A cancer diagnosis inevitably causes stress — and high stress is tied to poorer health outcomes in cancer patients.
Research from the Jefferson-Myrna Brind Center of Integrative Medicine has shown that an eight-week program combining creative art therapy and mindfulness-based stress reduction, or MBSR, can lead to changes in brain activity associated with lower stress for women with breast cancer.
Daniel Monti, MD, director of the Myrna Brind Center and lead author on the study, and his colleagues have previously demonstrated the success of mindfulness-based art therapy, or MBAT, in helping cancer patients reduce stress and improve quality of life.
Daniel Monti, MD
“Our goal was to observe possible mechanisms for the observed psychosocial effects of MBAT by evaluating the cerebral blood flow changes associated with an MBAT intervention in comparison with a control of equal time and attention,” Dr. Monti explains. “This type of expressive art and meditation program has never before been studied for physiological impact and the correlation of that impact to improvements in stress and anxiety.”
Eighteen patients were randomly assigned to the MBAT program or an education program control group. All had received a breast cancer diagnosis between six months and three years prior to enrollment and were not in active treatment.
The MBAT group consisted of the MBSR curriculum – awareness of breathing and emotion; mindful yoga; walking; eating; and listening – paired with expressive art tasks to provide opportunities for self-expression, facilitate coping strategies, improve self-regulation and allow participants to express emotional information in a personally meaningful manner.
Response was measured using a 90-item symptom checklist completed by patients before and after the eight-week program.
In addition, functional magnetic resonance imaging was used to evaluate cerebral blood flow, corresponding to changes in the brain’s activity. Scans were performed at rest and then during a “neutral task” (control), a meditation task, a stressor task and at rest again in order to provide a thorough analysis of the changes between the pre- and post-program scans.
Members of the MBAT group demonstrated significant effects on cerebral blood flow compared with the control group, showing increases in the emotional centers of the brain including the left insula, which helps us to perceive our emotions; the amygdala, which helps us experience stress; the hippocampus, which regulates stress responses; and the caudate nucleus, which is part of the brain’s reward system. These increases correlated with a reduction in stress and anxiety that was also reflected in the results of the pre- and post-program anxiety scores among the MBAT intervention group.
The observed psychological and neuropsychological changes are consistent with current literature that states that MBSR interventions have been shown to reduce anxiety, depression and psychological distress in a variety of populations. These results have been associated with improved immune function, quality of life and coping effectiveness in women with breast cancer.
Given the improvements in anxiety levels and changes in cerebral blood flow, these findings suggest that the MBAT program helps mediate emotional responses in women with breast cancer.
“With the sample size enlarged, perhaps we can extrapolate these results to other disease populations and gain a fuller understanding of the physiological mechanisms by which mindfulness practices confer psychological benefits,” Dr. Monti says.
Reprinted from the Fall 2013 issue of the Jefferson Alumni Bulletin
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