Meditation

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Meditation

Common Names

  • Mindfulness
  • MBSR
  • Lovingkindness
  • Metta
  • Focused attention

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


What Is It

Meditation has been practiced for ages in many traditions around the world. It is often described as a state in which the practitioner is relaxed but focused and alert.

Most meditation practices include key features like attention to breathing, letting go of judgements, and developing awareness. Common goals include inner calmness, relaxation, psychological balance, and improved vitality and coping. The most researched form of meditation is mindfulness-based stress reduction (MBSR), typically offered as an 8-week program.

Both the American Society of Clinical Oncology (ASCO) and the Society of Integrative Oncology (SIO) recommend meditation as part of a multidisciplinary approach to reduce stress, depression, and mood disturbance, and to improve the quality of life in cancer patients. The American Heart Association also recommends meditation as a lifestyle tool to help reduce heart disease risk.

How It Works

The most researched form of meditation is mindfulness-based stress reduction (MBSR). It is typically offered as an 8-week program and uses sitting meditation, a sensing practice called body scan to reestablish the connection of mind to body and breath, and walking meditation to apply these practices in moving form.

MBSR can help reduce distress, fatigue, and pain. It improves mental functioning, mood, and well-being, including in cancer patients undergoing treatment.

Meditation may also help reduce blood pressure and heart disease risks, and can also benefit children, helping to improve self-confidence and coping skills.

Repeated practice and patience are important mechanisms to allow for optimal benefits.

Purported uses and benefits
  • Anxiety
    Several studies show that meditation reduces anxiety associated with many diseases including cancer.
  • Cognitive impairment
    MBSR practice resulted in improvements in cognitive impairment resulting from cancer and its treatments.
  • Depression
    Many clinical trials indicate that MBSR can help reduce depression.
  • Fatigue
    Studies in breast cancer survivors show that MBSR practice decreases fatigue severity.
  • Insomnia
    MBSR may help relieve insomnia and improve sleep quality.
  • Lifestyle modification
    Meditation practice may help support making lifestyle changes or modifying behaviors.
  • Mood disturbance
    MBSR practice helps improve mood disturbance in patients including those with cancer.
  • Pain
    A few studies indicate that MBSR is useful in relieving chronic pain. Larger trials are needed.
Special Point

It is important to note that regular meditation practice is essential for continued benefits.

Is It Safe

Meditation is generally considered safe, and few cases of adverse effects have been reported. Various medical panels have endorsed meditation as a useful lifestyle tool, including the American Society of Clinical Oncology (ASCO), the Society of Integrative Oncology, and the American Heart Association.

Who Can Provide this Service

Practitioners who teach MBSR go through a certification process. They may also have specific training and experience with certain patient populations, such as cardiac or cancer patients.

Where Can I Get Treatment

Meditation classes are offered in communities, at hospitals, and at universities. Cancer centers across the country also offer programs that are led by experienced teachers.

MSK offers free meditations online and with our Integrative Medicine at Home program. Both offer an opportunity to try guided meditations geared towards concerns relevant to cancer patients.

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For Healthcare Professionals

Clinical Summary

Meditation has been practiced for millennia in many traditions around the world. It is defined as “a wakeful hypo-metabolic physiologic state” (1) in which the practitioner is relaxed but focused and alert.

In addition to developing attention, most formats include regulated breathing and developing nonjudgmental awareness. Common goals include inner calmness, physical relaxation, psychological balance, and improved vitality and coping. The most researched form of meditation is mindfulness-based stress reduction (MBSR), typically offered as an 8-week program.

Meditation can help reduce

  • Anxiety, stress
  • Pain
  • Fatigue

It can also help improve

  • Coping skills
  • Well-being
  • Awareness
  • Cognition

Oncology guidelines recommend meditation
Both the American Society of Clinical Oncology (ASCO) (63) and Society of Integrative Oncology (SIO) (24) (50) recommend meditation for anxiety, stress reduction, depression, mood disturbance, and improved quality of life in cancer patients. In addition, the American Heart Association added meditation to intervention guidelines to possibly reduce risk of heart disease (51).

