Mindfulness-Based Interventions Integrating Buddhist-Wisdom Principles for Coping with Cancer: A Systematic Review

Abstract Objectives This systematic review sought to evaluate the effectiveness of mindfulness-based interventions (MBIs) that explicitly or implicitly integrate Buddhist wisdom principles, such as impermanence, interconnectedness, and/or non-attachment, for enhancing psychological well-being, pain management, and quality of life among cancer patients. Method Following PRISMA 2020 guidelines, a comprehensive literature search was conducted across PsycArticles, Scopus, PsycINFO, and Google Scholar electronic databases. Only randomised controlled trials (RCTs) were deemed eligible for inclusion and two reviewers independently screened studies, extracted data, and assessed risk of bias using the RoB 2 tool. Any discrepancies were resolved by discussion. Results Nine RCTs ( N = 769) met all of the inclusion criteria. MBIs incorporating Buddhist wisdom principles were most effective for improving psychological outcomes (e.g., moderate effect sizes of Cohen's d = 0.53–0.68) rather than for pain management, with participant means frequently crossing clinical thresholds for reduced anxiety and depression (e.g. CES- D ≥ 16.00). Interventions varied by cultural context, with explicit integration of Buddhist wisdom principles more common in studies conducted in Thailand (four RCTs), while studies conducted in the USA (five RCTs) tended more towards implicit incorporation. Furthermore, some interventions demonstrated sustained improvements in outcomes for cancer patients, while others showed a gradual decline over time. The predominance of female participants (88.45%) limits generalisability. Conclusions MBIs incorporating Buddhist wisdom principles show promise for enhancing psychological well-being and quality of life in cancer patients. However, the cultural context and specific design of interventions appear to play a crucial role in their effectiveness. Future research should focus on culturally tailored approaches and explore the mechanisms through which these interventions operate. Preregistration PROSPERO Registration No. CRD42024588606.