Despite studies showing that Head and Neck Cancer (HNC) patients experience some of the highest distress of all cancer patients, few psychological interventions exist to help these patients cope with the challenges of diagnosis and treatment. We examined the feasibility and acceptability of an adapted Mindfulness-Based Stress Reduction (MBSR) intervention tailored for Head and Neck Cancer patients undergoing radiotherapy with curative intent. This intervention used a novel one-on-one administration to accommodate patients’ radiotherapy schedules. A successful pilot study conducted at Peter Mac in 2013/14 will be described entailing 19 HNC patients completing up to 7 sessions of the MBSR program concurrently with radiotherapy. The primary aims were to assess the feasibility of administering this intervention in a hospital setting and the acceptability of this intervention to patients. The secondary aim was to measure patient’s meditation practice and how this related to distress and quality-of-life. Patients were assessed at baseline and post-intervention. During the intervention, patients’ attendance of sessions and their adherence to mindfulness practice outside of sessions was recorded. Correlations were conducted between time spent meditating and post-intervention measures.
Results
The primary outcomes in this study were generally met, with 88% of patients attending 4 or more MBSR sessions, 88% of patients practicing meditation 3 or more times per week, and clinicians demonstrating fidelity to session content. The intervention was generally acceptable to all eligible HNC patients, with those patients who participated differing significantly from those who declined only in weekly alcohol consumption. Higher median levels of meditation practice were moderately to strongly related to higher post-intervention total quality-of-life (r = 0.31, p = 0.25), social wellbeing (r = 0.57, p = 0.03) and functional well-being (r = 0.40, p = 0.14), and lower cancer-related regret (r = -0.36, p = 0.19) and shame (r = -0.27, p = 0.35).
Conclusion
Our pilot study demonstrates that a mindfulness strategy can be adapted for patients during cancer treatment and that delivery to patients one-on-one is feasible and applicable in a hospital setting. The results of this study demonstrate that an adapted MBSR intervention is of general interest to this population. In addition, it is possible for both patients and clinicians to adhere to this program. Finally, these preliminary results demonstrate that this program may have some positive effects on patient’s quality-of-life and cancer-related distress. We intend to further assess the effectiveness of this intervention in reducing distress and increasing quality of life in the months and years after completion of HNC treatment using a randomized controlled trial.