Exercise and Mindfulness-Based-Stress-Reduction: A Multidimensional Approach Towards Cancer Survivorship Care


 Cancer, Survivorship, Exercise, Mindfulness-Based-Stress-Reduction, Quality of Life, Health.

How to Cite

Timothy F. Marshall. (2016). Exercise and Mindfulness-Based-Stress-Reduction: A Multidimensional Approach Towards Cancer Survivorship Care. Journal of Basic & Applied Sciences, 12, 62–67. https://doi.org/10.6000/1927-5129.2016.12.10


Cancer survivors often experience a variety of physiological deficits resulting from cancer treatment such as reduced muscle strength, decreased range of motion and poor balance. Cancer survivors also commonly experience psychosocial side effects, such as anxiety, depression and fear of recurrence. Overall, it is common for cancer survivors to report a decrease in physical and emotional wellbeing and overall quality of life. Research suggests that improvements in physical health can be achieved through moderate intensity exercise such as light resistance training and moderate aerobic exercise in this population. Mindfulness-Based-Stress-Reduction (MBSR) programming utilizes various mind/body techniques that can reduce state anxiety levels, distress and depression. While cancer survivors face numerous physiological and psychological challenges, exercise interventions focus on physical health, while MBSR interventions focus on psychosocial health. The American Medical Association (AMA) recommends a patient’s care should include psychological, physiological, psychosocial and educational components, emphasizing the need for an integrated approach to cancer survivorship. Integrating exercise and MBSR interventions may serve to optimize the overall health and quality of life of a cancer survivor.



Scott D, Mills M, Black A, Cantwell M, Campbell A, Donnelly M, et al. Multidimensional rehabilitation programmes for adult cancer survivors. The Cochrane Database of Systematic Reviews 2013; 3CD007730.

Courneya K. Exercise interventions during cancer treatment: biopsychosocial outcomes. Exer & Sport Sci Reviews 2001; 29(2): 60-64. http://dx.doi.org/10.1097/00003677-200104000-00004

Courneya K, Friedenreich C. Physical exercise and quality of life following cancer diagnosis: A literature review. Annals of Behav Med1999; 21(2): 171-179. http://dx.doi.org/10.1007/BF02908298

Schneider CM, Dennehy CA, Carter SD. Exercise and cancer recovery. Champaign IL: Human Kinetics; 2003.

Schwartz A, Mori M, Gao R, Nail L, King M. Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med& Sci In Sports & Exer 2001; 33(5): 718-723. http://dx.doi.org/10.1097/00005768-200105000-00006

Campbell T, Labelle L, Bacon S, Faris P, Carlson L. Impact of Mindfulness-Based Stress Reduction (MBSR) on attention, rumination and resting blood pressure in women with cancer: A waitlist-controlled study. J of Behav Med 2012; 35(3): 262-271. http://dx.doi.org/10.1007/s10865-011-9357-1

Lengacher C, Shelton M, Reich R, Barta M, Johnson-Mallard V, Kip K, et al. Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT). J of Behav Med 2014; 37(2): 185-195. http://dx.doi.org/10.1007/s10865-012-9473-6

Speca M, Carlson L, Goodey E, Angen M. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Med 2000; 62(5): 613-622. http://dx.doi.org/10.1097/00006842-200009000-00004

Tacón A. Mindfulness Effects on Symptoms of Distress in Women with Cancer. J of Cancer Pain & Symptom Palliation 2006; 2(2): 17-22. http://dx.doi.org/10.1300/J427v02n02_03

Würtzen H, Dalton S, Elsass P, Sumbundu A, Steding-Jensen M, Johansen C, et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: Results of a randomised controlled trial among 336 Danish women treated for stage I–III breast cancer. Euro J of Cancer 2013; 491365-1373. http://dx.doi.org/10.1016/j.ejca.2012.10.030

Blanchard C, Denniston M, Baker F, Ainsworth S, Courneya K, Kennedy J, et al. Do adults change their lifestyle behaviors after a cancer diagnosis? Am J of Health Behav 2003; 27(3): 246-256. http://dx.doi.org/10.5993/AJHB.27.3.6

Blanchard C, Courneya K, Stein K. Cancer survivors' adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society's SCS-II. J of Clin Onc 2008; 26(13): 2198-2204. http://dx.doi.org/10.1200/JCO.2007.14.6217

Labelle L, Campbell T, Faris P, Carlson L. Mediators of Mindfulness-Based Stress Reduction (MBSR): assessing the timing and sequence of change in cancer patients. J of Clin Psy 2015; (1): 21.

