Evidence base of mind body intervention in palliative care.

BACKGROUND: The diagnosis of cancer is taken as life threatening issue and creates violent emotional strain. It results in anxiety , depresson , fatigue, fear of recurrence and insomnia. Hence it is logical that for a fruitful cancer care , physical , mental and spiritual aspects are treated as a whole . That is why interest towards integrative palliative care is shown by growing number of cancer patients . However, the effects of MBSR on telomere length (TL) and telomerase activity (TA), known markers of cellular aging are not known. We assess correct evidence base about the benefits and risks of Mindfulness based stress reduction [MBSR]. METHODS: 50 women with breast cancer [BC] were recruited from a cancer center in Pakistan. They were randomized after 6 weeks of radiotherapy, to an MBSR group [N = 25] and a control group. The MBSR group took MBSR practice for 8 weeks as twice weekly practice while control group was left as such. Quality of life [QoL] was assesed at baseline in both groups for mental symptoms at end of treatment, after 1 month and after 3 months. RESULTS: Compared to controls, the MBSR group reported large post-intervention reducations as assessed by effect size (d). In analyses adjusted for baseline TA and psychological status, TA increased steadily over 12 weeks in the MBSR(BC) group (approximately 17%) compared to essentially no increase in the control group (approximately 3%, p < .01). In contrast, no between-group difference was observed for TL (p = .92). These results provide preliminary evidence that MBSR(BC) increases TA in peripheral blood mononuclear cells from BC patients and have implications for understanding how MBSR(BC) may extend cell longevity at the cellular level. CONCLUSIONS: The results show moderate to high evidence of MBSR effect in palliative care and further studies are warrented.