Cancer, anxiety and mindfulness

It’s no secret that a cancer diagnosis makes people depressed and anxious. It is less known that some medicines used in the treatment of breast cancer can cause anxiety, particularly hormonal treatments.(1)

It is even less well known that, in contrast to the depression, which tends to decrease over time, the anxiety tends to persist and may even become worse.(2) This study was cited and discussed in the New York Times “Well” blog post “Anxiety Lingers Long After Cancer” by Jan Hoffman.

I recently wrote about the things I do to (attain and) maintain mental health, and in an earlier post I wrote about my choice to live intentionally, to live an examined life:

This business of living intentionally isn’t New Age or mystical or Buddhist or maladaptively introspective.  It only requires pausing in your day, or even in your week or month, to be aware of your interior and exterior worlds. What am I doing? Is it what I want to be doing? Is there a change I’d like to see? Can I bring it about? What path am I on; is it likely to bring me to where I want to go?

I started this practice when I was about fifteen years old. I was a member of a dramatics group and the director used to have us sit quietly at the beginning of each lesson or rehearsal to do a “here and now” exercise. It’s very simple. You start by sitting still in a comfortable position and saying, “Here and now, I am aware of…” and naming what you see, hear, smell, feel. You do this quietly, in pace with your breathing. As you physically relax, you can close your eyes and your awareness gradually switches to the interior world.

By interior world I mean thoughts, feelings, wishes, desires, discomfort, contentment, hopes, satisfaction, anger, delight… a kind of mindfulness. It was a great exercise for me at that difficult age, and it remains so when I am in a tizzy or need to get back in touch with myself.

I was very interested to see that my intuition about using mindfulness to cope with stress and anxiety was borne out in a small Danish study that was published this past April in the European Journal of Cancer.(3) The investigators provided a “structured, eight-week group mindfulness-based stress reduction program (MBSR)” and found that even a year later it had “clinically meaningful, statistically significant effects on depression and anxiety after 12 months’ follow-up, and medium-to-large effect sizes”.

The women participating in the study had been diagnosed with breast cancer at Stage I, II or III and had undergone surgery. I wonder if the results would be different with participants who have Stage IV cancer (advanced or metastatic breast cancer). As usual, however, we mets-ers were not included. (A topic for another post.)

In any case, the statistical results are far less important to me than my lived experience: mindfulness exercises and meditation and living an examined life help me to cope better with stress and anxiety, and that is all the proof I need. Studies like this one, however, might lead cancer centers to provide MBSR or similar approaches to patients in their survivorship programs, and I think that would be a very good thing.


(1)See, for example, this page at BreastCancer.org.

(2)See, for example, a UK study published in Lancet Oncology online in June of this year. The abstract can be accessed free of charge at PubMed. (Click)

(3)The abstract can be read free on line at the journal’s website. (Click)

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23 Responses

  1. helensamia says:

    I use mindfulness often to centre myself in the here and now… Not letting anxiety and panic set in from things that have not actually happened yet..

  2. Elana Rosenbaum, a cancer survivor, wrote a wonderful book on Mindfulness-based Stress Reduction (MBSR), Being Well (Even When You’re Sick): Mindfulness Practices for People with Cancer and Other Serious Illnesses. Very accessible!

    Readers can even preview it at googlebooks http://books.google.com

    And here’s a recently completed study from Canada on MBSR in breast cancer…

  3. I’ve been hearing more and more about mindfulness. Some of our FCT bloggers talk quite often about mindfulness, and it seems to help them tremendously. ~Catherine

    • Knot Telling says:

      Yes, it really seems to be an idea whose time has come. I’ve been practicing it off and on for over 40 years, more and more consistently as time went on. It’s been a huge help in my life.

  4. Great post, KT. As you know, I practice mindfulness, too. I started off with a cancer specific week by week program and have kept with twice daily meditations combined with just trying to live a more mindful existence. It has given me so much peace and strength.

    FYI: Here is a link to the program I used

    • Knot Telling says:

      Thanks so much for the link, Eyes. (May I call you that?) I’ve also found that the combination of specific mindfulness meditations with the more general approach of leading a mindful, examined life has been very, very beneficial.

      Thanks for commenting.

      • Of course you may call me Eyes. And you may also call me Elizabeth. Your preference, KT.

        And you are very welcome.

        • Knot Telling says:

          I would have called you Elizabeth, but you didn’t sign your given name to the comment so I didn’t know if you were okay with it. I’ll try to remember. 🙂

          • I figured that, KT. That’s why I said that both were fine so you wouldn’t feel like you needed to be extra careful.
            Either moniker is fine with me. I just didn’t want you to trouble yourself.

  5. Maxine D says:

    Having read your earlier post (when you first posted it) I have become more mindful, and find that in this life which is not cancer struck, but still at times stressful, it is a useful tool. I loved your definition of it and the brief ‘how to’. Thanks TK.
    Prayers and Blessings

  6. Susan says:

    This is really helpful information and can really help with the anxiety.

  7. Victoria says:

    Tamoxifen can cause anxiety? I had no idea. It wasn’t listed as a side effect by my oncologist. Well, that certainly makes me feel better. I’ve suffered from anxiety since I stopped active treatment and started those pills every day. I thought it was all due to post-treatment blues. I’m sure that is part of it but knowing that the tamoxifen isn’t helping is news to me. Thank you!

    • Knot Telling says:

      Anxiety can be due to many factors at one and the same time, but my experience is that I can deal with it using the same techniques no matter what the reasons are. As my oncologist reminded me, it’s a quality of life issue so you might want to discuss it with your oncologist or family doctor. Other things that I’ve found helpful (in addition to mindfulness) are good basic nutrition, exercise (if my condition allows it), a balance of work, rest and play. Meds can help, too.

      Good luck!

  8. Elizabeth J. says:

    I have found daily prayer and exercise both help a lot. The exercise also helps with the aching caused by the meds, the tightness from radiation, the range of motion from the surgery adhesions, and the lymphedema. (I go to a ladies only gym where most of it is designed for overall fitness and flexibility – my youngest calls it the “old ladies gym”). I am also going to a weekly counselor. She helps a lot, especially since I can talk to her about things family and friends don’t want to hear. My family does complain I am more “sensitive,” I tell them it’s the meds, so they need to get more sensitive in what they say and live with it.
    At one point, partway through cancer treatment, they tried putting me on antidepressants. They did not check my TSH (thyroid) first and let’s just say, my reaction was unusual in a baadddd way. Many things (including depression and fatigue) that were blamed on cancer treatment were partly because during treatment my TSH had changed from 2 to 15! Am I full of energy now? No, but about 50% of the fatigue was thyroid and most of the depression and even some of the aching and puffiness.
    In general, anyone with another chronic health problem (like my hyperthyroidism) needs to make sure that is properly treated, as chemo, radiation, and any drugs used to prevent recurrences or control metastasis will alter your body and you may need the dosages of non-cancer meds changed. And make sure you have some kind of quiet times, prayer, meditation, mindfulness. And whatever exercise or activity you are up to.

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