Effect of mindfulness-based stress reduction on somatic symptoms, distress, mindfulness and spiritual wellbeing in women with breast cancer: results of a randomized controlled trial
Open accessAbstract
BACKGROUND: Women with breast cancer experience different symptoms related to surgical or adjuvant therapy. Previous findings and theoretical models of mind-body interactions suggest that psychological wellbeing, i.e. levels of distress, influence the subjective evaluation of symptoms, which influences or determines functioning. The eight-week mindfulness-based stress reduction (MBSR) program significantly reduced anxiety and depression in breast cancer patients in a randomized controlled trial (NCT00990977). In this study we tested the effect of MBSR on the burden of breast cancer related somatic symptoms, distress, mindfulness and spiritual wellbeing and evaluated possible effect modification by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing. MATERIAL AND METHODS: A population-based sample of 336 women Danish women operated for breast cancer stages I-III were randomized to MBSR or usual care and were followed up for somatic symptoms, distress, mindfulness skills and spiritual wellbeing post-intervention and after six and 12 months. Effect was tested by general linear regression models post-intervention, and after six and 12 months follow-up and by mixed effects models for repeated measures of continuous outcomes. Effect size (Cohen's d) was calculated to explore clinical significance of effects among intervention group. Finally, modification of effect of MBSR on burden of somatic symptoms after 12 months' follow-up by adjuvant therapy and baseline levels of, distress, mindfulness and spiritual wellbeing were estimated. RESULTS: General linear regression showed a significant effect of MBSR on the burden of somatic symptoms post-intervention and after 6 months' follow-up. After 12 months' follow-up, no significant effect of MBSR on the burden of somatic symptoms was found in mixed effect models. A statistically significant effect of MBSR on distress was found at all time-points and in the mixed effect models. Significant effects on mindfulness were seen after six and 12 months and no significant effect was observed for spiritual wellbeing. No significant modification of MBSR effect on somatic symptom burden was identified. CONCLUSION: This first report from a randomized clinical trial on the long-term effect of MBSR finds an effect on somatic symptom burden related to breast cancer after six but not 12 months follow-up providing support for MBSR in this patient group.
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Among individuals with cancer, mindfulness-based interventions have been shown to improve depression, anxiety, fatigue, sleep, and overall physical functioning in randomized trials.
“Among individuals with cancer, mindfulness-based interventions have been shown to improve depression, anxiety, fatigue, sleep, and overall physical functioning in randomized trials [15, 23, 24]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [24]
The trial’s introductory passage reports lower anxiety and depression in its randomized breast-cancer sample, and its Results report reduced somatic symptom burden through six months. The cited paper does not report improvements in fatigue, sleep, or overall physical functioning as outcomes of this trial; its Discussion mentions improved physical wellbeing in a separate trial, which is not the same outcome. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAn accepting, flexible approach to one's experience reduces distress and improves functioning and well-being.
“This accepting, flexible approach to one's experience has been found to reduce distress and improve functioning and well-being [21-24]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [24]
The Results (page unavailable) report that mindfulness-based stress reduction reduced distress in women with breast cancer and improved spiritual well-being at six months, though the well-being difference was not significant at 12 months. The study tested the MBSR program, not the accepting approach separately, and did not establish improved functioning. (LLM, conf=0.86)
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“Later, Würtzen et al. (2015) [11] conducted another RCT in Denmark with a similar study design: the same intervention strategy, but with different outcomes assessed (namely somatic symptoms, distress, core mindfulness skills, and spiritual well-being), requiring the use of different scales (BCPT,…”
Mulyati, L., & Upoyo, A. S. (2026) · Journal of Holistic Nursing · doi:10.1177/08980101261457682
- Authors
- Würtzen, H., Dalton, S. O., Christensen, J., Andersen, K. K., Elsass, P., Flyger, H. L., Pedersen, A. E., Sumbundu, A., Steding-Jensen, M., & Johansen, C.
- Affiliations
- Copenhagen University Hospital (DK)
- Danish Cancer Society (DK)
- University of Copenhagen (DK)
- Herlev Hospital (DK)
- Ringsted Sygehus (DK)
- Corresponding author
- Würtzen, Hanne
- ORCID
- Venue
- Acta Oncologica
- Published
- 2015-03-09
- Volume
- 54
- Issue
- 5
- Pages
- 712-719
- ISSN
- 0284-186X (ISSN-L)
- 1651-226X
- OpenAlex
- W2163949450
- Cited by
- 61
- References
- 30
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 9 · 2018: 9 · 2017: 8 · 2016: 4 · 2015: 2
- FWCI
- 9.51
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Acta Oncologica (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Dansk Kræftforsknings Fond
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- mindfulness-based stress reduction, breast cancer, somatic symptoms, psychological distress, mindfulness, spiritual well-being, adjuvant therapy, mind-body problem, long-term effects, women with cancer
- MeSH terms
- Breast Neoplasms, Denmark, Female, Follow-Up Studies, Humans, Middle Aged, Surveys and Questionnaires, Stress, Psychological, Time Factors, Linear Models, Chemotherapy, Adjuvant, Radiotherapy, Adjuvant, Spirituality, Mindfulness
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