Mind-body therapies reduce depression and anxiety in people with cancer, network meta-analysis finds

This is a network meta-analysis, a type of systematic review, that synthesized evidence on mind-body therapies for depression and anxiety in people with cancer. The population included 16,835 individuals with cancer. The intervention was mind-body therapies, including biofeedback, spiritual interventions, mindfulness-based interventions, yoga, physical relaxation, qigong/Tai Chi, and music therapy. The comparator was usual care. The primary outcome was reduction in depression and anxiety symptoms.

For depression symptoms, the analysis found several interventions with statistically significant large effects. Biofeedback showed a large effect with a standardized mean difference (SMD) of -1.18 (p = 0.038). Spiritual interventions also showed a large effect with an SMD of -0.98 (p = 0.047). Mindfulness-based interventions (MBIs) demonstrated a large effect with an SMD of -0.87 (p < 0.001).

For anxiety symptoms, multiple interventions showed statistically significant large effects. Yoga had an SMD of -1.13 (p < 0.001). Mindfulness-based interventions (MBIs) had an SMD of -1.02 (p < 0.001). Physical relaxation showed an SMD of -0.93 (p < 0.001). Qigong/Tai Chi (QTC) had an SMD of -0.90 (p = 0.004). Music therapy also showed an SMD of -0.90 (p < 0.001).

The review did not report specific secondary outcomes, safety data, adverse event rates, serious adverse events, discontinuations, or tolerability findings. The limitations of the network meta-analysis were not detailed in the input. Potential biases in network meta-analyses can include heterogeneity in included studies, inconsistency between direct and indirect comparisons, and the assumption of transitivity.

The practice relevance note indicates that mind-body therapies prioritized for depression symptoms are biofeedback, spiritual interventions, and MBIs. For anxiety symptoms, the prioritized therapies are yoga, MBIs, physical relaxation, QTC, and music therapy in people with cancer. This synthesis does not compare these results to prior landmark studies in the therapeutic area, as that information was not reported.

Key clinical implications are that these mind-body therapies may be considered as adjunctive options for symptom management in oncology settings. However, the evidence is from a network meta-analysis, and the findings should be interpreted with caution due to the lack of reported safety data and methodological limitations. Unanswered questions include the optimal dosing and protocol specifics for each therapy, long-term efficacy, and comparative effectiveness against other non-pharmacological interventions.