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Comparative Investigation Between the Effectiveness of Auriculotherapy and Counselling Based on Mindfulness Based Cancer Recovery (MBCR) On Coping and Mental Adjustment to Cancer (MAC) in Women with Breast Cancer Undergoing Chemotherapy

This quasi-experimental study found that both auriculotherapy and mindfulness-based cancer recovery interventions were equally effective in improving coping strategies and psychological adjustment among women with breast cancer undergoing chemotherapy, with both groups showing significant benefits compared to a control group.

Original authors: Hediyeh Barkhordari, Atefeh Ahmadi, Mahboubeh Valiani, Behjat Kalantari Khandani, Yones Jahani, Masumeh Ghazanfarpour

Published 2026-07-27

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CC BY 4.0

Original authors: Hediyeh Barkhordari, Atefeh Ahmadi, Mahboubeh Valiani, Behjat Kalantari Khandani, Yones Jahani, Masumeh Ghazanfarpour

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine your mind is like a high-performance car. When you're driving down a smooth highway, everything runs perfectly. But sometimes, life throws a massive pothole in your path—like a diagnosis of a serious illness. Suddenly, your car is jolting, the engine is sputtering, and the GPS is spinning wildly. This is what happens to the mind when facing cancer. Scientists have long known that while medicine can fix the physical "engine" (the body), the driver (the mind) often needs extra help to navigate the bumpy road without crashing. Two popular tools for helping drivers stay calm and focused are "mindfulness" (which is like learning to drive with your eyes wide open, noticing every bump without panicking) and "auriculotherapy" (which is like pressing specific buttons on your car's dashboard to reset the alarm system and calm the nerves). The big question researchers have been asking is: If you have a broken GPS, is it better to hire a professional driving coach (mindfulness) or to press the dashboard buttons (ear therapy)? Does one work better than the other, or are they both just as good at getting you back on track?

This paper sets out to answer that exact question by putting two very different approaches to the test. The researchers gathered a group of women with breast cancer who were currently undergoing chemotherapy—a tough treatment that can leave patients feeling physically and emotionally drained. They split these women into three teams. One team received Auriculotherapy, a type of complementary medicine where tiny seeds are taped to specific spots on the ear to stimulate the nervous system. Think of this as gently tapping the "reset" button on your car's alarm system to stop the panic. The second team received Mindfulness-Based Cancer Recovery (MBCR), a program where they learned to meditate, breathe deeply, and practice yoga to stay present and calm. This is like hiring a driving coach to teach you how to handle the potholes without losing your cool. The third team was the Control group, meaning they didn't get either of these special treatments during the study period; they just continued with their usual care.

The scientists checked on these women at three different times: before the treatments started, right after the treatments finished, and one month later. They asked the women to fill out surveys about how they were "coping" (how they handled stress) and how they were "mentally adjusting" to their illness. The results were quite clear and surprisingly equal. Both the "ear button" team and the "mindfulness coach" team did significantly better than the team that didn't get any special help. They reported feeling less hopeless, less anxious, and more ready to fight the disease. They also used better strategies to handle stress, like planning ahead and accepting their situation, rather than trying to ignore it or blaming themselves.

However, here is the twist: when the researchers compared the two successful teams against each other, they found no difference. The women who pressed the seeds on their ears improved just as much as the women who meditated and did yoga. It wasn't that one was a "winner" and the other a "loser." Instead, the study suggests that both methods are powerful tools that work in their own unique ways to help the mind recover. The paper explicitly rules out the idea that one method is superior to the other for these specific goals. While the study didn't find a "magic bullet" that works for every single feeling (for example, neither method significantly changed how much people used humor or religion to cope), it did show that both approaches are highly effective at reducing the mental weight of cancer. The authors conclude that doctors and patients can feel confident choosing either path, or perhaps even using both, to help the mind navigate the difficult journey of cancer treatment.