Davis C. Psychosocial needs of women with breast cancer: how can social workers make a difference? Health & Social Work 2004; 29(4): 330-334. http://dx.doi.org/10.1093/hsw/29.4.330

Mello S, Tan A, Armstrong K, Sanford Schwartz J, Hornik R. Anxiety and Depression Among Cancer Survivors: The Role of Engagement With Sources of Emotional Support Information. Health Comm 2013; 28(4): 389-396. http://dx.doi.org/10.1080/10410236.2012.690329

Glajchen M, Blum D, Calder K. Cancer pain management and the role of social work: barriers and interventions. Health & Social Work 1995; 20(3): 200-206.

Fialka-Moser V, Crevenna R, Korpan M, Quittan M. Cancer Rehabilitation. Journal of Rehabilitation Medicine 2003; 35(4): 153-162. http://dx.doi.org/10.1080/16501970306129

Pirl W, Roth A. Diagnosis and treatment of depression in cancer patients. Oncology (Williston Park, N.Y.) 1999; 13(9): 1293-1301.

Savard J, Morin C. Insomnia in the context of cancer: a review of a neglected problem. J of Clin Onco 2001; 19(3): 895-908.

Aguado Loi C, Baldwin J, McDermott R, McMillan S, Martinez Tyson D, VandeWeerd C, et al. Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship. Psycho-Oncology 2013; 22(12): 2779-2788. http://dx.doi.org/10.1002/pon.3357

Mustian K, Sprod L, Palesh O, Peppone L, Janelsins M, Carroll J, et al. Exercise for the Management of Side Effects and Quality of Life Among Cancer Survivors. Current Sports Med Reports (American College Of Sports Medicine) 2009; 8(6): 325-330. http://dx.doi.org/10.1249/JSR.0b013e3181c22324

Lengacher C, Johnson-Mallard V, Barta M, Fitzgerald S, Moscoso M, Kip K, et al. Feasibility of a mindfulness-based stress reduction program for early-stage breast cancer survivors. J of Holistic Nursing 2011; 29(2): 107-117. http://dx.doi.org/10.1177/0898010110385938

Addy C, Wilson D, Kirtland K, Ainsworth B, Sharpe P, Kimsey D. Associations of perceived social and physical environmental supports with physical activity and walking behavior. Am J of Pub Health 2004; 94(3): 440-443. http://dx.doi.org/10.2105/AJPH.94.3.440

Gunnarsson O, Judge J. Exercise at midlife: how and why to prescribe it for sedentary patients. Geriatrics 1997; (5): 71.

Oweis P, Spinks W. Biopsychological, affective and cognitive responses to acute physical activity. J Sports Med Phys Fitness 2001; 41(4): 528.

Pate R, Pratt M, Blair S, Haskell W, Macera C, Wilmore J, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA, The J of The Am Med Assoc 1995; (5): 402. http://dx.doi.org/10.1001/jama.1995.03520290054029

Kabat-Zinn J. Some reflections on the origins of MBSR, skillful means, and the trouble with maps. Contemporary Buddhism 2011; 12(1): 281-306. http://dx.doi.org/10.1080/14639947.2011.564844

Witek-Janusek L, Albuquerque K, Chroniak K, Chroniak C, Durazo-Arvizu R, Mathews H. Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav an Imm 2008; 22969-981.

Baer R. Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice 2003; 10(2): 125-143. http://dx.doi.org/10.1093/clipsy.bpg015

Bonadonna R. Meditation's impact on chronic illness. Holistic Nursing Practice 2003; 17(6): 309-319. http://dx.doi.org/10.1097/00004650-200311000-00006

Brown D. A model for the levels of concentrative meditation. Meditation: classic and contemporary perspectives [monograph on the Internet

Matchim Y, Armer J, Stewart B. Mindfulness-Based Stress Reduction Among Breast Cancer Survivors: A Literature Review and Discussion. Oncology Nursing Forum 2011; 38(2): E61-71. http://dx.doi.org/10.1188/11.ONF.E61-E71

Ott MJ. Mindfulness meditation: a path of transformation & healing. J Psychosoc Nurs Ment Health Serv 2004; 42(7): 22.

Valentine E, Sweet P. Meditation and attention: a comparison of the effects of concentrative and mindfulness meditation on sustained attention. Mental Health, Religion & Culture 1999; 2(1): 59. http://dx.doi.org/10.1080/13674679908406332

Azulay J, Smart C, Mott T, Cicerone K. A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. The J of Head Trauma Rehab 2013; (4): 323.

Jedel S, Merriman P, Hoffman A, Swanson B, Fogg L, Keshavarzian A. Relationship of mindfulness, quality of life, and psychiatric symptoms among patients with ulcerative colitis. Mindfulness 2013; 4(4): 296-300. http://dx.doi.org/10.1007/s12671-012-0128-z

Kearney D, McDermott K, Malte C, Martinez M, Simpson T. Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. J of Clin Psy 2012; (1): 101.

