Meditation effect on psychological stress level in women with breast cancer: a systematic review

Araujo, Raquel Vilanova; Fernandes, Ana Fátima Carvalho; Nery, Inez Sampaio; Andrade, Elaine Maria Leite Rangel; Nogueira, Lídya Tolstenko; Azevedo, Francisco Honeidy Carvalho

Raquel Vilanova Araujo Corresponding author: Raquel Vilanova Araujo, Campus Universitário Ministro Petrônio Portella, Bairro Ininga CEP 64049-550 – Teresina, PI, Brazil ppgenf@ufpi.edu.br

Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brazil

http://orcid.org/0000-0002-1752-296X

Ana Fátima Carvalho Fernandes

Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brazil

http://orcid.org/0000-0001-5110-6364

Inez Sampaio Nery

Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brazil

http://orcid.org/0000-0002-7481-2250

Elaine Maria Leite Rangel Andrade

Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brazil

http://orcid.org/0000-0002-1772-7439

Lídya Tolstenko Nogueira

Universidade Federal do Piauí, Departamento de Enfermagem, Teresina, PI, Brazil

http://orcid.org/0000-0003-4918-6531

Francisco Honeidy Carvalho Azevedo

Centro Universitário, Teresina, PI, Brazil

http://orcid.org/0000-0002-8431-2022

Corresponding author: Raquel Vilanova Araujo, Campus Universitário Ministro Petrônio Portella, Bairro Ininga CEP 64049-550 – Teresina, PI, Brazil ppgenf@ufpi.edu.br