Technical Summary: Comparative Investigation of Auriculotherapy and Mindfulness-Based Cancer Recovery (MBCR) in Breast Cancer Patients

Problem Statement
Breast cancer and its associated treatments, particularly chemotherapy, impose significant physical, cognitive, and psychological burdens on patients, including anxiety, depression, and maladaptive coping strategies. While pharmacological interventions are standard, they often carry undesirable side effects, prompting a growing interest in non-pharmacological complementary and alternative medicine (CAM) approaches. Although both auriculotherapy (a physical-physiological intervention) and Mindfulness-Based Cancer Recovery (MBCR) (a psychological intervention) have shown promise individually in improving psychological adjustment and coping, there is a lack of direct comparative evidence evaluating their relative effectiveness. This study addresses this gap by comparing the efficacy of auriculotherapy and MBCR counseling against a control group in enhancing coping strategies and mental adjustment to cancer among women undergoing chemotherapy.

Methodology
The study was a randomized controlled clinical trial with a pretest–posttest design and a control group, conducted with 105 women diagnosed with breast cancer undergoing chemotherapy in Kerman, Iran. Participants were randomly assigned (1:1:1) to one of three groups:

Auriculotherapy Group: Received eight sessions of auriculotherapy twice weekly. The protocol involved stimulating specific auricular points (Shen Men, Kidney, Relaxation, Lung, Thalamic, Master Shoulder, Liver, Anxiety, and Cerebral) using manual probes and sterile Vaccaria seeds applied to the ear.
Mindfulness Group: Participated in an eight-week online MBCR program consisting of 90-minute group sessions. The curriculum included mindfulness meditation, relaxation, deep breathing, gentle yoga, and interactive discussions, supplemented by a one-day silent retreat.
Control Group: Received standard care without specific psychological or auricular interventions.

Data were collected at three time points: baseline, immediately post-intervention, and one month post-intervention. Instruments included the Brief COPE questionnaire (assessing 14 coping subscales) and the Mini-Mental Adjustment to Cancer (Mini-MAC) scale (assessing five subscales: Fighting Spirit, Anxious Preoccupation, Helplessness/Hopelessness, Fatalism, and Cognitive Avoidance). Statistical analysis utilized Repeated-Measures ANOVA to evaluate group, time, and interaction effects, with Bonferroni post-hoc tests for pairwise comparisons.

Key Results
The study found that both intervention groups significantly outperformed the control group in most measured outcomes, though no statistically significant differences were observed between the auriculotherapy and mindfulness groups.

Mental Adjustment to Cancer (Mini-MAC): Both intervention groups demonstrated significantly better scores than the control group across most subscales (Helplessness/Hopelessness, Anxious Preoccupation, Fighting Spirit, and Total Score) at both post-intervention assessments. The only subscales showing no significant group differences were Fatalism and Cognitive Avoidance.
Coping Strategies (Brief COPE): Both auriculotherapy and mindfulness groups showed significant improvements compared to the control group in most coping variables, including Active Coping, Positive Reframing, Acceptance, and Behavioral Disengagement. Exceptions where no significant differences were found between interventions and controls included Religion and Humor.
Comparative Efficacy: Crucially, the study found no statistically significant differences ( $p > 0.05$ ) between the auriculotherapy and mindfulness groups for any outcome at either post-intervention time point. Both interventions were equally effective in improving psychological adjustment and coping relative to the control.
Sustainability: Improvements in the intervention groups were largely maintained at the one-month follow-up, although some slight regression was noted in specific subscales compared to immediate post-test scores.

Significance and Claims
The authors conclude that both auriculotherapy and MBCR are effective complementary strategies for improving coping mechanisms and psychological adjustment in women with breast cancer undergoing chemotherapy. The study claims that these non-pharmacological approaches offer viable alternatives or adjuncts to standard care, potentially enhancing psychological well-being without the side effects associated with pharmacotherapy.

The paper emphasizes that while the mechanisms differ—auriculotherapy potentially acting through the hypothalamic–pituitary–adrenal axis and sympathetic nervous system, and MBCR through emotion regulation and non-judgmental awareness—both yield comparable clinical benefits in this population. The authors suggest that these interventions can be integrated into oncology support programs to reduce psychological distress and improve quality of life.

Limitations and Future Directions
The authors acknowledge several limitations, including the relatively small sample size, recruitment from a single center, reliance on self-report measures which may introduce bias, and the lack of long-term follow-up beyond one month. They note that the study population was restricted to women with stages I–III breast cancer. Consequently, the authors modestly claim that while the findings are promising, future research with larger, multi-center samples and extended follow-up periods is necessary to further clarify the mechanisms and long-term durability of these interventions.

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