Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET)

Carlson, Linda E.; Doll, Richard; Stephen, Joanne; Faris, Peter; Tamagawa, Rie; Drysdale, Elaine; Speca, Michael

doi:10.1200/jco.2012.47.5210

Cited by 282Cancer survivorship and careMindfulness and Compassion InterventionsCancer, Stress, Anesthesia, and Immune Response

Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET)

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Carlson, Linda E., Doll, Richard, Stephen, Joanne, Faris, Peter, Tamagawa, Rie, Drysdale, Elaine, Speca, Michael·2013·Journal of Clinical Oncology

DOI 10.1200/jco.2012.47.5210

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Abstract

Purpose: To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET). Patients and Methods: This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support. Results: Using linear mixed-effects models, in intent-to-treat analyses, cortisol slopes were maintained over time in both SET (P = .002) and MBCR (P = .011) groups relative to the control group, whose cortisol slopes became flatter. Women in MBCR improved more over time on stress symptoms compared with women in both the SET (P = .009) and control (P = .024) groups. Per-protocol analyses showed greater improvements in the MBCR group in quality of life compared with the control group (P = .005) and in social support compared with the SET group (P = .012). Conclusion: In the largest trial to date, MBCR was superior for improving stress levels, quality of life, and social support for distressed survivors of breast cancer. Both SET and MBCR also resulted in more normative diurnal cortisol profiles than the control condition. The clinical implications of this finding require further investigation.

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Despite these factors, some people are able to continue to thrive when faced with cancer.
“However, studies show that despite these factors, some people are able to continue to thrive when faced with cancer (Carlson et al., 2013).”
From Effect of acceptance and commitment therapy on depression, anxiety, stress, and psychological flexibility in women with breast cancer. (2024) · cites this paper as Carlson et al., 2013
The Discussion describes a sense of control, calm, peace, and serenity in the face of cancer, supporting the idea that some people can experience positive well-being despite it. But the study concerns distressed breast cancer survivors receiving psychosocial interventions; it does not establish that people with cancer generally continue to thrive, or that such well-being persists over time. The Discussion notes a lack of long-term follow-up across groups (page unavailable). (LLM, conf=0.82)
Experimental — accuracy not yet measured
Except for a single study targeting distressed re-entry phase cancer survivors, interventions developed for re-entry phase cancer survivors target general cancer survivors rather than anxious or distressed survivors most in need of help.
“Yet except for a single study targeting distressed re-entry phase cancer survivors [38], the interventions developed for re-entry phase cancer survivors [39–48] target general cancer survivors rather than the anxious or distressed survivors most in need of help.”
From A randomized controlled trial of a group acceptance-based intervention for cancer survivors experiencing anxiety at re-entry ('Valued Living'): Study protocol (2019) · cites this paper as [38]
Prior studies predominately enrolled breast cancer survivors.
“However, it is notable that prior studies predominately enrolled breast cancer survivors [35, 36].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [35]

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Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET) LindaE.Carlson,RichardDoll,JoanneStephen,PeterFaris,RieTamagawa,ElaineDrysdale,andMichaelSpeca
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Authors: Carlson, L. E., Doll, R., Stephen, J., Faris, P., Tamagawa, R., Drysdale, E., & Speca, M.
Affiliations: Alberta Health Services (CA)
ORCID: Carlson, Linda E.
Faris, Peter
Speca, Michael
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2013-09-01
Volume: 31
Issue: 25
Pages: 3119-3126
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2012.47.5210
OpenAlex: W1992514016
Cited by: 282
References: 45
Citations by year: 2026: 18 · 2025: 12 · 2024: 11 · 2023: 8 · 2022: 26 · 2021: 25 · 2020: 21 · 2019: 30 · 2018: 25 · 2017: 36 · 2016: 27 · 2015: 21 · 2014: 21 · 2013: 1
FWCI: 12.49
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Funders: Alberta Cancer Foundation
Canadian Breast Cancer Research Alliance
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
Keywords: breast cancer survivors, supportive-expressive group therapy, distress, stress symptoms, quality of life, social support, mindfulness meditation, group intervention
MeSH terms: Adaptation, Psychological, Adult, Aged, Breast Neoplasms, Female, Humans, Hydrocortisone, Middle Aged, Psychotherapy, Group, Stress, Psychological, Yoga, Survivors, Meditation, Mind-Body Therapies

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Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET)

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