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Original research
Symptom reduction in advanced cancer from multi-session mindful breathing: randomised controlled study
  1. Yu Zhen Tung1,
  2. Diana Leh Ching Ng2,
  3. Natalie Zi Lai1,
  4. Chui Munn Ang1,
  5. Poh Khuen Lim3,
  6. Sheriza Izwa Zainuddin1,
  7. Chee Loong Lam1,
  8. Ee Chin Loh4,
  9. Chee Shee Chai2 and
  10. Seng Beng Tan4
  1. 1Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  2. 2Department of Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
  3. 3Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  4. 4Palliative Care Unit, Subang Jaya Medical Centre, Subang Jaya, Malaysia
  1. Correspondence to Dr Diana Leh Ching Ng; nlcdiana@unimas.my

Abstract

Objectives While single-session mindful breathing shows symptom reduction in palliative care, data on multi-session efficacy is lacking. This study aimed to determine the effectiveness of multi-session mindful breathing in reducing symptoms among patients with advanced cancer.

Methods Adult patients with advanced cancer who scored ≥4 in at least two or more symptoms based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from January to March 2020 at the University of Malaya Medical Centre, Malaysia. Participants were randomly assigned to receive either four daily sessions of 30 min mindful breathing and standard care (intervention) or standard care alone (control). The outcome measured was the change in the ESAS score after each session.

Results 80 patients were recruited and randomised equally into the intervention and control groups. The demographic and clinical characteristics between the two groups were not statistically different. For the intervention group, there were statistically significant reductions in the total ESAS scores following all four sessions of 30 min mindful breathing (n1=40: z1=−5.09, p<0.001; z2=−3.77, p<0.001; z3=−4.38, p<0.001; z4=−3.27, p<0.05). For the control group, statistically significant reductions in the total ESAS scores were seen only after sessions 1 and 3 (n2=40: z1=−4.04, p<0.001; z3=−4.53, p<0.001).

Conclusions Our result provides evidence that four daily sessions of 30 min mindful breathing may be effective in reducing multiple symptoms rapidly in patients with advanced cancer.

Trial registration number NCT05910541.

  • Palliative Care
  • Supportive care
  • Symptoms and symptom management
  • Cancer

Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request. Data are kept as hardcopy and soft copy by the authors.

https://doi.org/10.1136/spcare-2024-005086

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    Data availability statement

    Data are available upon reasonable request. Data are available upon reasonable request. Data are kept as hardcopy and soft copy by the authors.

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    Footnotes

    • Contributors All authors—YZT, DLCN, NZL, CMA, PKL, SIZ, CLL, ECL, CSC and SBT made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. DLCN is the guarantor.

    • Funding The study was supported by the UNIMAS Cross Discipline Research Grant with the grant number F05/CDRG/1844/2019. The funding body only financially supported the study, and did not take part in the design of the study; or collection, analyses, and interpretation of the data; or writing of the manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.