Cancer-related cognitive impairment, sometimes referred to as chemo brain or post-cancer cognitive fuzziness, is a prevalent and potentially debilitating condition that affects attention, memory and executive function in survivors. While it disrupts social relationships, work ability, self-confidence, and quality of life among survivors, clinicians have few treatment options to offer. Participation in a mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment, revealed a new study from the Regenstrief Institute and Indiana University School of Medicine.
The study is published online in the Journal of Cancer Survivorship
. It 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.
‘Mindfulness-based stress reduction program yields robust and sustained improvement in cancer-related cognitive impairment. It was found to have a positive impact on post-cancer fatigue, depression and sleep disturbance.’
In the study, MBSR participants reported significantly greater improvement in the ability to pay attention, and also made fewer mistakes on difficult cognitive tasks than those in the control group, which received patient education materials and supportive counseling. Both groups attended eight weeks of two-hour classes led by skilled facilitators.
Retention rates in the trial exceeded 95%, strongly suggesting that participants found the program to be worthwhile. Previous studies by the Regenstrief-IU research group have found MBSR to have a positive impact on post-cancer fatigue, depression and sleep disturbance.
Mindfulness training is thought to improve cognitive functioning through mechanisms of focused attention and non-reactive coping with one's internal experiences, such as thoughts, feelings, and bodily sensations. Programs in MBSR include a variety of meditation and yoga practices and other elements. These programs typically range in cost between $200 and $800 for an eight-week program, and are widely available in communities and over the Internet.
Those who participated in the MBSR arm of the Regenstrief-IU study reported significant engagement with high rates of self-reported home practice of mindfulness techniques during the study. The majority continued to practice mindfulness throughout the six-month period following conclusion of the program.
Shelley Johns, the clinical health psychologist and health services researcher who led the Regenstrief-IU study, said, "More people than ever are surviving cancer due to the development of targeted and effective treatments. Yet many cancer survivors are living with difficult and persistent side effects of these treatments, which can be incapacitating."
Dr. Johns, who is a Regenstrief Institute investigator and assistant professor of medicine in the IU School of Medicine, said, "Mindfulness meditation practices enable cancer survivors to better manage cancer-related cognitive impairment, reported by approximately 35% of cancer survivors who have completed treatment. MBSR provides a creative solution for survivors whose social and occupational functioning may have been negatively impacted by cognitive difficulties."
While some oncologists provide patients with information on cancer-related cognitive impairment, the majority of clinicians do not address this symptom due to lack of evidence-based treatments for the condition according to Dr. Johns.