Posted 05.28.2019 | by AMRA
Newly diagnosed breast cancer patients often experience significant psychological distress including symptoms of depression, sleep disturbance, and fatigue. They can also exhibit stress-induced immune system compromises that have the potential to accelerate tumor growth and metastasis. Interventions that restore psycho-immunological balance may also help improve cancer treatment outcomes.
Witek-Janusek et al. [Brain, Behavior, and Immunity] tested the effect of Mindfulness-Based Stress Reduction (MBSR) on psychological and immunological functioning in newly diagnosed breast cancer patients in an experimental trial.
The researchers randomly assigned 164 women (average age = 55 years; 77% Caucasian) recently diagnosed with early stage breast cancer who had undergone surgery to either a standard MBSR or an active control condition. The active control consisted of eight 2.5 hour group sessions providing information on breast cancer, cancer treatment, communication with health providers, and other health-related topics. Attendance in both programs was fairly good, with 68% of MBSR and 78% of control participants attending at least 7 of the group sessions.
Each participant’s psychological status was assessed pre-intervention, mid-intervention, post-intervention, and at 1- and 6-month follow-ups for perceived stress, depression, sleep quality, fatigue, and mindfulness (Five Facet Mindfulness Questionnaire).
The researchers also measured natural killer cell anti-tumor activity (NKCA), monocyte production of Interleukin-6 (IL-6) and Interferon-gamma (INF-ɣ), and the amount of IL-6 and Tumor Necrosis Factor-alpha (TNF-α) present in blood plasma. NKCA prevents tumor growth and metastasis, and is thus associated with longer cancer-free periods. NK cells produce INF-ɣ, an anti-tumor cytokine which is a key immune system activator. IL-6 and TNF-α are pro-inflammatory cytokines that promote tumor progression and aggressiveness.
The results showed that the MBSR group had significantly greater increases in two protective immunological factors (NKCA and INF-ɣ) and significantly lower levels of two pro-inflammatory factors (IL-6 production and TNF-α plasma levels) than the control group.
These differences remained significant at the 6-month follow-up. MBSR INF-γ levels increased by 2,547 pg/ml from pretesting to 6-month follow-up, while control group INF-γ levels increased 973 pg/ml. Similarly, MBSR NKCA increased by 30 lytic units over the same time period, while the control group increased by 0.17 lytic units.
The MBSR group showed significantly more rapid improvements in perceived stress, fatigue, and sleep disturbance. Correspondingly, mindfulness was associated with significantly lower levels of stress, fatigue, and sleep disturbance. Greater improvements in sleep disturbance and fatigue were in turn significantly associated with faster increases in NKCA.
This study shows that MBSR is more useful in improving psychological and immune function in newly diagnosed breast cancer patients than an active control focused on cancer survivor education. It is possible that this experimental intervention may lead to longer cancer-free periods for these patients, although this end outcome was not evaluated. The study also suggests a crucial link between improved sleep and immune system recovery.
The study is important because it focuses on recently diagnosed patients who are at a vulnerable point when psychological distress has a significant impact on immune function and the possible progression of disease.
Witek-Janusek, L., Tell, D., & Mathews, H. L. (2019). Mindfulness based stress reduction provides psychological benefit and restores immune function of women newly diagnosed with breast cancer: A randomized trial with active control. Brain, Behavior, and Immunity.