Mind Body Medicine in Pediatric Cancer Care

Pediatric cancer patients experience significant psychological and mental distress related to their diagnosis and treatment.  From studies on adult oncology patients, we know that unaddressed psychological distress is associated with worse clinical outcomes (1,2).  Additionally, pediatric patients experience side effects related to their treatment protocols that may impact their quality of life.  These may include fatigue, pain, anxiety, sleep disturbances, and depression. 

In an effort to explore the role that Mind-Body Medicine may play in mitigating the psychological distress and treatment side effects experienced by pediatric cancer patients, a group of researchers from Germany and Brazil completed a narrative review of the literature.  Their results, published in Complementary Therapies in Medicine (2021), provide insights into the impact of yoga, meditation, and mindfulness on quality of life, physical activity, and adaptive stress responses of pediatric cancer patients (3).

But, first, what is Mind-Body Medicine (MBM)?  MBM recognizes the connection between the mind and body to promote relaxation and health.  It is an approach that employs a variety of practices to harness this connection, such as yoga, meditation, and mindfulness.   

Yoga is a multi-faceted philosophy, of which researchers focused on the element of linking physical postures and movements with the breath.   

Meditation is a practice of intentional focus and concentration.   

Mindfulness is awareness of the present moment without judging it. 

Now, back to the study:  Researchers identified eleven pediatric oncology studies that evaluated patient outcomes related to yoga, meditation, or mindfulness interventions.  Measured outcomes were quality of life, sleep, anxiety, pain, emotional distress, and appetite. 

Each study enrolled between 6-34 pediatric oncology patients, of any cancer diagnosis and with variability in treatment stage.  Depending on the study, interventions consisted of a single session up to multiple sessions over a few weeks of a yoga, meditation, or mindfulness-based practice facilitated by certified instructors or therapists.      

Results suggested that yoga, meditation, and/or mindfulness can decrease fatigue and anxiety, and improve: 

• Quality of life

• Physical activity levels

• Sleep quality, and

• Appetite 

The mind-body interventions were found to be feasible in inpatient, outpatient, and community settings and whether patients were newly diagnosed, in treatment, post-treatment, or in palliative care.  This feasibility is an important consideration in pediatric oncology, where energy levels, mobility, and treatment schedules can vary widely. 

While these results are encouraging, a limitation of this review is the variability in study designs that lend difficulty to establishing guidelines regarding dosage, duration, frequency, and modes of facilitation.  Additionally, studies had small sample sizes, were not randomized and did not have control groups, which make it difficult to draw conclusions on their efficacy.    

In consideration of these limitations, this narrative review suggests that yoga, meditation, and mindfulness-based activities may improve quality of life, physical activity, and adaptive stress responses for children at any stage of their cancer journey.  These findings suggest that mind-body practices may serve as meaningful adjuncts to conventional care, offering supportive tools for managing stress and improving overall well-being. 

Resources: 

1. Mäkitie AA, Alabi RO, Pulkki-Råback L, Almangush A, Beitler JJ, Saba NF, Strojan P, Takes R, Guntinas-Lichius O, Ferlito A. Psychological Factors Related to Treatment Outcomes in Head and Neck Cancer. Adv Ther. 2024 Sep;41(9):3489-3519. doi: 10.1007/s12325-024-02945-3. Epub 2024 Aug 7. PMID: 39110309; PMCID: PMC11349815. 

2. Senchak JJ, Fang CY, Bauman JR. Interventions to improve quality of life (QOL) and/or mood in patients with head and neck cancer (HNC): a review of the evidence. Cancers Head Neck. 2019 Jun 11;4:2. doi: 10.1186/s41199-019-0041-4. PMID: 31210980; PMCID: PMC6560898. 

3. Stritter W, Everding J, Luchte J, Eggert A, Seifert G. Yoga, Meditation and Mindfulness in pediatric oncology - A review of literature. Complement Ther Med. 2021 Dec;63:102791. doi: 10.1016/j.ctim.2021.102791. Epub 2021 Nov 19. PMID: 34808385. 

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