Mindfulness meditation cuts depressive symptoms in young breast cancer survivors

Behavioural interventions are effective in mitigating depressive symptoms in young survivors of breast cancer, according to a study presented at SABCS 2020. In particular, mindfulness meditation also improves other outcomes related to well-being such as fatigue and sleep disturbance. 

“For women in their 30s and 40s, the experience with breast cancer and its treatments is substantially different from that of older women,” said lead investigator Professor Patricia Ganz from the Fielding School of Public Health at University of California, Los Angeles (UCLA) in Los Angeles, California, US.

“These women often require more aggressive therapy that can be both disruptive and disfiguring, which can cause high levels of distress, putting them at an increased risk for the negative effects of cancer diagnosis and treatment,” she noted. “Yet, little research has been done on strategies to reduce the depression and manage the stress of this younger population.”

The phase III, multicentre trial enrolled 247 women (mean age 45.4 years) with mild depressive symptoms who had been diagnosed at with early-stage breast cancer at the age of 50 or younger and completed cancer treatment at least 6 months to 5 years ago. [SABCS 2020, abstract GS2-10]

They were randomized 1:1:1 to mindfulness meditation, survivorship education, or wait-list control. Both behavioural intervention programmes were delivered as structured content, run in a group format over 6 weeks. Those assigned to the wait list eventually received their chosen programme at the conclusion of study.

Women who underwent mindfulness meditation showed significant reduction in depressive symptoms from baseline after the intervention (CESD*, 13.6; p=0.001), at 3 months (CESD, 13.4; p<0.001), and at 6 months (CESD, 12.9; p=0.013) compared with wait-list controls (CESD, 16.3).

While more than 50 percent of the participants were in the clinically depressed range at baseline, this number dropped to 30 percent during the follow-up period.

Moreover, the mindfulness meditation group also had significantly less sleep disturbance, persistent hot flashes, and severe fatigue than controls during follow-up (p<0.05) — benefits that were not seen in the survivorship education group. 

Nonetheless, those who received survivorship education also had significantly fewer depressive symptoms than controls post-intervention (CESD, 13.3; p=0.007) and at 3-month follow-up (CESD, 13.6; p=0.003). 

Although both the mindfulness meditation and survivorship education programmes led to reduced anxiety levels after intervention compared with controls (p<0.05), the effects were not sustained over follow-up.

“Younger breast cancer survivors are in need of targeted, effective programs to help manage stress, depression, and other residual side effects of diagnosis and treatment,” said study co-investigator Professor Julienne Bower, also from UCLA.

“We are excited to have two new options to offer these survivors, and particularly the mindfulness programme which is available online and can be accessed by women across the country,” he highlighted. “These [behavioural] interventions are standardized, manualized, and have the potential for wide dissemination over virtual platforms.” 

*CESD: Center for Epidemiologic Studies Depression scale