Cancer Symptoms and Treatment Side Effects
There is evidence that mindfulness-based stress reduction, a type of meditation training, can help cancer patients relieve anxiety, stress, fatigue, and general mood and sleep disturbances, thus improving their quality of life. Most participants in these mindfulness studies have been patients with early-stage cancer, primarily breast cancer, so the evidence favoring mindfulness training is strongest for this group of patients.
The Evidence Base
- The current evidence base on efficacy of meditation for cancer symptoms and treatment side effects consists of clinical practice guidelines issued by the Society for Integrative Oncology on the use of integrative therapies as supportive care in patients treated for breast cancer (2014) and guidelines issued by the American College of Chest Physicians on the use of complementary and integrative medicine in patients with lung cancer (2013). The 2014 guidelines are based on evidence from 203 studies, and each modality was graded using a modified version of the U.S. Preventative Services Task Force grading system to develop and grade recommendations. The 2013 guidelines are based on evidence from 31 studies, including meta-analyses, systematic reviews and randomized controlled trials.
- Clinical practice guidelines issued by the Society for Integrative Oncology in 2014 (391KB PDF) on the use of integrative therapies as supportive care options in patients during breast cancer treatment recommends meditation, yoga, and relaxation imagery for routine use for commons conditions, including anxiety and mood disorders (Grade A). The guidelines also recommend stress management, yoga, massage, music therapy, energy conservation, and meditation for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B).
- Clinical practice guidelines issued by the American College of Chest Physicians in 2013 for patients undergoing lung cancer treatment recommend meditation, as well as other mind-body modalities, as part of a multidisciplinary approach to reduce anxiety, mood disturbance, chronic pain, and improve quality of life. These guidelines are based on evidence that meditation can help cancer patients relieve anxiety, stress, fatigue, and general mood and sleep disturbances, thus improving their quality of life.
- A 2013 randomized controlled trial in 271 distressed survivors of breast cancer examined the effects of mindfulness-based cancer recovery versus supportive expressive group therapy. Women in the mindfulness group improved more over time on stress symptoms compared with those in both the supportive expressive therapy group and the control. Greater improvements in quality of life were also seen in the mindfulness group compared with the control, and in social support compared with the supportive expressive therapy group.
- A 2012 randomized controlled trial in 229 women following surgery, chemotherapy, and radiotherapy for breast cancer (stage 0 to III) found that an 8-week mindfulness-based stress reduction program improved mood, breast- and endocrine-related quality of life, and well-being more effectively than standard care. The results persisted at 3 months.
There is evidence that meditation may have modest potential benefit for lowering blood pressure; however a possible mechanism of action remains unclear. A 2013 review and scientific statement on alternative approaches to lowering blood pressure from the American Heart Association recommends that meditation could be used as an adjunct or complementary therapy along with standard treatment, and provides the following statement: “The overall evidence supports that Transcendental Meditation (TM) modestly lowers blood pressure.” However, the review indicates that it is uncertain whether TM is truly superior to other meditation techniques in terms of blood pressure lowering because there are few head-to-head studies.
The Evidence Base
- The best evidence to date on the efficacy of meditation for lowering blood pressure consists of meta-analyses and several randomized controlled trials, as well as a 2013 review and scientific statement from the American Heart Association on alternative approaches for lowering blood pressure.
- A 2013 review and scientific statement on alternative approaches to lowering blood pressure from the American Heart Association suggests that the overall evidence supports that TM modestly lowers blood pressure. However, the review indicates that it is uncertain whether TM is truly superior to other meditation techniques in terms of blood pressure lowering because there are few head-to-head studies. Because of the paucity of data, no recommendation could be made on a specific method of practice when TM is used for the treatment of high blood pressure. Further, the mechanism whereby meditation techniques lower blood pressure when it occurs remains unclear.
