Description
Mindfulness-based clinical interventions are mind-body modalities that may encompass several components: psycho-educational elements, mindfulness meditation exercises, cognitive-behavioural interventions and movement exercises. Core practices are sitting meditation (breath awareness, focused attention), body scan (awareness of sensations in the body), and mindful movement.
The two most used mindfulness-based interventions (MBIs) in oncology are mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT).
Efficacy
In the context of cancer care, mindfulness is used as a supportive treatment to alleviate cancer-related symptoms and adverse effects of cancer treatments. CAM Cancer has summarised the data from systematic reviews published in the last five years (2021 to Jan 2026) about the efficacy of mindfulness-based interventions for various symptoms.
Anxiety and Depression
- Evidence from four systematic reviews (SRs) suggests that mindfulness-based interventions, particularly MBSR and MBCT, improve anxiety and depression in people with cancer.
- For anxiety, effect sizes ranged from small in eHealth interventions to large in lung cancer patients and patients with various cancer compared to no active controls (e.g. usual care). The confidence in these findings was rated as low to moderate.
- Depression also showed small to large effects but with low certainty.
- Confidence in the findings is limited by methodological issues of the trials included in the SRs, including high risk of bias, lack of blinding, variability in interventions and populations across studies, and small study sizes.
Fatigue
- Four systematic reviews (SRs) found that mindfulness-based interventions (MBI) reduce cancer-related fatigue, with effects ranging from small-moderate to large and benefits generally persisting beyond the intervention period.
- Although findings were consistent across reviews, the overall confidence into the findings was low or not formally assessed.
- Major limitations included high risk of bias in the included trials, lack of blinding, variations in intervention formats and fatigue measures, and small sample sizes.
Pain
- Two systematic reviews (SRs) found that mindfulness-based interventions (MBI) produce small reductions in cancer-related pain.
- Confidence in the findings ranged from low to moderate, with stronger evidence for comparisons against usual care than against active control interventions.
- The interpretation of the findings is limited by methodological weaknesses in the studies included in the SRs, including high or unclear risk of bias, lack of blinding, clinical and methodological variations, small sample sizes.
Sleep
- Two systematic reviews (SRs) found that mindfulness-based interventions improve subjective sleep outcomes in people with cancer, with moderate to large effects that may be maintained over time.
- Benefits were less clear when MBI was compared with active treatments, and objective sleep measures showed inconsistent results.
- In a comparison of several mind-body interventions, mindfulness ranged among the more effective interventions.
- Confidence into the findings ranged from low to moderate
- Key limitations included high risk of bias, substantial heterogeneity across studies, reliance on self-reported sleep outcomes in unblinded trials, small study sizes, and limited reporting of objective outcomes.
Safety
MBSR and MBCT are generally considered safe in supportive cancer care. However, the overall safety of mindfulness- and meditation-based interventions has not been systematically assessed and is often underreported. Adverse events were rarely assessed in the included systematic reviews.
Description and definition
Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) are structured, multi-component mind–body interventions that integrate psychoeducation, mindfulness meditation, cognitive–behavioural elements, and gentle movement practices. Core techniques include sitting meditation (focused attention on the breath), body scan, Hatha yoga, walking meditation, and insight meditation.
Mindfulness is commonly defined as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally” (Kabat‑Zinn 2003). These approaches are grounded in an ethical framework emphasising non-harming.
MBCT was specifically developed to prevent relapse in recurrent depression and includes more explicit psychoeducational components and shorter formal practices compared with MBSR.
Background and prevalence
Mindfulness-based interventions are derived from Buddhist contemplative traditions but were introduced into Western clinical practice by Kabat‑Zinn in 1979 for patients with chronic pain. They have since been adapted for use in secular healthcare settings. MBCT was later developed by Segal, Williams and Teasdale, combining mindfulness with cognitive behavioural therapy (Campbell 2012).
Alleged indications/claims of efficacy
MBSR and MBCT are widely used in supportive cancer care to address symptoms including emotional distress, anxiety, depression, sleep disturbances, fatigue, and reduced quality of life, (Chen 2025; Pedro 2021).
Adapted mindfulness programmes tailored for cancer populations are widely available and include mindfulness-based cancer recovery programmes (Pedro 2021; Chen 2025; Carlson 2010). These interventions are increasingly offered in integrative oncology settings, alongside growing use as self-help approaches through books and digital platforms.
Mechanisms of action
Overall, the effects of mindfulness are best understood within a biopsychosocial framework, (Grossman 2004); where psychological processes (e.g. attention, emotion regulation), neural changes (e.g. reduced amygdala reactivity, enhanced prefrontal control), endocrine responses (e.g. reduced cortisol and immune processes (e.g. reduced inflammation, enhanced immune function) interact to influence health outcomes. (Alsubaie 2017; Carlson 2004; Garland 2009; Matousek 2011).
