Mindfulness Can Alter Brain’s Perception of Pain in Cancer Survivors




Mindfulness can significantly improve brain health and pain perception in breast cancer survivors, according to a small Canadian study.

The findings suggest that an eight-week mindfulness intervention can reduce activity in parts of the brain related to pain and to emotional reactivity (having a heightened emotional response to something unpleasant).

The study, “Reduced Emotional Reactivity in Breast Cancer Survivors with Chronic Neuropathic Pain Following Mindfulness-Based Stress Reduction (MBSR): an fMRI Pilot Investigation,” was published in Mindfulness.

After treatment, as many as half of breast cancer survivors will experience neuropathic pain, which is caused by damage to parts of the nervous system. This kind of pain can be difficult to treat with medications, and some medications, like opioids, carry substantial risks (i.e., addiction).

Mindfulness refers to paying attention to moment-to-moment experiences (and not worrying about things outside of the moment). In the context of pain management, the goal of mindfulness is to train the mind to accept pain, rather than to fight or control it.

“We have heard a lot about mindfulness over the past few years, about how it helps people relax and feel better,” Andra Smith, PhD, study co-author and a professor at the University of Ottawa, said in a press release. “If mindfulness, a non-pharmacological tool, can be used to help with neuropathic pain, women will feel better and might not experience such disruptive pain.”

To test this idea, Smith and colleagues designed a study (NCT02758197) that recruited 21 breast cancer survivors, who were split into two groups: 10 were allocated to a waitlist control group, while the remaining 11 underwent an eight-week mindfulness-based stress reduction (MBSR) intervention.

Before and after the intervention, participants in both groups rated their pain severity and the amount that pain interfered with their daily life on the Brief Pain Inventory. Following the intervention, pain severity did not change significantly in either group. In the control group, pain interference did not significantly change either. However, pain interference decreased significantly in the MBSR group after the intervention, from an average score of 4.08 to 2.98.

The MBSR group also showed increased mindfulness following the intervention, as measured by the Five Facet Mindfulness Questionnaire; average scores increased from 119.09 to 136. Scores on this questionnaire did not significantly change in the control group.

Emotional reactivity, as assessed with the Emotional Stroop Task, also was reduced in the MBSR group following the intervention, whereas no significant change was observed in the control group.

After undergoing the MBSR intervention, participants had significantly reduced activity in parts of the brain that help to regulate pain and emotion, as measured by functional MRI. In the control group, no notable changes in brain activity were found.

“Our results show a significant improvement in brain health as well as in pain perception,” Smith said. “There are many anecdotal reports of how this or that made a person ‘feel better’ but the really exciting results here are that we can see that there are actual changes in the brain and the way a person can alter their response to pain.”

Overall, the study’s findings “suggest a positive widespread neurophysiological impact of MBSR that can be interpreted as altering perception, attention, emotional response to, and anticipation for pain,” the researchers wrote.

They cautioned, however, that the limitations to the study should be taken into account when interpreting the findings. For instance, they stressed that the study population was quite small and predominantly white, and included participants across a range of ages.

“The small sample size, although a limitation, is also interesting given that there were significant differences between and within groups … This suggests that the effect [of MBSR] is considerable to be detectable with such a small sample size,” the researchers wrote.

Additional research is needed to verify the results, they noted. Still, the researchers stressed the importance of providing patients with non-pharmacological options, such as mindfulness, for pain relief to help reduce the use of “potentially addictive and destructive” opioids.

“This research shows that there are adjunctive treatment options,” Smith said. “If used properly, the information we have published can improve health outcomes for the people involved and could potentially also reduce health costs, as well as some of the related problems — particularly those related to mental health.”

“Pain is a subjective experience and mindfulness is often dismissed as a ‘buzz word,’ ” Smith added. “But our research provides objective, empirical evidence of a significant impact of mindfulness on the brain” of breast cancer survivors.

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