- Results of a 2009 randomized controlled trial involving 298 college students that assessed the effects of Transcendental Meditation (TM) versus wait-list control on blood pressure, psychological distress, and coping suggest that meditation may lower the blood pressure of people at increased risk of developing hypertension. The findings also suggested that practicing meditation can help with psychological distress, anxiety, depression, anger/hostility, and coping ability.
A growing body of evidence suggests that meditation-based programs may be helpful in reducing common menopausal symptoms, including the frequency and intensity of hot flashes, sleep and mood disturbances, stress, and muscle and joint pain.
The Evidence Base
- The current evidence base on efficacy of meditation therapy for menopausal symptoms consists of a systematic review and several randomized controlled trials.
- A 2010 review of 21 papers (representing 18 clinical trials from 6 countries) assessed mind and body therapies for menopausal symptoms. The researchers found that yoga, tai chi, and meditation-based programs may be helpful in reducing common menopausal symptoms including the frequency and intensity of hot flashes, sleep and mood disturbances, stress, and muscle and joint pain. However, the limitations characterizing most studies included in the review hinder interpretation of findings and preclude firm conclusions regarding efficacy.
There is moderate evidence that meditation is useful for symptoms of anxiety and depression in adults.
The Evidence Base
- The current evidence base on efficacy of meditation for anxiety disorders consists of a few systematic reviews and meta-analyses and many randomized controlled trials. Most studies measured only improvement in anxiety symptoms, but not anxiety disorders as clinically diagnosed.
- A 2014 systematic review and meta-analysis of 47 trials in 3,515 participants found that mindfulness meditation programs had moderate evidence of improved anxiety, depression, and pain, and low evidence of improved stress/distress and mental health-related quality of life. No evidence of benefit was found on meditation for health-related behaviors affected by stress, such as substance abuse and sleep.
- A 2012 systematic review and meta-analysis of 36 randomized controlled trials found that 25 of the studies reviewed reported statistically superior outcomes in the meditation group compared to the control.
To date, there have been a few randomized studies on mindfulness-based interventions for smoking cessation, but overall, there is not enough evidence to know whether mind-body practices are as efficacious as other more established smoking cessation treatments.
The Evidence Base
- The current evidence base on efficacy of meditation therapy for smoking cessation consists of a systematic review and several small randomized controlled trials.
- Findings from a 2013 systematic review of 14 trials (8 were randomized controlled trials with different number of study arms) supports meditation-based therapies as candidates to assist smoking cessation; however, the small number of available studies provides insufficient evidence to determine rigorously if meditation is an effective treatment.
- A 2011 randomized controlled trial comparing mindfulness training with a standard behavioral smoking cessation treatment found that individuals who received mindfulness training showed a greater rate of reduction in cigarette use immediately after treatment and at 17-week follow-up.
- A couple of studies have used functional magnetic resonance imaging to examine the effects of mindful attention on the anterior cingulate and prefrontal cortex in smokers, the areas of the brain associated with cravings and self-control. In one study, participants’ self-reported results demonstrated that mindful attention reduced cravings. In addition, the brain imaging results indicated that mindful attention reduced neural activity in a craving-related region of the subgenual anterior cingulate cortex. In another study, a 2-week course of meditation (5 hours in total) produced a significant reduction in smoking, compared to a relaxation training control. Results of brain imaging showed increased activity for the meditation group in the anterior cingulate and prefrontal cortex.
Because only a few studies have been conducted on the effects of meditation for attention deficit hyperactivity disorder (ADHD), there isn’t sufficient evidence to support the use of meditation for this condition.
The Evidence Base
- The current evidence base on efficacy of meditation for ADHD consists of a Cochrane systematic review and few randomized controlled trials.
- A 2010 Cochrane review of four studies involving 83 participants found that because of the limited number of studies, the small sample size, and the high risk of bias, no conclusions could be drawn regarding the effectiveness of meditation for ADHD.
- Meditation is considered to be safe for healthy people.
- There have been rare reports that meditation could cause or worsen symptoms in people who have certain psychiatric problems, but this question has not been fully researched.
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