Application and providers
The standard MBSR programme consists of eight weekly group sessions lasting 2.5–3.5 hours, plus a full-day retreat, totalling approximately 20–35 hours of contact time. Shortened versions adapted for cancer patients have also been evaluated (Carlson 2010). Evidence suggests that reduced contact hours do not necessarily diminish psychological benefits (Carmody 2009), which may improve accessibility for patients experiencing treatment-related burdens such as fatigue.
Participants are typically encouraged to engage in daily home practice (approximately 45 minutes, six days per week). Greater adherence to home practice has been associated with increased mindfulness and improved psychological outcomes (Carmody 2009). Follow-up support, such as retreats or drop-in sessions, may be offered in some settings (Carlson 2010). Online and app-based formats are increasingly available.
Legal aspects
Training of MBSR and MBCT teachers is not formally regulated. However, established institutions such as the Center for Mindfulness at the University of Massachusetts and the Oxford Mindfulness Centre have developed structured training pathways and competency frameworks (Santorelli 2014; OMC 2026).
Requirements typically include formal coursework, supervised teaching, and a sustained personal meditation practice. However, specific standards, including required training hours and prior meditation experience, vary across organisations.
This evidence summary is based on systematic reviews (SRs) published between January 2021 and 2026, which were retrieved through systematic literature searches. It assesses whether mindfulness-based interventions (MBI) improve various cancer-related symptoms:
- Does mindfulness work for cancer-related anxiety and depression?
- Does mindfulness work for cancer-related fatigue?
- Does mindfulness work for cancer-related pain?
- Does mindfulness work for cancer-related sleep/insomnia?
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 studies can be viewed in the evidence tables.
Mindfulness-based interventions (MBIs) are generally considered low risk, with very few serious adverse events reported. However, the overall safety of mindfulness- and meditation-based interventions has not been systematically assessed and is often underreported (Wong 2018; Farias 2020; Britton 2021; Baer 2021; O'Brien-Venus 2024).
No systematic reviews specifically focusing on the safety of MBIs in oncology are currently available. Therefore, this summary is based on evidence from general populations rather than cancer patients.
Adverse events
One systematic review including 36 randomised controlled trials (RCTs) (25 mindfulness-based stress reduction [MBSR], 11 mindfulness-based cognitive therapy [MBCT]) found that the number of reported adverse events was very low and similar between mindfulness and control groups (<1%) (Wong 2018). No serious adverse events were reported.
Another systematic review of meditation-based interventions, including 83 studies, reported an overall prevalence of adverse events of 8.3%, comparable to rates observed in psychotherapy. Higher rates were reported in observational studies (33.2%) compared with experimental studies (3.7%) (Farias 2020).
Common adverse events
Reported adverse events are generally mild and include:
- Psychological/emotional: anxiety, depression, increased stress
- Cognitive: thought disorganisation, confusion, unusual thinking patterns
- Perceptual: mild visual or auditory disturbances (non-severe, hallucination-like experiences)
Serious or rare adverse events
Rare cases reported in the literature (primarily from individual case reports and not specific to mindfulness interventions) suggest that meditation practices may trigger or worsen symptoms in individuals with certain psychiatric conditions. These include psychotic episodes, severe mood disturbances, suicidal ideation, dissociation, mania.
However, these events are uncommon and the evidence base remains limited (Farias 2020).
Contraindications
No absolute contraindications are known. However, individuals with existing mental or physical health conditions should consult their healthcare provider before starting a mindfulness or meditation practice and inform their instructor of any relevant conditions (Cramer 2016).
A systematic review of 39 RCTs in individuals with psychosis found no evidence that mindfulness interventions are harmful in this population, despite earlier concerns (O'Brien-Venus 2024).
Interactions
No direct pharmacological interactions have been identified. However, clinical trials rarely assess interactions with medications (Park 2020).
There are also some concerns that mindfulness practices may exacerbate symptoms when combined with psychological treatments if not appropriately guided (Britton 2021).
Systematic reviews of mindfulness for anxiety and depression
Systematic reviews of mindfulness for fatigue
Systematic reviews of mindfulness for pain
Systematic reviews of mindfulness for sleep
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Citation
CAM Cancer Consortium. Mindfulness [online document], June 2026.
Document history
Summary updated between June and August 2026 by the CAM Cancer Collaboration. Summary updated in March 2021, October 2019 and August 2016 by Holger Cramer. Updated in February 2016 by Ann-Christine Moenaert. Summary first published in August 2012, authored by Ann-Christine Moenaert and Michaela Sieh.
Next update due: June 2029
Photos: mp62367493 from Mostphotos.com, licence via UiT The Arctic University of Norway.
