those who underwent breast reconstruction more than 1 year postmastectomy. Psychosocial functioning was assessed according to levels of total distress, obsessiveness, and cancer-related distress…

“According to the investigators, psychosocial functioning improved over time in patients treated with mastectomy in the long-term breast cancer survivorship period, which may be related to the effect of time posttreatment and not whether or not these women chose to undergo delayed breast reconstruction. Over the course of the study, the investigators did not observe any statistically significant differences in changes in quality of life over time as a result of having mastectomy alone or delayed breast reconstruction.

“ ‘It is critical for health-care providers to recognize that women who seek out delayed breast reconstruction may have higher baseline levels of distress and body image issues postmastectomy, which may persist after delayed breast reconstruction,’ the authors said.”

Patients Turn to Palliative Care for Relief from Serious Illness

“Patients with serious illnesses need medical treatments to survive. But they are increasingly taking advantage of the specialty known as palliative care, which offers day-to-day relief from symptoms as well as stress and lifestyle management.

“Though often regarded as only for older patients with terminal illness before they enter hospice programs at the end of life, palliative care is increasingly being offered to patients of any age with a range of chronic illnesses such as cancer, multiple sclerosis and Parkinson’s. It may be provided at the same time as curative medical regimens to help patients tolerate side effects of disease and treatment, and carry on with everyday life.

“ ‘Most people who need palliative care are in fact not dying, but have one or more chronic diseases which they may live with for many years,’ says Diane E. Meier, director of the nonprofit Center to Advance Palliative Care and a professor at the Icahn School of Medicine at Mount Sinai in New York. For a 24-year-old with acute leukemia, there is a 70% chance of survival, Dr. Meier says, ‘but the treatment is physically devastating, and that suffering is remediable with palliative care.’ ”

Phone Support Groups Help Women with BRCA Mutations Cope with Stress

“In an Australian study reported in the Journal of Clinical Oncology, White et al found that a telephone-based peer-support intervention reduced breast cancer distress among women with a BRCA1 or BRCA2 gene mutation.

“In the study, 207 mutation carriers reporting interest in talking to other mutation carriers were randomly assigned to the peer-support intervention (n = 105) or usual care (n = 102). The intervention involved trained peer volunteers’ contacting study participants six times over 4 months to provide informational, emotional, and practical support. Outcomes included breast cancer distress (measured by Impact of Event Scale), anxiousness, unmet information needs, and stress and confidence (measured by Cognitive Appraisals About Genetic Testing scale). Outcomes were assessed at the end of intervention (4 months after randomization) and 2 months later…

“The investigators concluded: ‘The intervention is effective in reducing distress and unmet information needs for this group of women. Identifying strategies for prolonging intervention effects is warranted.’ ”

Report Card on Complementary Therapies for Breast Cancer

“Over eighty percent of breast cancer patients in the United States use complementary therapies following a breast cancer diagnosis, but there has been little science-based guidance to inform clinicians and patients about their safety and effectiveness. In newly published guidelines from the Society for Integrative Oncology, researchers at Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering, and other institutions in the U.S. and Canada, analyzed which integrative treatments appear to be most effective and safe for patients. They evaluated more than 80 different therapies.

“Meditation, yoga, and relaxation with imagery were found to have the strongest evidence supporting their use. They received an “A” grade and are recommended for routine use for anxiety and other mood disorders common to breast cancer patients. The same practices received a “B” grade for reducing stress, depression, and fatigue, but are also endorsed for most breast cancer patients. Acupuncture received a “B” grade for controlling chemotherapy induced nausea and vomiting and can be recommended to most patients. More than 30 interventions, including some natural products and acupuncture for other conditions, had weaker evidence of benefit due to either small study sizes or conflicting study results, and received a “C” grade. Seven other therapies were deemed unlikely to provide any benefit and are not recommended. One therapy was found to be harmful: acetyl-l-carnitine, which is marketed to prevent chemotherapy-related neuropathy, and actually increased risk for the condition.”

Work-Related Stress Unlikely to Cause Prostate Cancer

Researchers at the Finnish Institute of Occupational Health and University College London have conducted a meta-analysis of 12 studies to determine if job strain is related to cancer risk. Their findings suggest there is no relationship between work-related stress and overall cancer risk.

In the UK, Rate of Prostate Cancer Diagnoses Increase as Deaths from the Disease Decrease

Cancer Research UK has released figures indicating that the number of prostate cancer cases diagnosed yearly have tripled over the last 20 years. In contrast, the number of deaths from the disease have decreased by 18%. Experts suggest the increase in diagnoses is due to widespread use of PSA (prostate-specific antigen) testing and the decrease in deaths is because of earlier diagnosis and improved treatments.