Mindfulness therapy in the recovery from colorectal cancer.

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Colorectal cancer (CRC) is the most common cancer in New Zealand with 3030 registrations in 2011 and also has the second highest age-standardised mortality per 100,000 of the cancers in New Zealand. CRC is also associated with impaired quality of life (QoL) as well as increased psychosocial distress usually measured as anxiety and depression in most patients. Psychosocial distress and QoL in CRC patients have been shown to improve through psychological interventions. Mindfulness based interventions have shown promise for improving depressive symptoms, anxiety, stress, QoL, and physical functioning in a range of physical illnesses and cancer. However, mindfulness interventions have not been tested in CRC patients. This study aims to see if a group-based mindfulness intervention reduces psychosocial distress and improves QoL in people with CRC relative to group-based patient education and discussion alone; it also compares the group-based interventions to a self-selected control group. This study will recruit and randomly allocate 200 patients who consent to a psychological intervention to a four week group-based mindfulness intervention versus group-based patient education and discussion. In addition to the consenters, non-consenters (to a psychological intervention) will be given the opportunity to participate in an observational study which will measure outcomes in parallel to the intervention groups; this group will be called the self-selected control group (SSCG). It will be seen if the group-based mindfulness intervention completers improve more than those who are in the patient education and discussion group or SSCG in terms of psychological distress (i.e. anxiety and depression; primary outcome), QoL (secondary outcome) and mindfulness (secondary outcome). The outcomes will be measured at baseline (i.e. pre-intervention), post-intervention (i.e. eight weeks post-baseline), and six months post-baseline. Recruitment will begin at one centre and may be expanded at two more centres (University of Otago Dunedin and Wellington) in the long-term. Multiple disciplines are involved in the design and implementation of the study and intervention, including a postdoctoral research fellow, nurses, colorectal surgeons, and oncologists. The findings from this study are important because impaired QoL and psychological distress after CRC survivorship is well documented.