Comparison of Mindfulness and Exercise During and After Cancer Treatment

INTERVENTION: A comparison of what effect either mindfulness and/or exercise has on a range of physical and psychological symptoms in people who have had or are having treatment for cancer. Feasibility study whether this population group (both on and off treatment) are able to attend and benefit from 6 weeks of either mindfulness or exercise classes.The mindfulness group will involve group discussion, mindfulness practice and a workbook providing information including key themes in mindfulness. The exercise group will involve a circuit of exercises with variation of exercises depending on suitability for each individual. Exercise classes include: Warm Up stretches for 10 minutes Timed exercise stations (40 secs) with a rest period between (15 secs) Three circuits through stations with 30 second rest to hydrate after each completion Cool Down/Stretching exercises for 10 minutes Exercises: Step Ups (on to low step) Sit to Stand from chair (no hands on chair or knees) Wall Pushoffs (hands at shoulder height) Lunges (alternating sides) Upper Body Strengthening using Theraband Sitting on Exercise Ball ‐ balance/core (alternating leg lift) Stair climbs The mindfulness group will be run by two Clinical Psychologists each with 14 years experience. The exercise group will be run by one physiotherapist with thirty years experience including in cancer rehabilitation. Arm One: Six weeks of 1 hour of group mindfulness classes with take home practice. Adherence will be measured by class attendance and a homework diary documenting daily formal and informal mindfulness practice (measured by time). Mindfulness groups will have two different time lengths of formal mindfulness home work (either >10 minutes per day or <15 minutes per day). Half of the participants will be given the >10 minute audiofiles and the other half will be given <15 minute audiofiles. Class length will be the same . Arm Two: Six weeks of I hour of group exercise classes with take home exercises. Adherence will be measured by class attendance and a homework diary documenting daily exercise (including 20 min walk, sit to stand, wall push ups and lunges) Recommended each activity to be done 3 times a week.. A treatment as usual group will be used as a control. Measures will be taken at Baseline (prior to starting the intervention), 3 weeks (midway in the mindfulness or exercise program), 6 weeks (on completion of the mindfulness or exercise program) and at 6 months (after completing the mindfulness or exercise program). Measures will look at amount of exercise and mindfulness practice (homework sheets), intensity and impact of physical and psychological symptoms commonly experienced in patients during or after cancer treatment (MDASI), and mindfulness skills (FFMQ‐SF). 6 month follow up will also look at current practice of mindfulness or amount/type of exercise. CONDITION: Cancer PRIMARY OUTCOME: Change from baseline physical and psychological symptom impact as assessed by the MD Anderson Symptom Inventory. Change from baseline physical and psychological symptom severity as assessed by the MD Anderson Symptom Inventory. ; ; Mindfulness skills as assessed by the Five Facet Mindfulness Questionnaire‐ Short Form (FFMQ‐SF). ; Measure: Five Facet Mindfulness Questionnaire‐ Short Form INCLUSION CRITERIA: People attending St Georges Cancer Care Centre for treatment or follow up appointments SECONDARY OUTCOME: Level of fitness as assessed by 6 minute walk test. Level of fitness as assessed by the 30 second chair stand test. Level of fitness as assessed by the resting heart rate. Level of fitness as assessed by the SOZO. The SOZO is a bio‐impedance spectroscope which measures full body composition, including muscle mass and intra/extra cellular fluids. Mindfulness and exercise class acceptability as assessed by class attendance rolls. ; Patients adherence to homework will be monitored. Recommended frequency of mindfulness practice (daily formal <10 or >15mins) and exercise (3 times per week) will be suggested. A homework sheet (self report) will obtain self reported practice frequency.