Authors/years	Objectives
Sarenmalm et al., 2017⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ⁾	To determine the effectiveness of mindfulness-based stress reduction (MBSR) meditation intervention for mood disorders in women with breast cancer.
Boyle et al., 2017⁽²¹21. Boyle CC, Stanton AL, Ganz PA, Crespi CM, Bower JE. Improvements in emotion regulation following mindfulness meditation: effects on depressive symptoms and perceived stress in younger breast cancer survivors. J Consult Clin Psychol. 2017;85(4):397-402. DOI: http://dx.doi.org/10.1037/ccp0000186 http://dx.doi.org/10.1037/ccp0000186... ⁾	To test emotion regulation strategies as mediators of MBSR intervention effects in a sample of young women treated for breast cancer, a risk group for psychological distress.
Offidani et al., 2017⁽²²22. Offidani E, Peterson JC, Loizzo J, Moore A, Charlson ME. Stress and response to treatment: insights from a pilot study using a 4-week contemplative self-healing meditation intervention for posttraumatic stress in breast cancer. J Evid Based Complementary Altern Med. 2017;22(4):715-20. DOI: http://dx.doi.org/10.1177/2156587217708522 http://dx.doi.org/10.1177/21565872177085... ⁾	To evaluate whether a Contemplative self-healing program has different effect on post-traumatic stress reduction among breast cancer survivors with or without chronic stress.
Johns et al., 2016⁽²³23. Johns SA, Brown LF, Beck-Coon K, Talib TL, Monahan PO, Giesler RB, et al. Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors. Support Care Cancer. 2016; 24(10):4085-96. DOI: http://dx.doi.org/10.1007/s00520-016-3220- http://dx.doi.org/10.1007/s00520-016-322... ⁾	To compare MBSR to psychoeducation between persistently fatigued breast and colorectal cancer survivors and associated symptoms.
Carlson et al., 2016⁽²⁴24. Carlson LE, Tamagawa R, Stephen J, Drysdale E, Zhong L, Speca M. Randomized-controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long-term follow-up results. Psychooncology. 2016;25(7):750-9. DOI: http://dx.doi.org/10.1002/pon.4150 http://dx.doi.org/10.1002/pon.4150... ⁾	To measure the effects of two interventions (MBSR) and Supportive Expressive Group Therapy (SET) on breast cancer survivors.
Bower, 2015⁽²⁵25. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer. 2015;121(8):1231-40. DOI: http://dx.doi.org/10.1002/cncr.29194 http://dx.doi.org/10.1002/cncr.29194... ⁾	To evaluate the feasibility and effectiveness of an MBSR intervention for women who were diagnosed with breast cancer before or at age 50.
Charlson et al., 2014⁽²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ⁾	To evaluate the results of a 20-week contemplative self-healing program on the quality of life of women with breast cancer.
Lengacher et al., 2014⁽²⁷27. Lengacher CA, Reich RR, Kip KE, Barta M, Ramesar S, Paterson CL, et al. Influence of mindfulness-based stress reduction (MBSR) on telomerase activity in women with breast cancer (BC). Biol Res Nurs. 2014;16(4):438-47. DOI: http://dx.doi.org/10.1177/1099800413519495 http://dx.doi.org/10.1177/10998004135194... ⁾	To investigate the effects of MBSR meditation on telomere length and telomerase activity.
Lengacher et al., 2014⁽²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ⁾	To investigate the action mechanisms of MBSR in reducing fear of recurrence and other potential mediators.
Henderson et al., 2013⁽²⁹29. Henderson VP, Massion AO, Clemow L, Hurley TG, Druker S, Hébert JR. A randomized controlled trial of mindfulness-based stress reduction for women with early-stage breast cancer receiving radiotherapy. Integr Cancer Ther. 2013;12(5):404-13. DOI: http://dx.doi.org/10.1177/1534735412473640 http://dx.doi.org/10.1177/15347354124736... ⁾	To test the relative effectiveness of MBSR compared to a nutrition education and usual care intervention in newly diagnosed women with early-stage breast cancer undergoing radiotherapy.
Calrson et al., 2013⁽³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ⁾	To compare the effectiveness of two group interventions in helping distressed breast cancer survivors: MBSR and Supportive Expressive Group Therapy (SET).
Andersen et al., 2013⁽³¹31. Andersen SR, Würtzen H, Steding-Jessen M, Christensen J, Andersen KK, Flyger H, et al. Effect of mindfulness-based stress reduction on sleep quality: results of a randomized trial among Danish breast cancer patients. Acta Oncol. 2013;52(2):336-44. DOI: http://dx.doi.org/10.3109/0284186X.2012.745948 http://dx.doi.org/10.3109/0284186X.2012.... ⁾	To determine the effect of the MBSR program on sleep quality in breast cancer patients, stress reduction and hot flashes.
