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Background The objective of this randomized clinical experiment was to test the influence of a mindfulness meditation practice, when delivered during one session of active chemotherapy administration, on acute salivary cortisol response as a marker of the neuroendocrine system activity in cancer patients. Methods A mindfulness, attention control, or resting exposure was assigned to N=57 English- or Spanish- speaking colorectal cancer patients at one county oncology clinic and one university oncology clinic at the start of chemotherapy. Four saliva samples were collected at the start of chemotherapy and at subsequent 20-minute intervals during the first 60 minutes of chemotherapy. Self-report on biobehavioral assessments post-chemotherapy included distress, fatigue, and mindfulness. Results Area under the curve analysis (AUCI and AUCB) denoted a relative increase in cortisol reactivity in the mindfulness group after adjusting for biological and clinical measures (β=123.21, p=.03), indicating reduced acute cortisol blunting. More than twice as many patients in the mindfulness group as compared to controls displayed a cortisol rise from baseline to 20 minutes (69% vs. 34%, p=.02). AUCi values were uncorrelated with biobehavioral measure scores although mindfulness scores were inversely correlated with fatigue (r=−.46, p<.01) and distress (r=−.54, p<.01) scores. Conclusions Findings suggest that a mindfulness practice during chemotherapy can reduce blunting of neuroendocrine profiles typically observed in cancer patients. Implications include support for the use of mindfulness practice in integrative oncology.

Cancer-related cognitive decline (CRCD) may have particularly significant consequences for older adults, impacting their functional and physical abilities, level of independence, ability to make decisions, treatment adherence, overall quality of life, and ultimately survival. In honor of Dr. Hurria's work we explore and examine multiple types of screening, assessment and nonpharmacologic treatments for CRCD. We then suggest future research and clinical practice questions to holistically appreciate the complexity of older adults with cancer's experiences and fully integrate the team-based approach to best serve this population.

OBJECTIVE. To describe sleeping behaviors and trends over time among an ethnically diverse group of community-living older adults. METHOD. A descriptive secondary data analysis of a subsample (n = 217) from the Lifestyle Redesign randomized controlled trial was done to explore baseline napping and sleeping patterns as well as 6-mo changes in these outcomes. RESULTS. At baseline, the average time sleeping was 8.2 hr daily (standard deviation = 1.7). Among all participants, 29% reported daytime napping at baseline, of which 36% no longer napped at follow-up. Among participants who stopped napping, those who received an occupation-based intervention (n = 98) replaced napping time with nighttime sleep, and those not receiving an intervention (n = 119) experienced a net loss of total sleep (p &lt; .05). CONCLUSION. Among participants who stopped napping, the occupation-based intervention may be related to enhanced sleep. More research examining the role of occupation-based interventions in improving sleep is warranted.

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Participation refers to a state of health in which a person is able to fully engage in roles and life situations. Adults living with and beyond cancer often report persistent participation restrictions that affect their productivity and quality of life. The American Occupational Therapy Foundation convened a group of scientists from seven different disciplines in a Planning Grant Collective (PGC) to stimulate research to identify scalable ways to preserve and optimize participation among cancer survivors. Participants identified challenges, prioritized solutions, and generated novel research questions that move beyond symptom and impairment mitigation as outcomes to identify interventions that improve participation in roles and life situations. This article summarizes the PGC discussion and recommendations regarding three challenges: (a) the dynamic and multi-faceted nature of participation, (b) a need to integrate the concept of participation within the culture of oncology, and (c) identification of priority areas in which new lines of research regarding participation would be most impactful.

Objective To assess the extent to which spiritual well‐being moderates the relationship between anxiety and physical well‐being in a diverse, community‐based cohort of newly diagnosed cancer survivors. Methods Data originated from the Measuring Your Health (MY‐Health) study cohort (n = 5506), comprising people assessed within 6‐13 months of cancer diagnosis. Life meaning/peace was assessed using the 8‐item subscale of the Spiritual Well‐Being Scale (FACIT‐Sp‐12). Anxiety was measured with an 11‐item PROMIS Anxiety short form, and physical well‐being was assessed using the 7‐item FACT‐G subscale. Multiple linear regression models were used to assess relationships among variables. Results Life meaning and peace was negatively associated with anxiety, b = −0.56 (P < .001) and positively associated with physical well‐being, b = 0.43 (P = <.001) after adjusting for race, education, income, and age. A significant interaction between life meaning/peace and anxiety emerged (P < .001) indicating that spiritual well‐being moderates the relationship between anxiety and physical well‐being. Specifically, for cancer survivors high in anxiety, physical well‐being was dependent on levels of life meaning/peace, b = 0.19, P < .001. For those low in anxiety, physical well‐being was not associated with levels of life meaning/peace, b = 0.01, P = .541. Differences in cancer clinical factors (cancer stage at diagnosis, cancer type) did not significantly impact results. Conclusions Further research is needed to assess how spiritual well‐being may buffer the negative effect of anxiety on physical well‐being. A clinical focus on spiritual well‐being topics such as peace and life meaning may help cancer survivors of all types as they transition into follow‐up care.