Mind-body interventions investigated alongside chemotherapy in breast cancer patients
Many cancer patients use mind-body interventions to help them overcome stress associated with the disease and demanding treatments. There is evidence that some of these therapies may help improve immune function. In a new NCI-supported study*, researchers investigated the effects of two stress management therapies on quality of life and stress biomarkers in breast cancer patients undergoing chemotherapy.
Breast cancer patients were randomized to participate in a tai chi intervention or a spiritual growth group for 10 weeks while receiving chemotherapy. Their results were compared to a third group of patients who received only standard care. The tai chi training used in this study emphasized balance, focused breathing, and increased control of attention. The spiritual growth intervention was designed for personal exploration of spirituality, with each weekly session focusing on a particular aspect of spirituality. Participants were followed for 6 months. During the course of the study, they completed quality of life and depressive symptoms questionnaires and provided urine and plasma samples for analysis of stress- and immune-related biomarkers.
The results, recently published in Evidence-Based Complementary and Alternative Medicine**, revealed that participants in all three groups had similar patterns for stress throughout the study – levels of stress were highest at the start of the study, decreased during chemotherapy, and then plateaued during the follow-up period. In addition, quality of life scores dropped during chemotherapy but increased following treatment. Participants in the tai chi group reported a significant increase (compared to the two other groups) in depressive symptoms immediately after chemotherapy but by the first follow-up, those symptoms decreased. Six months after chemotherapy, levels of interferon-gamma were significantly greater in the tai chi and spiritual growth groups than in the standard care group. Interferon-gamma is a protein that is critical for the immune system to function properly.
Although it was not measured in this study, the authors suggested that greater self-awareness may have contributed to increases in depressive symptoms reported by the tai chi group after chemotherapy. According to the authors, “Tai chi training, like other mindfulness-based interventions, focuses on enhancing mindfulness and self-awareness, which may temporarily increase depressive-like symptoms in the face of critical illness situations such as cancer chemotherapy.”
A number of studies have been conducted examining mind-body interventions used by breast cancer patients after they completed standard cancer treatments. However, the authors of the current report noted that their study was “one of few reports of psychosocial interventions involving movement and spirituality for individuals during the period of active chemotherapy and/or radiotherapy for cancer.” They went on to observe, “We undertook a ‘high-risk’ study with respect to the delivery of somewhat novel interventions during a period of high stress and complex physical symptoms related to breast cancer and its treatment.”
*Project number: 5R01CA114718
**Robins, J.W., McCain, N.L., Elswick Jr, R.K., Walter, J.M., Gray, D.P., & Tuck, I. Psychoneuroimmunology-based stress management during adjuvant chemotherapy for early breast cancer. Evidence-based Complementary and Alternative Medicine. in press.