The SEAMLESS Study: A pragmatic multi-site randomized waitlist-controlled trial of a SmartphonE App-based MindfuLnEss intervention for French- and English-speaking cancer SurvivorS

The number of cancer survivors in Canada is increasing because of advances in early detection and new treatments. Unfortunately, almost half of all survivors experience long-term negative symptoms and side-effects after treatment such as fatigue, pain, anxiety, distress, and fear of cancer recurrence/progression. These symptoms impair survivors' ability to enjoy a good quality of life, work and give back to their families and society. Thus, cost-effective and safe ways to provide psychosocial care to cancer survivors after treatment are needed. Our team has developed and studied Mindfulness-Based Cancer Recovery (MBCR), a program which trains people to manage symptoms and live life more fully using mindfulness meditation. MBCR has shown positive effects on a broad range of health outcomes in cancer survivors. However, many cannot attend the MBCR program in person for reasons such as living far away from treatment centres, costs of parking, travel and time off work, low immunity, side-effects, scheduling problems, and now COVID-19 precautions. Therefore, to overcome such difficulties our team has developed a low-cost smartphone/mobile app-based version of MBCR which includes teaching in mindfulness and guided meditation exercises. Now, we want to learn whether app-based MBCR is effective in reducing symptoms for a wide range of cancer survivors in real world settings. We will use pragmatic methods to compare a group of patients receiving app-based MBCR for 4 weeks in their own homes, to a waitlist control group on a range of symptoms including stress, fear of cancer recurrence, fatigue, anxiety, depression and physical function. If we are successful in showing the effectiveness of app-based MBCR for cancer survivors, this low-cost app could easily be made available for wider application across Canada and safely reach a large number of patients and survivors to help ease the transition from acute cancer care, without needing to come to a health care facility.