Guidelines Recommend Mindfulness-Based Interventions for Anxiety and Depression During Cancer Treatment

Guidelines now recommend mindfulness-based interventions such as meditation and mindful movement to manage anxiety and depression in adults with cancer.

In particular, two oncology organizations —Society for Integrative Oncology (SIO) and American Society of Clinical Oncology (ASCO) — reviewed previously conducted trials to determine whether integrative therapies such as yoga, relaxation, hypnosis, acupuncture and music therapy were beneficial in managing anxiety and depression symptoms in adults with cancer.

“Anxiety and depression symptoms have long been associated with lower quality of life in people with cancer,” Heather Greenlee, co-chair of the SIO clinical practice guideline committee, explained in a press release. “Treating these symptoms using evidence-based integrative therapies will not only improve a patient’s quality of life, but it can help them better manage their care too. Now we know which therapies could have the biggest impact.”

The guideline committee gave the strongest recommendations for mindfulness-based interventions such as stress reduction, meditation and mindful movement, as they were the most beneficial therapies for both anxiety and depression in adults currently undergoing cancer treatment and for those post-treatment, according to a press release.

“Mindfulness-based interventions and other mind-body therapies not only provide tools to manage patients’ anxiety and depression symptoms, but they can also offer patients a sense of control over their illness, which we know can be helpful for patients who have to navigate a complex treatment journey,” Dr. Scott T. Tagawa, past chair of the ASCO evidence-based medicine committee, explained in the release.

The guidelines were prepared by an expert panel who evaluated existing information focused on the use of integrative therapies for anxiety and depression in adults with cancer. Upon completion of the review, the expert panel made recommendations based on how strong the available evidence was in the area of integrative oncology.

Of note, integrative oncology is a field of cancer care that is informed by evidence and focuses on the patient by using techniques related to mind and body practices, according to the release. The main goal of integrative oncology is to improve quality of life, health and clinical outcomes throughout a patient’s journey with cancer, while empowering them to be active participants in their care.

“We have seen a steady increase in interest in these therapies among cancer patients over the years, but certain roadblocks have prevented patients from accessing them,” Julia Rowland, co-chair of the SIO-ASCO guideline, said in the release. “We hope that comprehensive cancer centers and governing administrative bodies consider prioritizing MBIs in patient care.”

The guidelines highlight other interventions as part of their recommendations — although not as strong as the mindfulness-based interventions — such as music therapy, relaxation and reflexology for patients with anxiety and depression who are undergoing conventional treatment. The expert panel also noted that yoga may benefit patients with breast cancer to treat anxiety and depression.

“We want to clarify that this does not mean yoga can only benefit women with breast cancer,” Linda E. Carlson, president of SIO, professor of oncology at the University of Calgary and co-chair of the guideline, said in the release. “There is research that shows yoga can benefit people with various cancer types, and we need to continue building the evidence base.”

The expert panel noted that there are several areas of integrative oncology that may be relevant to cancer care but require more research before they decided whether to recommend it. This lack of endorsement does not mean that it is ineffective or unsafe, but rather more information is needed to make a decision.

“Rather, it indicates that the evidence was insufficient to support its recommendation,” Rowland said in the release. “For instance, more studies are needed to assess the safety and effectiveness of natural health products.”

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