Grant title: Stress Reduction and Healthy Living in Younger Breast Cancer Survivors: Intervention Development & Evaluation
Funding: Susan G Komen Breast Cancer Foundation
Breast cancer is the most common cancer in women and is the leading cause of death in women under 55 years of age. Approximately 25% of breast cancer cases occur premenopausally. The management of younger women presents many challenges, as the diagnosis often comes at a time when women are in the midst of child-rearing and career development and feel “too young” to be confronting a life-threatening illness. In empirical studies, younger women demonstrate increased psychological distress and depression, increased fatigue, and decreased physical functioning after cancer diagnosis relative to older women. These changes cause significant impairment in quality of life and may also negatively impact health behaviors (e.g., physical activity) and biological systems (e.g., inflammation) linked to breast cancer recurrence and mortality. Given that younger women diagnosed and treated for early-stage breast cancer will likely live for many years, interventions that target stress are vital for reducing suffering and enhancing well-being in this vulnerable group. There is compelling evidence that stress management interventions such as mindfulness-based stress reduction (MBSR) are effective in improving mental and physical health outcomes in clinical populations. However, few randomized trials of MBSR have been conducted with breast cancer patients, none have focused specifically on younger survivors, and none have examined health behaviors or biomarkers relevant to cancer progression. The primary objective of the proposed study is to evaluate the feasibility and preliminary efficacy of a mindfulness-based intervention for this at-risk group of women. We hypothesize that a structured program of mindfulness-based stress reduction will lead to significant improvements in psychological well-being (i.e., depression, fatigue), with corresponding improvements in health behaviors and biomarkers of cancer risk,in women diagnosed with premenopausal breast cancer. We will also examine mechanisms for intervention effects, including increased mindfulness and ability to relax.