Hoffman et al., 2012⁽³²32. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335-42. DOI: http://dx.doi.org/10.1200/JCO.2010.34.0331 http://dx.doi.org/10.1200/JCO.2010.34.03... ⁾	To evaluate the effectiveness of MBSR in relation to mood, quality of life and well-being after hospital treatment in women with stage 0 to III breast cancer.
Lengacher et al., 2012⁽³³33. Lengacher CA, Reich RR, Post-White J, Moscoso M, Shelton MM, Barta M, et al. Mindfulness based stress reduction in post-treatment breast cancer patients: an examination of symptoms and symptom clusters. J Behav Med. 2012;35(1):86-94. DOI: http://dx.doi.org/1007/s10865-011-9346-4 http://dx.doi.org/1007/s10865-011-9346-4... ⁾	To investigate the prevalence and severity of symptoms and symptom clustering in breast cancer survivors who participated in the MBSR.
Matousek et al., 2011⁽³⁴34. Matousek RH, Pruessner JC, Dobkin PL. Changes in the cortisol awakening response (CAR) following participation in Mindfulness-Based Stress Reduction in women who completed treatment for breast cancer. Complement Ther Clin Pract. 2011;17(2):65-70. DOI: http://dx.doi.org/10.1016/j.ctcp.2010.10.005 http://dx.doi.org/10.1016/j.ctcp.2010.10... ⁾	To assess changes in cortisol awakening response (CAR) level following participation in the MBSR Program in women who have completed breast cancer treatment.
Lengacher et al., 2011⁽³⁵35. Lengacher CA, Johnson-Mallard V, Barta M, Fitzgerald S, Moscoso MS, Post-White J, et al. Feasibility of a mindfulness-based stress reduction program for early-stage breast cancer survivors. J Holist Nurs. 2011;29(2):107-17. DOI: http://dx.doi.org/10.1177/089801011038593 http://dx.doi.org/10.1177/08980101103859... ⁾	To evaluate the positive effect of MBSR on the psychological status of breast cancer survivors, psychosocial characteristics, symptoms, and quality of life during treatment until returning to daily activities.
Matchim et al., 2010⁽³⁶36. Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996-1016. DOI: http://dx.doi.org/10.1177/0193945910385363 http://dx.doi.org/10.1177/01939459103853... ⁾	To examine the effects of an MBSR program on physiological and psychological outcomes among early stage breast cancer survivors.
Lengacher et al., 2009⁽³⁷37. Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, et al. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology. 2009;18(12):1261-72. DOI: http://dx.doi.org/10.1002/pon.1529 http://dx.doi.org/10.1002/pon.1529... ⁾	To determine if an MBSR intervention is effective in improving the physical and psychological status of breast cancer survivors compared to usual care, and whether such effects are modified by the extent of compliance with the MBSR program.
Nidich et al., 2009⁽³⁸38. Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, et al. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009;8(3):228-34. DOI: http://dx.doi.org/10.1177/153473540934300 http://dx.doi.org/10.1177/15347354093430... ⁾	To evaluate the impact of the Transcendental Meditation program and standard care compared with standard treatment alone on the quality of life (QoL) of older adult women (≥55 years) with breast cancer, stages II to IV.
Witek-Janusek et al., 2008⁽³⁹39. Witek-Janusek L, Albuquerque K, Chroniak KR, Chroniak C, Durazo-Arvizu R, Mathews HL. Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav Immun. 2008;22(6):969-81. DOI: http://dx.doi.org/10.1016/j.bbi.2008.01.012 http://dx.doi.org/10.1016/j.bbi.2008.01.... ⁾	To evaluate the effect and viability of an MBSR program on immune function, quality of life and coping in women recently diagnosed with breast cancer.
Carlson et al., 2007⁽⁴⁰40. Carlson LE, Speca M, Faris P, Patel KD. One year pre–post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients, Brain Behav Immun. 2007;21(8): 1038-49. DOI: https://doi.org/10.1016/j.bbi.2007.04.002 https://doi.org/10.1016/j.bbi.2007.04.00... ⁾	To investigate the effects of continuous participation in an MBSR program on quality of life (QoL), stress symptoms, mood, and endocrine, immunological, and autonomic parameters in early stage breast and prostate cancer patients.
Carlson et al., 2003⁽⁴¹41. Carlson LE, Speca Michael PSYD, Patel, Kamala D. PHD; Goodey, Eileen MSW. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571-81.⁾	To investigate the relationship between an MBSR program for early stage breast and prostate cancer patients and quality of life, mood, stress symptoms, lymphocyte count and cytokine production.

