Mindfulness Training May Improve End-of-Life Conversations in Advanced Cancer

Mindfulness training is an easily applicable intervention that may increase quality of life (QOL) and confidence in advance care planning (ACP) for both caregivers and patients with advanced cancer, according to a poster to be presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting. 

Previous studies for early-stage cancer survivors have shown that mindfulness training may improve emotional regulation and adaptive coping. Once applied to patients with advanced cancer, this training may allow for easier facilitation of ACP conversations with family caregivers, EOL planning, and improved QOL for both patients and family caregivers.

For the Mindfulness to Enhance Quality of Life and Support Advance Care Planning (MEANING) study, researchers randomly assigned 55 patient and caregiver dyads to 6 mindfulness meditation classes with communication training or to usual care. Eligible patients had a life expectancy of 1 year or less, and also had high scores of cancer-related cognitive avoidance. 

Of the 55 dyads initially enrolled, program retention was 84% after 10 weeks.

Dyads assigned to the mindfulness arm experienced significant benefits early, reporting large improvements in existential QOL by week 6 compared with those assigned to usual care; however, the extent of improvement was not sustained at 10 weeks.

Family caregivers assigned to mindfulness had significant within-group improvements in QOL after 10 weeks, but there were no improvements observed for between-group QOL at any point in the study.

Patients assigned to the mindfulness group also trended towards improvement in ACP confidence compared with patients in usual care at week 6, and reached significance by week 10. 

The authors concluded that “results suggest that mindfulness training is feasible and potentially beneficial for improving QOL and ACP confidence in dyads coping with advanced cancer. A full-scale efficacy trial with a more diverse sample is planned.”

Reference

Johns SA, Beck-Coon KA, Brown LF, et al. Effects of mindfulness meditation on quality of life in adults with advanced cancer and family caregivers: a randomized pilot. Poster presentation at: 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL.