The MATCH Study: Mindfulness And Tai chi for Cancer Health. This innovative clinical trial conducted by the University of Calgary/Tom Baker Cancer Centre and the Princess Margaret Cancer Centre is now recruiting cancer survivors! As a participant you get to choose which treatment approach you want, or let us assign you to a group if you are equally interested in both. We will measure program effects on psychological, physical and biological outcomes including quality of life, mood, stress, balance, blood pressure, heart rate, immune function and more! Visit www.thematchstudy.ca for more details.
by Dr. Linda E. Carlson, Study Principal Investigator
I had the opportunity to introduce the MATCH Study to you in this blog last month, so you know that we are comparing the effects of two different mind-body therapies for cancer survivors. This month I want to focus on one of the interventions we are testing – Mindfulness-Based Cancer Recovery, or MBCR for short.
MBCR is an adaptation of a program developed in the late 1970s by Jon Kabat-Zinn and colleagues at the University of Massachusetts Medical Centre called Mindfulness-Based Stress Reduction (MBSR). MBSR has been around for almost 40 years now and has spurred a whole host of research studies testing its applicability to many different mental and physical health conditions, and it has inspired many adaptations specific to different groups of people.
MBSR itself is an 8-week group program which focused on training in mindfulness skills through meditation practice. The objective is to develop the capacity to be more mindful in your daily life through practice of formal meditations. Mindfulness is simply paying attention on purpose in the present moment, with an attitude that is accepting, non-judging, open and curious. There are three main components to mindfulness: Intention (WHY you are practicing; to learn to be more present in your life), attention (WHAT you are practicing; attention training) and attitude (HOW you are practicing; with kindness and acceptance). Shauna Shapiro and I wrote a book called The Art and Science of Mindfulness: Integrating Mindfulness into Psychology and the Helping Professions that talks more about this. It turns out that when people are able to be more mindful, in the present moment, they tend to be happier and better able to cope with difficult life circumstances like cancer.
Key components of the MBSR program are the practice of body scan sensory awareness meditation, where you systematically direct attention to all parts of the body moving from head to toe (or toe to head), the practice of sitting meditation with the focus on breath awareness, walking meditation with awareness of movement, mindful movement in the form of gentle yoga, and practice cultivating loving kindness towards the self and other. Participants practice mindfulness meditation every day at home during the program, supported by guided meditations.
Interestingly, when you look at the research studies published in scientific journals under the heading of “Mindfulness”, they have skyrocketed. From only a few publications all through the 80s and 90s, the output increased exponentially in the 2000s and 2010s, culminating in almost 700 papers published in 2015! MBSR interventions have now been repeatedly shown to help people reduce stress and anxiety, improve mood, improve overall quality of life and adapt to a huge variety of illnesses and life circumstances.
In terms of applying the MBSR model to people living with cancer, we developed MBCR in the late 1990s, and our first publication was in the year 2000. This was also the first paper which had ever applied mindfulness-based therapies to people with cancer. You can find full details of our MBCR program in a “home-study” manual Michael Speca and I wrote called Mindfulness-Based Cancer Recovery: A Step-by-Step MBSR Approach to Help You Cope with Treatment and Reclaim Your Life.
What we found in that first study was surprising even to us – we measured stress and mood symptoms before and after the 8-week group intervention, and compared the changes in people who did the program to another group of patients who were still waiting for the group, and in the meantime just receiving their usual cancer care. We saw a huge reduction in overall mood disturbance of over 65% in people who did the MBCR program! This included symptoms of depression, anxiety, anger, confusion and lack of vigor. They also reported about 35% reduction in stress symptoms like tense muscles, racing heart, difficulty concentrating and bad habits like overeating, smoking and drinking. These were large effects that we hadn’t really anticipated, and we were motivated from that study to keep exploring the effects of the program.
Since that time, my team and I (and other groups around the world) continued to study the effect of mindfulness training on many cancer-related symptoms, including sleep difficulties, fatigue, pain and fear of recurrence (some of the most common problems for cancer survivors), showing significant improvements. In a recent study we followed people for a whole year after they did the MBCR group, and found the benefits that were present after the program persisted for the entire time!
We have also taken samples of saliva and blood to look “inside the body” to see how the program might affect these measures. We found that stress hormones shifted towards healthier patterns, and immune function also changed to be less inflammatory, which is thought to be beneficial. Recently we also looked at a marker of cell aging in the DNA, telomere length, and found that the program seemed to provide stability in the telomere length, whereas the telomeres became shorter in a comparison group. This may be important because shorter telomere length has been associated with greater risk for many diseases.
In summary, mindfulness-based interventions have many proven benefits for cancer patients, survivors and family members in our studies, and we are excited now to compare MBCR head-to-head with another promising mind-body therapy (tai chi/qigong). We hope to be able to match people to programs if we can determine which group is best for treating specific symptoms, moving towards more “personalized medicine” when it comes to supportive care interventions.
For more information visit our website: www.thematchstudy.ca
“I found this program to be extremely valuable. Beyond the practises introduced in this program (which I have now adopted), I find that I am now able to challenge my thinking and in many instances, I am able to prevent my thoughts from trending to the negative. I feel I now have the coping strategies I can draw upon, on those difficult days. This program has created an awareness for me and has prompted me to truly notice my environment – basic things and some not so basic things, which I would have previously overlooked. I now have a clearer understanding of the mind/body connection and feel I am better prepared to manage my health. The full day retreat was a very worthwhile bonus. I feel fortunate to have been included in this program.”
Dr. Linda Carlson holds the Enbridge Research Chair in Psychosocial Oncology, is an Alberta Innovates-Health Solutions Health Scholar, Full Professor in Psychosocial Oncology in the Department of Oncology, Cumming School of Medicine at the University of Calgary, and Adjunct Professor in the Department of Psychology. She is the Director of Research and works as a Clinical Psychologist at the Department of Psychosocial Resources at the Tom Baker Cancer Centre.
Dr. Carlson’s research in Mindfulness-Based Cancer Recovery has been published in many high-impact journals and book chapters, and she published a patient manual in 2010 with Michael Speca entitled: Mindfulness-Based Cancer Recovery: A step-by-step MBSR approach to help you cope with treatment and reclaim your life, in addition to a professional training manual in 2009 with Shauna Shapiro entitled The Art and Science of Mindfulness: Integrating mindfulness into psychology and the helping professions. She has published over 150 research papers and book chapters in the area of psycho-oncology, been awarded several national and international reserach awards, holds several millions of dollars in grant funding and is regularly invited to present her work at international conferences.