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From the Department Psychosocial Resources, Tom Baker Cancer Centre (L.E.C., M.S., E.G.), Calgary, Alberta, Canada; and the Departments of Oncology (L.E.C., M.S.) and Physiology and Biophysics (K.D.P.), Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
Address reprint requests to: Linda E. Carlson, PhD, Department of Psychosocial Resources, Tom Baker Cancer Centre, 1331 29th Street NW, Calgary, Alberta, Canada T2N 4N2. Email: lcarlso{at}ucalgary.ca
Received for publication January 23, 2002; revision received August 5, 2002.
OBJECTIVES: This study investigated the relationships between a mindfulness-based stress reduction meditation program for early stage breast and prostate cancer patients and quality of life, mood states, stress symptoms, lymphocyte counts, and cytokine production.
METHODS: Forty-nine patients with breast cancer and 10 with prostate cancer participated in an 8-week MBSR program that incorporated relaxation, meditation, gentle yoga, and daily home practice. Demographic and health behavior variables, quality of life (EORTC QLQ C-30), mood (POMS), stress (SOSI), and counts of NK, NKT, B, T total, T helper, and T cytotoxic cells, as well as NK and T cell production of TNF, IFN-
, IL-4, and IL-10 were assessed pre- and postintervention.
RESULTS: Fifty-nine and 42 patients were assessed pre- and postintervention, respectively. Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. Although there were no significant changes in the overall number of lymphocytes or cell subsets, T cell production of IL-4 increased and IFN- decreased, whereas NK cell production of IL-10 decreased. These results are consistent with a shift in immune profile from one associated with depressive symptoms to a more normal profile.
CONCLUSIONS: MBSR participation was associated with enhanced quality of life and decreased stress symptoms in breast and prostate cancer patients. This study is also the first to show changes in cancer-related cytokine production associated with program participation.
Key Words: psychoneuroimmunology (PNI), • meditation, • cancer, • stress, • quality of life, • lymphocytes, • cytokines.
Abbreviations: ANOVA = analysis of variance;; EORTC-QLQ-C30 = European Organization for Research and Treatment of Cancer Quality of Life Questionnaire;; FBS = fetal bovine serum;; IFN- = interferon gamma;; IL = interleukin;; MBSR = mindfulness-based stress reduction;; NK = natural killer;; PBS = phosphate-buffered saline;; PI = principal investigator;; PMA = phorbol 12-myristate 13-acetate;; POMS = Profile of Mood States;; PTSD = posttraumatic stress disorder;; QL = quality of life;; RA = research assistant;; RBC = red blood cells;; SOSI = Symptoms of Stress Inventory;; TNF = tumor necrosis factor;; WBC = white blood cells.
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