Mindfulness-based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Wellbeing and Quality of Life in Patients with Breast Cancer – a Randomized Control Trial

Abstract Context Mindfulness-based interventions have been receiving growing attention in cancer care. Objectives The purpose of this randomized controlled trial is to examine the effectiveness of mindfulness-based cognitive therapy (MBCT) for psychological distress (anxiety and depression), fear of cancer recurrence (FCR), fatigue, spiritual wellbeing and quality of life (QOL) in Japanese ambulatory patients with stage I to III breast cancer. Methods A total of 74 patients were randomly assigned to either an eight-week MBCT intervention group (n = 38) or a wait-list control group (n = 36). The primary outcome was psychological distress, measured on Hospital Anxiety and Depression Scale. The secondary outcomes were FCR (Concerns About Recurrence Scale - overall anxiety subscale), fatigue (Brief Fatigue Inventory), spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual), QOL (Functional Assessment of Cancer Therapy-General) and mindfulness skills (Five Facet Mindfulness Questionnaire). The participants were assessed at baseline (T0), week8 (T1), and week12 (T2). The results were analyzed using a linear mixed model, intention-to-treat. Results The participants in the MBCT group experienced significantly better outcomes in their psychological distress (Cohen's d=1.17, p Conclusions MBCT was demonstrated to improve wellbeing that encompasses psychological, physical and spiritual domains in Japanese patients with nonmetastatic breast cancer. The favorable effect was maintained up to four weeks after the completion of the intervention.