Types of meditation and group practices
Mindfulness-based stress reduction. Kabat-Zinn. Eight-week group activity program (meditation, mindfulness, yoga), orientation, practice, home, handbook, CD, and home practice diary⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ^–²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ^,31–³²32. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335-42. DOI: http://dx.doi.org/10.1200/JCO.2010.34.0331 http://dx.doi.org/10.1200/JCO.2010.34.03... ^,³⁴34. Matousek RH, Pruessner JC, Dobkin PL. Changes in the cortisol awakening response (CAR) following participation in Mindfulness-Based Stress Reduction in women who completed treatment for breast cancer. Complement Ther Clin Pract. 2011;17(2):65-70. DOI: http://dx.doi.org/10.1016/j.ctcp.2010.10.005 http://dx.doi.org/10.1016/j.ctcp.2010.10... ^,⁴¹41. Carlson LE, Speca Michael PSYD, Patel, Kamala D. PHD; Goodey, Eileen MSW. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571-81.⁾.
Mindfulness-based stress reduction. Kabat-Zinn. Program adapted for 6 weeks of group activities (meditation, mindfulness, yoga), home practice guidance, handbook, CD, and home practice diary⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ^,²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ^,³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^,³⁶36. Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996-1016. DOI: http://dx.doi.org/10.1177/0193945910385363 http://dx.doi.org/10.1177/01939459103853... ^–³⁷37. Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, et al. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology. 2009;18(12):1261-72. DOI: http://dx.doi.org/10.1002/pon.1529 http://dx.doi.org/10.1002/pon.1529... ⁾.
Mindful Awareness Practices (MAP) of the University of California, in Los Angeles. Six weekly sessions in a group of 2 hours. Presentation of theoretical material on mindfulness meditation, relaxation and mind-body connection⁽²⁵25. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer. 2015;121(8):1231-40. DOI: http://dx.doi.org/10.1002/cncr.29194 http://dx.doi.org/10.1002/cncr.29194... ^,²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ⁾.
Contemplative self-healing meditation. Eight-week program, 90-minute group class. Meditation, conscious breathing, healing images. Reading material, audio tapes and diary provided⁽²²22. Offidani E, Peterson JC, Loizzo J, Moore A, Charlson ME. Stress and response to treatment: insights from a pilot study using a 4-week contemplative self-healing meditation intervention for posttraumatic stress in breast cancer. J Evid Based Complementary Altern Med. 2017;22(4):715-20. DOI: http://dx.doi.org/10.1177/2156587217708522 http://dx.doi.org/10.1177/21565872177085... ^,²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ⁾.
Transcendental Meditation Program. Seven-step program from 1 to 1.5 hours. Lectures, personal interviews, instruction, monthly group meetings, and home practice⁽³⁸38. Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, et al. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009;8(3):228-34. DOI: http://dx.doi.org/10.1177/153473540934300 http://dx.doi.org/10.1177/15347354093430... ⁾.
Home Practices
Delivery of informative material, CD disc and diary for making notes; initial sessions of five to 20 minutes, 6 days a week⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ^,²⁴24. Carlson LE, Tamagawa R, Stephen J, Drysdale E, Zhong L, Speca M. Randomized-controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long-term follow-up results. Psychooncology. 2016;25(7):750-9. DOI: http://dx.doi.org/10.1002/pon.4150 http://dx.doi.org/10.1002/pon.4150... ^,²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ^,³³33. Lengacher CA, Reich RR, Post-White J, Moscoso M, Shelton MM, Barta M, et al. Mindfulness based stress reduction in post-treatment breast cancer patients: an examination of symptoms and symptom clusters. J Behav Med. 2012;35(1):86-94. DOI: http://dx.doi.org/1007/s10865-011-9346-4 http://dx.doi.org/1007/s10865-011-9346-4... ^–³⁶36. Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996-1016. DOI: http://dx.doi.org/10.1177/0193945910385363 http://dx.doi.org/10.1177/01939459103853... ^,³⁸38. Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, et al. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009;8(3):228-34. DOI: http://dx.doi.org/10.1177/153473540934300 http://dx.doi.org/10.1177/15347354093430... ^,⁴¹41. Carlson LE, Speca Michael PSYD, Patel, Kamala D. PHD; Goodey, Eileen MSW. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571-81.⁾.