Lauche R, Cramer H, Dobos G, Langhorst J, Schmidt S. Review: A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. J of Psychosomatic Research 2013; 75500-510. http://dx.doi.org/10.1016/j.jpsychores.2013.10.010

Pbert L, Madison J, Druker S, Olendzki N, Magner R, Carmody J, et al. Effect of mindfulness training on asthma quality of life and lung function: a randomised controlled trial. Thorax 2012; 67(9): 769-776. http://dx.doi.org/10.1136/thoraxjnl-2011-200253

Gotink R, Chu P, Busschbach J, Benson H, Fricchione G, Hunink M. Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs. Plos ONE 2015; 10(4): 1-17. http://dx.doi.org/10.1371/journal.pone.0124344

Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Richardson A, et al. Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J of Clin Onc 2009; 27(36): 6172-6179. http://dx.doi.org/10.1200/JCO.2009.22.5151

Baker F, Denniston M, Smith T, West M. Adult cancer survivors: how are they faring? Cancer 2005; 104(11 Suppl): 2565-2576. http://dx.doi.org/10.1002/cncr.21488

Deimling G, Bowman K, Sterns S, Wagner L, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psycho-Oncology 2006; 15(4): 306-320. http://dx.doi.org/10.1002/pon.955

Hodges L, Humphris G. Fear of recurrence and psychological distress in head and neck cancer patients and their careers. Psycho-Oncology 2009; 18(8): 841-848. http://dx.doi.org/10.1002/pon.1346

Humphris G, Rogers S, McNally D, Lee-Jones C, Brown J, Vaughan D. Fear of recurrence and possible cases of anxiety and depression in orofacial cancer patients. Intl J of Oral & Maxillofacial Surgery 2003; 32486-491. http://dx.doi.org/10.1054/ijom.2002.0399

Llewellyn C, Weinman J, McGurk M, Humphris G. Can we predict which head and neck cancer survivors develop fears of recurrence? J of Psychosomatic Research 2008; 65(6): 525-532. http://dx.doi.org/10.1016/j.jpsychores.2008.03.014

Matthews B. Role and gender differences in cancer-related distress: a comparison of survivor and caregiver self-reports. Oncology Nursing Forum 2003; 30(3): 493-499. http://dx.doi.org/10.1188/03.ONF.493-499

Mehta S, Lubeck D, Pasta D, Litwin M. Clinical Urology: Original Articles: Fear Of Cancer Recurrence In Patients Undergoing Definitive Treatment For Prostate Cancer: Results From CaPSURE. The J of Urology 2003; 1701931-1933.

Simard S, Savard J, Ivers H. Fear of cancer recurrence: Specific profiles and nature of intrusive thoughts. J of Cancer Survivorship 2010; 4(4): 361-371. http://dx.doi.org/10.1007/s11764-010-0136-8

Lee-Jones C, Humphris G, Dixon R, Hatcher M. Fear of Cancer Recurrence — A Literature Review and Proposed Cognitive Formulation to Explain Exacerbation of Recurrence Fears. Psycho-Oncology 1997; 6(2): 95-105. http://dx.doi.org/10.1002/(SICI)1099-1611(199706)6:2<95::AID-PON250>3.0.CO;2-B

Fish J, Ettridge K, Sharplin G, Hancock B, Knott V. Mindfulness-based Cancer Stress Management: impact of a mindfulness-based programme on psychological distress and quality of life. Eur J of Cancer Care 2014; 23(3): 413-421. http://dx.doi.org/10.1111/ecc.12136

Carlson L, Speca M, Faris P, Patel K. One year pre–post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav and Imm 2007; 211038-1049.

Sephton S, Spiegel D. Circadian disruption in cancer: a neuroendocrine-immune pathway from stress to disease? Brain Behav and Imm 2003; 17(5): 321-328. http://dx.doi.org/10.1016/S0889-1591(03)00078-3

Sephton S, Sapolsky R, Kraemer H, Spiegel D. Diurnal cortisol rhythm as a predictor of breast cancer survival. Journal of The National Cancer Institute 2000; 92(12): 994-1000. http://dx.doi.org/10.1093/jnci/92.12.994

Joynt K, Whellan D, O'connor C. Review article: Why is depression bad for the failing heart? a review of the mechanistic relationship between depression and heart failure. J of Cardiac Failure 2004; 10258-271.

Anisman H, Merali Z. Cytokines, stress, and depressive illness. Brain Behav and Imm 2002; 16513-524.

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