This is an in-depth assessment of the current evidence for mindfulness for cancer-related anxiety and depression. Follow the links for other information regarding mindfulness for cancer:
The findings of reliable systematic reviews (SRs) on mindfulness-based interventions for cancer-related anxiety and depression published in the past five years (2021-2026) have been summarized below. CAM Cancer appraised the quality of the SRs with the AMSTAR2 tool and only included SRs of moderate or high quality, while SRs of low or critically low quality were excluded. The full description of the included SRs can be found in the evidence tables.
General characteristics of included studies
Number of studies: Four systematic reviews with meta-analyses were included: Fung 2024, Li 2023, Reangsing 2025, and Stanerová 2025.
Number of RCTs per SR: From 13 RCTs to 26 RCTs. Two SRs also included non-randomized controlled studies or quasi-experimental studies.
Participants per SR: From approximately 1,200 to 2,720 participants.
Participants: Adult cancer patients and cancer survivors diagnosed with a wide range of cancer types and stages, including breast cancer, lung cancer, and mixed cancer populations. Breast cancer patients constituted the largest subgroup in most reviews.
Interventions: Mindfulness-based interventions (MBIs), primarily Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). Additional interventions included Mindfulness-Based Cancer Recovery (MBCR), adapted mindfulness programmes, guided self-help mindfulness interventions, Acceptance and Commitment Therapy (ACT), and eHealth/internet-based mindfulness programmes delivered via websites, videoconferencing, telephone, or mobile applications.
Comparators: Usual care, waitlist controls, no intervention, psychoeducation, health education, routine psychological care, symptom management, and other active control interventions.
Outcomes: Anxiety and depression measured using validated instruments, including HADS, STAI, GAD-7, BAI, PHQ-9, BDI-II, DASS-21, CES-D, SDS, SAS, and related scales.
Effects of the intervention
Anxiety
The evidence consistently suggests that mindfulness-based interventions reduce anxiety symptoms in people with cancer. Beneficial effects were reported across mixed cancer populations, lung cancer populations, and eHealth-delivered interventions. One review rated the certainty of evidence as moderate, while the other tree rated it low because of risk of bias, heterogeneity, lack of blinding, and imprecision.
Effect sizes ranged from small to large. Structured programmes such as MBSR and MBCT tended to demonstrate the most robust effects. Online and eHealth interventions tended to show smaller but still statistically significant benefits. Some evidence suggests benefits may persist for at least three months after intervention completion.
Small effects: SMD −0.28 to −0.30 in eHealth interventions, low certainty of evidence (Fung 2024).
Moderate effects: moderate effect size SMD = - 0.64, low certainty of evidence (Stanerova 2025).
Large effects: SMD −1.15 in lung cancer populations, low certainty of evidence (Li 2023), and SMD 0.98, moderate certainty of evidence in reviews focusing on anxiety outcomes (Reansing 2025).
Depression
Mindfulness-based interventions reduced depressive symptoms in cancer patients in three of the four reviews thus were not entirely consistent. Moderate to large positive effects were demonstrated across mixed cancer populations and lung cancer populations. eHealth interventions showed smaller effects, with some analyses finding no significant post-intervention benefit.
Certainty of evidence was judged as low in all SRs; one SR did not conduct a GRADE assessment. Overall confidence in the evidence was reduced by risk of bias, heterogeneity, and imprecision.
Small effects: SMD −0.22 in eHealth interventions (Fung 2024).
Moderate effects: SMD −0.71 in mixed cancer populations (Stanerova 2025).
Large effects: SMD −1.04 in lung cancer populations compared with usual care (Li 2023).
One review did not assess depression outcomes (Reansing 2025).
Limitations of the evidence
Quality of systematic reviews: The reviews were assessed as moderate to high methodological quality. Common weaknesses included inadequate incorporation of risk-of-bias findings into interpretation, incomplete publication-bias assessment, and absence of GRADE assessment in some reviews. Lack of adverse-event evaluation.
Common limitations across included studies: The RCTs included in the SRs were predominantly rated as having high or unclear risk of bias, with only few studies at low risk. Common key issues are the lack of blinding, which is challenging to achieve in behavioural interventions, and substantial heterogeneity in terms of interventions, intervention formats (face-to-face vs remote); cancer types, outcomes and outcome measurement tools, as well as small sample sizes. Adverse events were rarely assessed or reported.
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