This systematic review and meta-analysis evaluates (1) the effectiveness of psychedelic-assisted therapy (PAT) using psilocybin and ketamine for psychosocial symptoms in adults with cancer, (2) contextualizes findings with non-randomized and exploratory studies of other psychedelics, and (3) examines the role of therapeutic frameworks in shaping outcomes. We searched PubMed, Cochrane Library, PsycINFO, and EMBASE (2000–2024) for randomized controlled trials (RCTs) and non-randomized studies investigating psychedelic agents in cancer populations. Meta-analyses pooled RCTs of psilocybin or ketamine using random-effects models. Non-randomized studies were synthesized narratively. Risk of bias and evidence certainty were assessed via Cochrane ROB 2.0, NIH Before–After tool, and GRADE. Eleven placebo-controlled RCTs and four single open-label studies were included. Meta-analysis of four ketamine RCTs (n = 354) showed large, rapid effects on depression/anxiety (Hedges’ g = −1.37, 95% CI: −2.66 to −0.08; I² = 92%). Three psilocybin RCTs (n = 101) showed a large effect of psilocybin on alleviating depression (Hedges’ g = −3.13, 95% CI: −10.04 to 3.77; I² = 95%). MDMA and LSD trials suggested promise but lacked rigor. PAT may offer meaningful relief for cancer-related distress, though effects vary by therapeutic model and context. Oncology-specific trials are needed to standardize and scale for implementation.

Many people with cancer (PWC) continue to experience persistent biopsychosocial and existential challenges across the cancer care continuum. Symptoms such as anxiety, depression, cancer-related fatigue and pain, sleep disturbance, fear of cancer recurrence, cognitive impairment, and reduced quality of life remain highly prevalent during and after treatment, underscoring the need for interventions that address both psychological and physiological dimensions of distress. Mind-body interventions encompass a diverse group of practices that explicitly target the bidirectional relationship between mental and physical processes and are increasingly incorporated into integrative oncology as adjuncts to standard care. This narrative review synthesizes current evidence on mind-body interventions for improving biopsychosocial outcomes in adult PWC. We review guideline-recommended interventions including mindfulness-based interventions, yoga, tai chi and qigong, relaxation therapies, hypnosis, music therapy, acupuncture, acupressure, massage, reflexology, and aromatherapy; as well as emerging modalities such as psychedelic-assisted therapy, biofield therapies, nature-based interventions, and mindfulness-based approaches for sexual dysfunction. For each intervention, we summarize target symptoms, treatment-phase considerations, and the quality and limitations of the supporting evidence. Finally, we discuss future directions with an emphasis on improving methodological rigor, elucidating mechanisms of action, expanding implementation and access, and extending research across diverse populations and all stages of cancer care, including survivorship and end-of-life contexts.

Objectives: While Mindfulness-Based Interventions (MBIs) are evidenced to reduce common psychosocial symptoms experienced by people with cancer (PWC), few studies have tested their mechanisms. Additionally, studies have yet to assess sex assigned at birth as a moderator of the relationship between mindfulness and psychosocial symptoms through specified mediators. This study (1) explored the mediating role of rumination and experiential avoidance (EA) in the relationship between mindfulness and a range of psychosocial symptoms and (2) tested sex as a moderator of the mediation models. Methods: This cross-sectional study assessed baseline data from 134 participants recruited for a mindfulness app clinical trial. Validated patient reported outcome measures of trait mindfulness, rumination, experiential avoidance, depression, anxiety, FCR, and fatigue were collected. Structural Equation Modelling was employed in R. Results: Rumination was a significant partial mediator between mindfulness, depression and anxiety and FCR, but not fatigue. EA acted as a weak mediator from mindfulness to FCR only. Subgroup analyses found that rumination may be more important for females than males in the relationship between mindfulness and depression and anxiety. Conclusions: Rumination may be a stronger mediator than EA for anxiety, depression and FCR, and this may be particularly important for females. Findings may help MBI researchers and developers target potentially relevant mediators to maximize robust study design and intervention efficacy.