Patricia Ganz, MD, Director, Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California Los Angeles, presented recent research findings at the virtual 2020 San Antonio Breast Cancer Symposium about the “Pathways to Wellness Study,” a trial looking at factors that impact the overall health of young breast cancer survivors. The goal of this study is to determine if behavioral interventions may improve the overall health of these patients.
A group of researchers have been testing methods to improve the overall health of breast cancer patients aged ≤50 years, who account for approximately 20% of breast cancer diagnoses in women. These survivors regularly experience unique emotional and physical challenges after their diagnosis and treatment, such as anxiety, stress, fear of recurrence, fatigue, sleep disturbance, and other physical effects of treatments. The researchers observed that younger women with breast cancer often report feeling more isolated and less satisfied with support groups and are susceptible to depressive symptoms. The investigators felt it was important to establish group programs specifically designed to help young women feel better and find support among their peers.1
They hypothesized that either of 2 approaches—mindfulness meditation or survivorship education—may help improve the health behaviors and behavioral symptoms of younger breast cancer survivors. Mindfulness meditation uses techniques to help patients change the way they respond to environmental triggers that produce a negative reaction. After treatment, survivorship education may decrease anxiety and improve the well-being and quality of life of patients with breast cancer.
Both of these structured, standardized 2-hour-per-week behavioral interventions were 6-week programs that specifically targeted depressive symptoms. The researchers compared the effectiveness of these 2 interventions with a control group.
Known as Mindfulness Awareness Practices, the meditation educational program focused on topics such as listening, and obstacles such as working with pain, difficult emotions, positive emotions, and mindful interactions. The survivorship education focused on basics of breast cancer for younger survivors, quality-of-life issues, energy balance, work–life balance, nutrition and physical activity, genetic issues and testing, and body image and sexual health.
Patients were recruited over 3 years. A total of 247 patients aged ≤50 years between 6 months and 5 years after treatment for stage 0-III breast cancer were included in this study. Participants did not have metastatic disease and had a minimum level of depressive symptoms as measured by a questionnaire.
The study looked at changes in depressive symptoms, such as fatigue, anxiety, hot flashes, and sleep disturbance.
At baseline, more than half of each group scored in the clinically depressed range before receiving behavioral intervention. Afterwards, only 30% of participants scored in the clinically depressed range, and these improvements persisted. In addition, in the behavioral intervention groups, there were meaningful improvements in sleep disturbances, hot flashes, and anxiety. Those participants in the meditation intervention group seemed to have slightly better outcomes in terms of reduction in fatigue, insomnia, and hot flashes, and this improvement was continued at 6 months after treatment began. More research is needed to understand the full impact of these meditation and survivorship education interventions, but this preliminary study suggests a positive impact on young breast care survivors’ quality of life.
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