Encouraging formal practice (sitting, lying, walking meditation and conscious and informal movement of meditation (awareness and attention in daily activities, eating, commuting, talking, etc.)⁽²⁷27. Lengacher CA, Reich RR, Kip KE, Barta M, Ramesar S, Paterson CL, et al. Influence of mindfulness-based stress reduction (MBSR) on telomerase activity in women with breast cancer (BC). Biol Res Nurs. 2014;16(4):438-47. DOI: http://dx.doi.org/10.1177/1099800413519495 http://dx.doi.org/10.1177/10998004135194... ^–²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ^,³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^,³⁴34. Matousek RH, Pruessner JC, Dobkin PL. Changes in the cortisol awakening response (CAR) following participation in Mindfulness-Based Stress Reduction in women who completed treatment for breast cancer. Complement Ther Clin Pract. 2011;17(2):65-70. DOI: http://dx.doi.org/10.1016/j.ctcp.2010.10.005 http://dx.doi.org/10.1016/j.ctcp.2010.10... ^,³⁷37. Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, et al. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology. 2009;18(12):1261-72. DOI: http://dx.doi.org/10.1002/pon.1529 http://dx.doi.org/10.1002/pon.1529... ⁾.
*Follow-up*
Two months⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ^–²³23. Johns SA, Brown LF, Beck-Coon K, Talib TL, Monahan PO, Giesler RB, et al. Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors. Support Care Cancer. 2016; 24(10):4085-96. DOI: http://dx.doi.org/10.1007/s00520-016-3220- http://dx.doi.org/10.1007/s00520-016-322... ^,²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ^,²⁹29. Henderson VP, Massion AO, Clemow L, Hurley TG, Druker S, Hébert JR. A randomized controlled trial of mindfulness-based stress reduction for women with early-stage breast cancer receiving radiotherapy. Integr Cancer Ther. 2013;12(5):404-13. DOI: http://dx.doi.org/10.1177/1534735412473640 http://dx.doi.org/10.1177/15347354124736... ^–³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^,³²32. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335-42. DOI: http://dx.doi.org/10.1200/JCO.2010.34.0331 http://dx.doi.org/10.1200/JCO.2010.34.03... ^,³⁴34. Matousek RH, Pruessner JC, Dobkin PL. Changes in the cortisol awakening response (CAR) following participation in Mindfulness-Based Stress Reduction in women who completed treatment for breast cancer. Complement Ther Clin Pract. 2011;17(2):65-70. DOI: http://dx.doi.org/10.1016/j.ctcp.2010.10.005 http://dx.doi.org/10.1016/j.ctcp.2010.10... ^–³⁶36. Matchim Y, Armer JM, Stewart BR. Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors. West J Nurs Res. 2011;33(8):996-1016. DOI: http://dx.doi.org/10.1177/0193945910385363 http://dx.doi.org/10.1177/01939459103853... ^,⁴¹41. Carlson LE, Speca Michael PSYD, Patel, Kamala D. PHD; Goodey, Eileen MSW. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65(4):571-81.⁾
Six weeks⁽²⁴24. Carlson LE, Tamagawa R, Stephen J, Drysdale E, Zhong L, Speca M. Randomized-controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long-term follow-up results. Psychooncology. 2016;25(7):750-9. DOI: http://dx.doi.org/10.1002/pon.4150 http://dx.doi.org/10.1002/pon.4150... ^–²⁵25. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer. 2015;121(8):1231-40. DOI: http://dx.doi.org/10.1002/cncr.29194 http://dx.doi.org/10.1002/cncr.29194... ^,²⁷27. Lengacher CA, Reich RR, Kip KE, Barta M, Ramesar S, Paterson CL, et al. Influence of mindfulness-based stress reduction (MBSR) on telomerase activity in women with breast cancer (BC). Biol Res Nurs. 2014;16(4):438-47. DOI: http://dx.doi.org/10.1177/1099800413519495 http://dx.doi.org/10.1177/10998004135194... ^,³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^,³³33. Lengacher CA, Reich RR, Post-White J, Moscoso M, Shelton MM, Barta M, et al. Mindfulness based stress reduction in post-treatment breast cancer patients: an examination of symptoms and symptom clusters. J Behav Med. 2012;35(1):86-94. DOI: http://dx.doi.org/1007/s10865-011-9346-4 http://dx.doi.org/1007/s10865-011-9346-4... ^,³⁷37. Lengacher CA, Johnson-Mallard V, Post-White J, Moscoso MS, Jacobsen PB, Klein TW, et al. Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psychooncology. 2009;18(12):1261-72. DOI: http://dx.doi.org/10.1002/pon.1529 http://dx.doi.org/10.1002/pon.1529... ^,⁴⁰40. Carlson LE, Speca M, Faris P, Patel KD. One year pre–post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients, Brain Behav Immun. 2007;21(8): 1038-49. DOI: https://doi.org/10.1016/j.bbi.2007.04.002 https://doi.org/10.1016/j.bbi.2007.04.00... ⁾
