Application of a mind-body tool in a rural population to improve post-operative outcomes in women with breast cancer: A pilot study

Author: David J Linshaw1, Erin G Floyd2, Kari M Rosenkranz3, James E Stahl4
Author Information:
1 Department of General Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: david.j.linshaw@hitchcock.org.
2 Geisel School of Medicine at Dartmouth College, Dartmouth-Hitchcock Medical Center, Zimmerman Lounge Box 47, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: erin.g.floyd.med@dartmouth.edu.
3 Department of General Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: kari.m.rosenkranz@hitchcock.org.
4 Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: james.e.stahl@hitchcock.org.
Conference/Journal: Surg Oncol
Date published: 2020 Sep 1
Other: Volume ID: 34 , Pages: 63-66 , Special Notes: doi: 10.1016/j.suronc.2020.03.007. , Word Count: 252


Background:
Breast cancer is the most commonly diagnosed cancer in women in the United States. While improvements in treatment have improved mortality, they can negatively impact quality of life (QOL). Mindfulness-based programs are low-cost interventions shown to improve QOL. The study aim was to evaluate a well-validated mind-body program - determining its feasibility, acceptability, and improvement in symptomatology in post-operative breast cancer patients in a rural setting.

Methods:
We recruited patients during post-operative appointments following mastectomy or lumpectomy for breast cancer. Each participant completed 3 surveys before and after the intervention: (8 PROMIS-29, PROMIS -Global QOL, and MAAS (Mindfulness Attention Awareness Scale). The intervention was an 8-week course: "The Stress Management and Resiliency Training (SMART) - Relaxation Response and Resiliency Program (3RP)", which has been well-validated for the treatment of various clinical problems. Feasibility, acceptability, quantitative survey data, and demographics were analyzed.

Results:
SMART-3RP was highly acceptable with greater than >80% completion rate. 23% of the invited participants enrolled, although over 70% of patients approached (34/48) expressed interest. The principal recruitment deterrent was scheduling. Sleep and anxiety/depression were improved in participants although not significantly due to small sample size. We also demonstrated improving trends in other QOL measures.

Conclusions:
This small pilot study proved feasibility, showed excellent acceptability, and demonstrated a benefit in post-operative breast cancer patients. Even with our small sample size, we found trends in improvement in certain QOL measures which emphasizes SMART-3RP's potential effectiveness. A large-scale randomized controlled trial is warranted.

Keywords: Breast cancer; Relaxation response; Rural.

PMID: 32891355 DOI: 10.1016/j.suronc.2020.03.007

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