Beyond Mindfulness: The Importance of Body Compassion in Colorectal Cancer Distress

Lauren A Zimmaro^1*Aimee J Christie²Andrew Nicklawsky³Jennifer K Altman⁴James W Carson⁵Christopher Lieu¹Carolyn Fang⁶Jennifer B Reese⁶

• ¹School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
• ²Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, Ohio, United States
• ³University of Colorado Cancer Center, Aurora, Colorado, United States
• ⁴Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, United States
• ⁵Oregon Health and Science University, Portland, Oregon, United States
• ⁶Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States

Objective: Psychological distress is common among people diagnosed with colorectal cancer (CRC), often stemming from physical changes and challenges associated with the disease and its treatment. Body compassion, a mindfulness-related construct emphasizing acceptance, defusion, and common humanity of the physical body, may offer new perspectives on the link between mindfulness and distress in cancer patients, but this remains unexplored. This study investigated the relationship between mindfulness, body compassion, and distress in individuals with CRC. Methods: Fifty-four people diagnosed with CRC completed surveys assessing demographic and medical characteristics [e.g., stage, treatment status, medical comorbidities (SCQ: Self-Administered Comorbidity Questionnaire)], mindfulness (FFMQ-15), body compassion (BCS), and distress (HADS). Relationships were assessed with Holm-corrected Pearson's correlations. Regression models of mindfulness and distress explored a potential mediating effect of body compassion. Interactions between body compassion and disease burden variables (e.g., SCQ) were explored for moderation. Results: Mindfulness and body compassion were moderately correlated (r=.62, p<.001), with the strongest relationships observed between the subscales of mindful nonjudgment and body compassion defusion (r=.70, p < .05). Greater mindfulness was associated with lower distress (B=-0.39, CI95% [-0.56, -0.16], p<.001). This relationship was significantly mediated by body compassion (B=-0.21, CI95% [-0.38, -0.08], p<.001), which accounted for 54% of the total effect (p<.001). No evidence of moderation was observed. Conclusions: Among individuals with CRC, body compassion appears to be a key factor within the mindfulness-distress relationship. Future studies are warranted, particularly experimental designs to assess body compassion as a potential mechanism by which mindfulness-based interventions improve distress.