title: Mindfulness-based cancer recovery and supportive-expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors.
abstract: BACKGROUND
  Group psychosocial interventions including mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET) can help breast cancer survivors decrease distress and influence cortisol levels. Although telomere length (TL) has been associated with breast cancer prognosis, the impact of these two interventions on TL has not been studied to date.
  
  
  METHODS
  The objective of the current study was to compare the effects of MBCR and SET with a minimal intervention control condition (a 1-day stress management seminar) on TL in distressed breast cancer survivors in a randomized controlled trial. MBCR focused on training in mindfulness meditation and gentle Hatha yoga whereas SET focused on emotional expression and group support. The primary outcome measure was relative TL, the telomere/single-copy gene ratio, assessed before and after each intervention. Secondary outcomes were self-reported mood and stress symptoms.
  
  
  RESULTS
  Eighty-eight distressed breast cancer survivors with a diagnosis of stage I to III cancer (using the American Joint Committee on Cancer (AJCC) TNM staging system) who had completed treatment at least 3 months prior participated. Using analyses of covariance on a per-protocol sample, there were no differences noted between the MBCR and SET groups with regard to the telomere/single-copy gene ratio, but a trend effect was observed between the combined intervention group and controls (F [1,84], 3.82; P = .054; η(2)  = .043); TL in the intervention group was maintained whereas it was found to decrease for control participants. There were no associations noted between changes in TL and changes in mood or stress scores over time.
  
  
  CONCLUSIONS
  Psychosocial interventions providing stress reduction and emotional support resulted in trends toward TL maintenance in distressed breast cancer survivors, compared with decreases in usual care.
authors.affiliation: Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada; Southern Alberta Cancer Research Institute, Health Research Innovation Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Linda E
authors.initials: LE
authors.lastname: Carlson
authors.forename: Tara L
authors.initials: TL
authors.lastname: Beattie
authors.forename: Janine
authors.initials: J
authors.lastname: Giese-Davis
authors.forename: Peter
authors.initials: P
authors.lastname: Faris
authors.forename: Rie
authors.initials: R
authors.lastname: Tamagawa
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Fick
authors.forename: Erin S
authors.initials: ES
authors.lastname: Degelman
authors.forename: Michael
authors.initials: M
authors.lastname: Speca
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008137:Longitudinal Studies; D019122:Meditation; D008875:Middle Aged; D064866:Mindfulness; D011613:Psychotherapy / Q000379:methods*; D017741:Survivors / Q000523:psychology; D016615:Telomere / Q000378:metabolism*; D015013:Yoga
chemical_list: D006854:Hydrocortisone
keywords: clinical trial; mindfulness-based stress reduction; psychosocial interventions; supportive-expressive therapy; telomere length