Mindfulness-Oriented Recovery Enhancement for Cancer Pain Relief: Pilot Randomized Controlled Trial.
Karolina L Bryl, Adam W. Hanley, Raymond E Baser, Krupali Desai, Michael Dowd, Qing Li, Beth Sandweiss, Eric L Garland, Jun J Mao
Journal of Pain and Symptom Management January 3, 2026 DOI: 10.1016/j.jpainsymman.2025.12.024 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 60 |
| Population | Cancer survivors with history of any type of cancer, living with no evidence of disease or stable oncological disease, with moderate-to-severe pain |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Duration | 12-week follow-up |
| Topics | Meditation |
| Keywords | Cancer survivors Mindfulness-oriented recovery enhancement Pain |
| Citations | 1 |
| Registration | NCT05877521 |
| Key findings | MORE was feasible and acceptable for cancer survivors, and while reductions in pain interference and severity favored MORE over waitlist, they were not statistically significant; a dose-response effect was observed across formats. |
Abstract
Chronic pain affects many cancer survivors yet remains underdiagnosed and inadequately managed. Existing treatments (e.g., opioids, NSAIDs) carry risks like addiction and limited long-term relief, while non-pharmacological options show modest effectiveness. Given these limitations innovative, evidence-based interventions are needed. Mindfulness-Oriented Recovery Enhancement (MORE), a multimodal intervention targeting neurocognitive mechanisms underlying chronic pain, has demonstrated effectiveness in noncancer populations but has not been studied in cancer survivors. This pilot randomized controlled trial evaluated the feasibility, acceptability, and explored preliminary efficacy of MORE on pain interference and severity in cancer survivors. Sixty patients with history of any type of cancer living with no evidence of disease or stable oncological disease with moderate-to-severe pain (mean age 60.3 ± 11.8 years; 75% female) were randomized 3:1 to one of three MORE formats (16-hour, 8-hour, or 2-hour) or waitlist control (WLC). Feasibility was assessed through enrollment, assessment completion, and adverse events rates. Acceptability was evaluated by treatment adherence, at-home practice, and satisfaction (Net Promoter Score). Pain interference and pain severity were measured with the Brief Pain Inventory at baseline and weeks 1, 4, 8, and 12. Descriptive statistics summarized feasibility and acceptability; constrained linear mixed models tested efficacy and dose-response effects. MORE demonstrated feasibility with high enrollment (70.6%) and assessment completion (91%) rates. Treatment adherence was high (16-hour: 64.3%; 8-hour: 81.3%; 2-hour: 100%), with satisfaction highest in the 16-hour format. Within-group reductions in pain interference (-1.22 vs. -0.81) and severity (-1.31 vs. -0.85) favored MORE over WLC, though not significant. A dose-response effect was observed, with all MORE formats yielding significant reductions in pain interference and severity. These findings support the feasibility and acceptability of MORE for cancer survivors and suggest potential efficacy in reducing chronic pain among cancer survivors. ClinicalTrials.gov/ NCT05877521.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 18
- Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials Psycho-Oncology September 11, 2019
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Positive Psychological States in the Arc from Mindfulness to Self-Transcendence: Extensions of the Mindfulness-to-Meaning Theory and Applications to Addiction and Chronic Pain Treatment Current Opinion in Psychology January 14, 2019
- The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia. Mindfulness 2023
- A Single-Session, 2-Hour Version of Mindfulness-Oriented Recovery Enhancement (One MORE) Improves Chronic Pain Patients' Pain-Related Outcomes Through 3-Month Follow-Up in a Randomized Controlled Trial. Journal of Integrative and Complementary Medicine September 1, 2024
and 13 more in the library