To our knowledge, the current study is the first report to demonstrate a potential effect of these psychosocial interventions on telomere length (TL) among distressed breast cancer survivors.

http://onlinelibrary.wiley.com/doi/10.1002/cncr.29063/full

(Because of browser and firewall issues, this link may not work. The paper is attached in PDF format.)

My impression of this paper in two words: seriously cool.

It is well established that cancer patients often struggle with psychiatric illnesses. As I’ve noted in a past Reading of the Week, a series of papers was recently published by the Lancet, the Lancet Oncology and the Lancet Psychiatry — three of the biggest journals in medicine — considering depression in the cancer population. Involving some 21,000 patients, the studies find that depression is 3 to 6.5 times more common in cancer patients than in the general population at a point in time.

It’s also well established that psychological interventions can materially help — a literature now decades old.

So a paper that considers the effects of Mindfulness on distressed cancer patients isn’t exactly news.

But what about the effects at the cellular level?

In this paper, just published in Cancer, researchers at the University of Calgary consider the effects of psychological interventions on telomere length.

A telomere, as you will recall, is a strip of nucleotides at the end of each chromatid. Among other things, telomeres help maintain structure — think of a book-end keeping in place your favourite books. But remember that the chromatid houses genetic material. Think then of book-ends keeping in place the books of our genome.

Needless to say, telomeres have been the focus of much research. Various observations have been made, including that, over time, telomeres naturally shorten. Also, after certain conditions, TL may also shorten.

Here’s a picture of a telomere (actually, several of them):

As the study authors note: “Shorter TL also was found to be predictive of earlier mortality in patients with chronic lymphocytic leukemia, promyelocytic leukemia, and breast cancer.”

The study authors randomly enrolled breast cancer survivors in three intervention groups:

  • Mindfulness-Based Cancer Recovery (MBCR). “Facilitators were clinical psychologists and a nurse who were fully trained in mindfulness-based stress reduction and had led groups in previous MBCR trials. Participants attended 8 weekly group sessions of 90 minutes in duration, and a six-hour retreat between weeks 6 and 7. Participants were provided with a course booklet and practice compact discs for guided meditation and mindful body movement at home.”
  • Supportive-Expressive Group Therapy (SET). “Participants met in a group for 90 minutes weekly for 12 weeks with clinical psychologist(s) and/or clinical social worker(s) who were highly experienced in SET. The SET program encourages openness and emotional expression, with an aim toward developing a mutual support system among members as well as improving interactions with family and treating physicians. Through group discussion, SET also aims to facilitate coping skills and to detoxify negative emotions surrounding mortality.”
  • Control: Stress Management Seminar (SMS). “Women in the control condition participated in a 1-day (6-hour) didactic SMS led by an experienced clinical social worker.”

Note that the control group actually did receive some intervention.

The result?

Mindfulness-based Stress Reduction and Supportive-Expressive Group Therapy were about equal in TL, and bested the control group.

Figure 2.

Or, in the words of the authors:

To our knowledge, the current study is the first report to demonstrate a potential effect of these psychosocial interventions on TL among distressed breast cancer survivors. There was little discernment between MBCR and SET. Both maintained TL over the 3-month intervention period, whereas women in the control condition demonstrated a trend toward decreases in relative TL… Given the increasingly well-documented association between TL and cancer initiation and survival, this finding adds to the literature supporting the potential for stress-reducing interventions to impact important disease-regulating processes and ultimately disease outcome.

Many limitations with this study: the n was smallish; the length of study was months, not years; the impact of decreased TL is, of course, not known.

Still, seriously cool.

Reading of the Week. Every week I pick a reading — often an article or a paper — from the world of Psychiatry.

Cancer.pdf