Improved psychological symptoms and functioning
Many studies (6) (10) (13) (15) (16) (17) (18) (20) (21) (22) (47) (48) (59) (65) (66) (70) (71) (72) (74) (76) (77) (83) show that mindfulness and other forms of meditation can boost positive emotions and significantly reduce stress, anxiety, depression, pain, and fatigue. In one of the largest long-term studies of distressed breast cancer survivors, Mindfulness-Based Cancer Recovery was superior to supportive expressive group therapy, with benefits lasting over one year (46). There is also modest evidence for its use among people of color (84).

Meditation and mindfulness interventions may reduce blood pressure (85), optimize immune function, and reduce levels of various stress biomarkers including cortisol and IL6 (49) (67) (68). Other data suggest meditation can improve coping (23), cognition (18) (19) (78) (86), and psychological functioning (13) (14).

Virtual mindfulness-based interventions have also shown benefit (81) (82) (87). MSK offers free meditations online and with our Integrative Medicine at Home program. Both offer an opportunity to try guided meditations geared towards concerns relevant to cancer patients.

Mixed or lacking evidence for other conditions
Mindfulness-based interventions may help support behavior change (11) (45) (61) (62) and improve sleep quality (15) (54), but meta-analyses found inconclusive evidence for benefit in substance use disorders or for sleep parameters in cancer survivors (79) (80). Another study did not find benefit with MBSR for chronic neuropathic pain (88).

Purported uses and benefits
  • Anxiety
  • Cognitive impairment
  • Depression
  • Fatigue
  • Insomnia
  • Lifestyle changes
  • Pain
Mechanism of Action

Meditation may affect changes in structural and functional aspects of the brain involved in regulating attention, emotion, and self-awareness (25) (28). MRI studies suggest various techniques correlate with behavioral improvements in attention, compassion, and cognitive perspective-taking: mindfulness or presence training increased cortical thickness in prefrontal regions; loving kindness or metta (affect) meditation induced plasticity in frontoinsular regions; and observing-thoughts or perspective meditation induced changes in inferior frontal and lateral temporal cortices (44).

Stress reduction effects have been attributed to acceptance training (64). Mindful breathing enhanced “decentering” from internal experiences, and reduced reactivity to repetitive thoughts (34). Improved self-control, emotion regulation, and stress reduction in smokers who practiced meditation were attributed to increased activity in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC), and other brain areas, as ACC/mPFC activity is diminished in smokers (29).

Mindfulness meditation significantly reduced neural activation in brain regions crucial for controlling nociceptive information (30). It is also associated with changes in learning and memory processes, perspective taking, and self-referential processing (31). In patients with generalized anxiety disorder, improvements were attributed to fronto-limbic regulation (32). MBSR also produced entrainment of chaotic activities in the brain and heart (33).

Immune system benefits may include reduced ratios of T1 pro-inflammatory to T2 anti-inflammatory lymphocytes (35). Increases in telomerase activity, a known marker of cellular aging and psychological risk, and reduced NFκB activity, a precursor to increased proinflammatory cytokines and circulating levels of C-reactive protein have been observed (36) (37) .

Adverse Reactions

Meditation is generally considered safe and effective, and few side effects have been reported. However, individuals who have experienced past traumas or abuse may respond negatively to some forms of meditation. Appropriate confidential screening may be needed to determine suitability of particular meditation practices in certain populations (52). In one survey, unwanted effects were transitory, and occurred more with focused attention meditation, when practicing longer than 20 minutes, and while being alone (53).

Case Reports
Psychosis: Following meditation (38) (39) and qigong practice (40) but some of these events occurred in concert with other issues including sleep loss, drug withdrawal, or pre-existing psychotic disorders.
Acute psychosis: In patients with schizophrenia after intensive meditation (41).
Qigong deviation syndrome: In patients following inappropriate qigong training, psychophysiological effects such as changes in heart rate, illusions, and pseudohallucinations (42).
Epilepsy: In a young woman after meditation (43).

Practitioners and Treatments

Practitioners who teach mindfulness-based stress reduction go through a certification process. They may also have specific training and experience with certain patient populations, such as cardiac or cancer patients.

Meditation classes are offered in communities, at hospitals, and at universities. Cancer centers across the country also offer programs that are led by experienced teachers. 

MSK offers free meditations online and with our Integrative Medicine at Home program. Both offer an opportunity to try guided meditations geared towards concerns relevant to cancer patients.

Dosage (OneMSK Only)
References
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