Study Finds 20 Minutes of Mindful Breathing Can Quickly Reduce Cancer Pain Intensity

Twenty minutes of mindful breathing, which focuses a person’s attention on their breathing, can rapidly reduce the intensity and unpleasantness of cancer pain and relieve associated anxiety, suggest the results of a small comparative study, published online in the journal Cancer Research. BMJ Supportive and Palliative Care.

Conscious breathing complements traditional pain relief and expands the repertoire of options available to cancer patients, researchers say.

According to researchers, moderate to severe pain affects approximately 30 to 40 percent of cancer patients worldwide, due to compression or invasion of surrounding tissues by the tumor, neuropathic mechanisms and side effects of treatment.

Despite advances in pain management and the evolving array of medications and nerve blocks, inadequate pain control remains a major challenge for clinicians, they add.

Among the range of complementary treatments, such as cognitive behavioral therapy, massage, acupuncture and exercise, the value of mindfulness-based interventions is increasingly recognized, researchers say.

But research to date on the effectiveness of mindfulness for pain relief has focused mostly on programs lasting several weeks or just 5 to 10 minutes, or on people who don’t have cancer.

In light of previously published research indicating that periods longer than 10 minutes could effectively relieve pain, the researchers wanted to know if a single 20-minute mindfulness breathing session could do the same for cancer patients.

To find out, they randomly assigned 40 hospitalized patients (out of 259 approached) with different types of cancer and a pain score of 4 or more out of 10, indicating moderate to severe pain, to one of two groups.

One group (21 people) underwent a mindful breathing session, guided by a physician trained in mindfulness techniques. The session included a brief explanation of mindfulness concepts and practices, followed by 20 minutes of mindful breathing.

The session consisted of four steps, each lasting five minutes: identifying the inhalation and exhalation; following the entire duration of the breath; bringing the mind back to the body; and relaxing the body, starting from the head down to the toes.

The other group (19 people) received a 20-minute supportive listening session led by a doctor, during which they were asked to talk about their experiences of the illness using semi-structured questions.

Before and after each procedure, the intensity and unpleasantness of each patient’s pain were measured using the validated Numerical Rating Scale (0 to 10), while the Hospital Anxiety and Depression Scale (HADS), composed of 14 items rated on a 4-point scale, was used to assess their mood.

General information and relevant clinical data, such as cancer types and stages and use of analgesics, including morphine, were extracted from hospital medical records.

The mean age of patients was 63 years, and although a variety of cancer types were represented among them, one in three had colorectal cancer; 29 of them had stage III or IV disease. Nearly two-thirds (65%) of them used opioids to control their pain.

The results showed that the conscious breathing group experienced a much greater (and significant) reduction in pain intensity and discomfort than the control group. They also experienced a much greater reduction in HADS score.

The researchers acknowledge the relatively small size of the study and the fact that it was conducted at only one medical center. The nature of pain/discomfort intensity and psychological consequences were also assessed subjectively.

But cancer patients often face practical constraints, so brief mindfulness interventions that can rapidly reduce pain and complement traditional pharmacological approaches are worth exploring, they suggest.

“Furthermore, the 100% response rate and the absence of adverse events underscore the feasibility and safety of the 20-minute conscious breathing intervention. The intervention can be quickly learned and applied with beneficial effect,” they add.

“The results suggest that this brief intervention holds promise for reducing pain intensity and discomfort, as well as relieving anxiety in cancer patients. Although further research is needed to consolidate these findings, the study provides valuable information on a feasible and accessible non-pharmacological approach to improving pain management in cancer care,” they conclude.