While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression.

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Submit your article to this journal ABSTRACTBackground. Women with breast cancer experience different symptoms related to surgical or adjuvant therapy. Previous fi ndings and theoretical models of mind -body interactions suggest that psychological wellbeing, i.e. levels of distress, infl uence the subjective evaluation of symptoms, which infl uences or determines functioning. The eight-week mindfulness-based stress reduction (MBSR) program signifi cantly reduced anxiety and depression in breast cancer patients in a randomized controlled trial (NCT00990977). In this study we tested the effect of MBSR on the burden of breast cancer related somatic symptoms, distress, mindfulness and spiritual wellbeing and evaluated possible effect modifi cation by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing. Material and methods. A population-based sample of 336 women Danish women operated for breast cancer stages I -III were randomized to MBSR or usual care and were followed up for somatic symptoms, distress, mindfulness skills and spiritual wellbeing post-intervention and after six and 12 months. Effect was tested by general linear regression models post-intervention, and after six and 12 months follow-up and by mixed effects models for repeated measures of continuous outcomes. Effect size (Cohen ' s d) was calculated to explore clinical signifi cance of effects among intervention group. Finally, modifi cation of effect of MBSR on burden of somatic symptoms after 12 months ' follow-up by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing were estimated. Results. General linear regression showed a signifi cant effect of MBSR on the burden of somatic symptoms post-intervention and after 6 months ' follow-up. After 12 months ' follow-up, no signifi cant effect of MBSR on the burden of somatic symptoms was found in mixed effect models. A statistically signifi cant effect of MBSR on distress was found at all time-points and in the mixed effect models. Signifi cant effects on mindfulness were seen after six and 12 months and no signifi cant effect was observed for spiritual wellbeing. No signifi cant modifi cation of MBSR effect on somatic symptom burden was identifi ed. Conclusion. This fi rst report from a randomized clinical trial on the long-term effect of MBSR fi nds an effect on somatic symptom burden related to breast cancer after six but not 12 months follow-up providing support for MBSR in this patient group.

In clinical practice, attention to differences in depressive symptom trajectories is important to identify and target patients and partners who might need support.

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A 6-day residential rehabilitation course did not relieve cancer patients' distress or improve their well-being.

Our findings indicate that participants are younger, have a less recent diagnosis and have a higher level of education than those who refuse. This should be taken into account in designing and evaluating trials of psychosocial interventions and in planning mindfulness-based interventions.