Four months, 12 months and 24 months⁽²²22. Offidani E, Peterson JC, Loizzo J, Moore A, Charlson ME. Stress and response to treatment: insights from a pilot study using a 4-week contemplative self-healing meditation intervention for posttraumatic stress in breast cancer. J Evid Based Complementary Altern Med. 2017;22(4):715-20. DOI: http://dx.doi.org/10.1177/2156587217708522 http://dx.doi.org/10.1177/21565872177085... ⁾
Three months⁽²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ⁾
Eighteen hours⁽³⁸38. Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, et al. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009;8(3):228-34. DOI: http://dx.doi.org/10.1177/153473540934300 http://dx.doi.org/10.1177/15347354093430... ⁾
Two months, 6 months and 12 months⁽³¹31. Andersen SR, Würtzen H, Steding-Jessen M, Christensen J, Andersen KK, Flyger H, et al. Effect of mindfulness-based stress reduction on sleep quality: results of a randomized trial among Danish breast cancer patients. Acta Oncol. 2013;52(2):336-44. DOI: http://dx.doi.org/10.3109/0284186X.2012.745948 http://dx.doi.org/10.3109/0284186X.2012.... ⁾
Professionals who conducted the intervention
Physician and psychologist with experience in MBSR⁽²³23. Johns SA, Brown LF, Beck-Coon K, Talib TL, Monahan PO, Giesler RB, et al. Randomized controlled pilot trial of mindfulness-based stress reduction compared to psychoeducational support for persistently fatigued breast and colorectal cancer survivors. Support Care Cancer. 2016; 24(10):4085-96. DOI: http://dx.doi.org/10.1007/s00520-016-3220- http://dx.doi.org/10.1007/s00520-016-322... ^,²⁶26. Charlson ME, Loizzo J, Moadel A, Neale M, Newman C, Olivo E, et al. Contemplative self healing in women breast cancer survivors: a pilot study in underserved minority women shows improvement in quality of life and reduced stress. BMC Complement Altern Med. 2014;14:349. DOI: http://dx.doi.org/10.1186/1472-6882-14-349 http://dx.doi.org/10.1186/1472-6882-14-3... ^,²⁸28. Lengacher CA, Shelton MM, Reich RR, Barta MK, Johnson-Mallard V, Moscoso MS, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J Behav Med. 2014;37(2):185-95. DOI: http://dx.doi.org/10.1007/s10865-012-9473-6 http://dx.doi.org/10.1007/s10865-012-947... ^,³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^–³¹31. Andersen SR, Würtzen H, Steding-Jessen M, Christensen J, Andersen KK, Flyger H, et al. Effect of mindfulness-based stress reduction on sleep quality: results of a randomized trial among Danish breast cancer patients. Acta Oncol. 2013;52(2):336-44. DOI: http://dx.doi.org/10.3109/0284186X.2012.745948 http://dx.doi.org/10.3109/0284186X.2012.... ⁾
Psychiatrist with experience in MBSR⁽²¹21. Boyle CC, Stanton AL, Ganz PA, Crespi CM, Bower JE. Improvements in emotion regulation following mindfulness meditation: effects on depressive symptoms and perceived stress in younger breast cancer survivors. J Consult Clin Psychol. 2017;85(4):397-402. DOI: http://dx.doi.org/10.1037/ccp0000186 http://dx.doi.org/10.1037/ccp0000186... ⁾
Certified instructors⁽²⁰20. Sarenmalm Ek, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-22. DOI: http://dx.doi.org/10.1002/cam4.1052 http://dx.doi.org/10.1002/cam4.1052... ^,³⁰30. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31(25):3119-26. DOI: http://ascopubs.org/doi/10.1200/JCO.2012.47.5210 http://ascopubs.org/doi/10.1200/JCO.2012... ^,³⁸38. Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, et al. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009;8(3):228-34. DOI: http://dx.doi.org/10.1177/153473540934300 http://dx.doi.org/10.1177/15347354093430... ⁾
Qualified Researcher, MBSR Instructor, University of Massachusetts Full Care Center⁽³²32. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW. Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol. 2012;30(12):1335-42. DOI: http://dx.doi.org/10.1200/JCO.2010.34.0331 http://dx.doi.org/10.1200/JCO.2010.34.03... ⁾

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[1] Corresponding author: Raquel Vilanova Araujo, Campus Universitário Ministro Petrônio Portella, Bairro Ininga CEP 64049-550 – Teresina, PI, Brazil ppgenf@ufpi.edu.br

Brasil

Brasil

Meditation effect on psychological stress level in women with breast cancer: a systematic review

ABSTRACT

Objective:

Method:

Results:

Conclusion:

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