Mindfulness-Based Stress Reduction in Breast Cancer Survivors with Chronic Neuropathic Pain: A Randomized Controlled Trial

Abstract

Context. Many breast cancer survivors live with chronic neuropathic pain (CNP) after breast cancer treatment. Despite pharmacological management of CNP, many women continue to report disabling pain and reduced quality of life. Addressing pain with psychosocial interventions as an adjunct to pharmacological treatment is often recommended for CNP. Objectives. The purpose of this study was to compare the effects of group-delivered mindfulness-based stress reduction as compared to a waitlist control group among breast cancer survivors living with CNP. Methods. A randomized controlled trial design was applied, and outcomes collected included pain, emotional function, quality of life, and global impression of change. Results. A total of 98 women were randomized and included in analyses. The sample included 49 women in the mindfulness-based stress reduction group, and 49 women in the waitlist control group. The intervention group participants (mean age 51.3 years, standard deviation = 11.4) and waitlist participants (mean age 55.1 years, standard deviation = 9.6) reported an average pain duration of approximately three years. No significant differences were found on the primary outcome of the proportions of women with reduced pain interference scores from the time of randomization to 3 months after the intervention was received. No significant changes were found among secondary outcomes. Conclusion. Our randomized clinical trial did not find significant benefits of group-based mindfulness-based stress reduction for the management of CNP. The current study findings should be replicated and are important to consider given ongoing concerns that nonsignificant results of mindfulness-based stress reduction are often unpublished.

Psychologically based interventions for adults with chronic neuropathic pain: a scoping review

“… 42 , 67 One (3%) study examined individuals with multiple sclerosis and peripheral neuropathy, 58 and another study was on NeuP in cancer survivors (3%). 62 The remaining 2 studies included individuals with central poststroke pain (3%) 54 and with trigeminal neuralgia (3%). 29 …”

Efficacy of treatments for pain and numbness in cancer survivors: a systematic review and meta-analysis

“…The meta-analysis for the effect of education/CBT on pain included 7 RCTs (n=655) (32)(33)(34)(35)(36)(37)(38). Of these, 3 studies focused on biofeedback (32-34); 2 on coping skills training (35,36), and 2 on mindfulness (37,38).…”

“…The meta-analysis for the effect of education/CBT on pain included 7 RCTs (n=655) (32)(33)(34)(35)(36)(37)(38). Of these, 3 studies focused on biofeedback (32-34); 2 on coping skills training (35,36), and 2 on mindfulness (37,38). There were 3 studies that included breast cancer survivors and 1 that included colon cancer survivors, with the remaining 3 studies including survivors of various types of cancer.…”

“…Subgroup analysis for coping skills training [2 studies; n=119; telephone-based coping skills training (35), online symptom self-management training (36)] did not show a significant effect on pain (SMD 0.11; 95% CI: −0.45 to 0.67; P=0.69; Figure 6). Subgroup analysis for mindfulness-based stress reduction training on pain (2 studies; n=377) (37,38) showed no significant effect compared with usual care (SMD 0.11; 95% CI: −0.09 to 0.31; P=0.28; Figure 6).…”

Contribution of immune cells to cancer-related neuropathic pain: An updated review

“… 11 , 12 , 13 Taking breast cancer for example, the causes of pain include surgical outcome, tumor spread, bony metastasis to the spine, and chemotherapy. 14 , 15 It is worthy to mention that cancer-related neuropathic pain is generally associated with poor outcomes. 16 , 17 Of interest, Rayment et al have reported that cancer patients with neuropathic pain have worse physical, cognitive, and social functioning.…”