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Mindfulness: Managing Anxiety and Depression in the Cancer Patient

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Anxiety and depression are often seen among patients with cancer. Cancer-related anxiety and depression are multifactorial and stem from a psychological response to the diagnosis and treatment of cancer and from changes in body image, sexual function, work and social interactions. Anxiety and depression reduce a person’s quality of life and can also reduce treatment adherence. 

Mindfulness is a mind-body technique whereby a person becomes purposefully cognizant of the present moment (otherwise referred to as present moment awareness) and learns to address their thoughts, feelings and sensations in a non-judgmental manner. Mindfulness consists of 2 simultaneous processes: The first is insight – paying attention to what is arising at any given moment and the second is surrender – letting go of attachment to the arising thoughts. 


Mindfulness can reduce anxiety and depression but also temper adverse effects of cancer treatment, relieve pain, stimulate immune responses and help people deal with a wide range of cancer-related stress including relationships, decision-making, planning for the future, dealing with loss and, if necessary, coming to terms with end of life issues. A recent article in the Journal of the American Medical Association confirmed the effectiveness of mindfulness practices on the management of anxiety and depression. 

Part of most mindfulness practices is regulated, slow intentional breathing. How we breathe can have profound effects on our physiologic and psychological wellbeing. Breathing slowly and intentionally through the nose can induce a state of calm and relaxation and is a part of almost all mindfulness practices. 

The most studied mindfulness practice is called Mindfulness Based Stress Reduction (MBSR for short). This is an 8 week course offering intensive training to assist people in managing stress, anxiety, pain and depression. To have an idea of how this works Victor Frankl says this: “Between stimulus and response theres’s a space, in that space lies our power to choose our response, in our response lies our growth and freedom.” In other words there is a moment of choice before we react to the stress and pain in life. Most of us are unaware of this space between stimulus and response because we get caught up in the habitual habits of life. MBSR helps us become more aware of these habitual reactions and helps us relate to ourselves in a new way to interrupt this cycle and create more choice in life. MBSR teaches us to notice what is happening in the present moment and that allows us to choose our response. Choice then gives us the freedom to live a life as we so choose. 

Besides MBSR there are many other ways to cultivate mindfulness practices. There are many phone apps which can be used including: Calm, Headspace, Insight timer and Waking Up. The key to developing a mindfulness practice is just that: PRACTICE. In order to maximize the benefits of these techniques daily practice is the key. Just as with anything in life the benefit improves with practice. 

We are fortunate here at the John Stoddard Cancer Center to be able to offer the intensive 8-week MBSR course. The next course will begin on Monday, September 14 with a 90-minute orientation. Classes will then be held on Mondays from 5-7:30 pm for the next consecutive 8 weeks. The course will be taught virtually and is basically free to cancer patients, caregivers and survivors. I would encourage anyone interested to join the course, as it can literally be a life changing experience. “All that you are is a result of what you have thought. Thought creates reality.” - Buddha. Change your thoughts and you change your reality. 

REFERENCES

1) Oberoi, S. et al. Association of Mindfulness-Based Interventions With Anxiety Severity in Adults with Cancer: A Systematic Review and Meta-Analysis. JAMA Network Open. 2020;3(8):1-15. 

2) Wurtzen H, et al. Mindfulness Significantly Reduces Self Reported Levels of Anxiety and Depression: Results of a Randomized Controlled Trial Among 336 Danish Women Treated for Stage 1-3 Breast Cancer. Eur J Cancer. 2013;49:1365-1373. 

3) Jon Kabat-Zinn. Wherever You Go There You Are. 1995; Hachette Book Group. 

4) Jon Kabat-Zinn. Full Catastrophe Living. 2013 Bantam Books. 

5) James Nestor. Breath. 2020 Riverhead Books.