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Benefits of Yoga and Meditation for Patients with Cancer

June 26, 2018
woman lying on yoga bolster
Yoga is a complementary mind–body therapy that may help people manage cancer symptoms or adverse effects of treatments and improve their quality of life. The summary of research from the National Center for Complementary and Integrative Health on mind–body interventions suggests that yoga may help with anxiety, depression, distress, and stress in people with cancer.1 Results of studies of patients with early-stage breast cancer and survivors suggest that yoga may help to reduce fatigue. Meditation, one of the tools of yoga, has similarly been shown to address anxiety, stress, fatigue, and general mood and sleep disturbances.

Yoga is a synergistic system of knowledge and practices grounded in ancient Indian philosophy, with a goal of stilling the fluctuations of the mind and developing physical, mental, and emotional equanimity.2 It is widely popular in the United States: As of 2012, 9.5% of US adults had reported using yoga, with 8% using meditation.3

Physically challenging styles of yoga are less appropriate for patients with cancer coping with health challenges than are hatha, yin, therapeutic, and Viniyoga. Viniyoga adapts the tools of yoga (breath, movement, meditation) to the needs, goals, and abilities of the individual.2,4-6 There is a continuum, ranging from group classes to individual yoga therapy, in which the therapist customizes and supports a program for the client.7,8

CLINICAL ONCOLOGY GUIDELINES

Clinical oncology practice guidelines based on a systematic literature review from 1990 through 2015 detail a growing body of evidence for recommending mind–body therapies as supportive breast cancer care during and after treatment. Specifically, yoga and meditation appear to be highly or moderately helpful for reducing anxiety and stress, improving depression and mood disorders, and enhancing quality of life.9

A review of 11 randomized clinical trials (RCTs) and 6 non- RCTs found consistent support from the efficacy of yoga to improve mental health outcomes (such as distress, mood and anxiety) during cancer treatment. Some research found improvements in sleep, fatigue, and quality of life during treatment.10 A review of 9 RCTs and 6 nonrandomized studies of yoga use by cancer survivors suggests physical and psychosocial benefits. Preliminary findings show potential relief from fatigue, dyspnea, gastrointestinal issues, menopausal symptoms, pain severity, and improvements in respiratory function, heart rate, and HRV, as well as sleep-related benefits, emotional well-being, vigor, stress, and cognitive functioning.11

YOGA CHANGES HOW THE MIND FUNCTIONS

Neuroscience and psychology show that the default state of the human brain is mind wandering—ruminating about the past or thinking about the future.12-14 Yoga and meditation shift attention to the interoceptive neural network by directing attention to present-moment interoceptive bodily sensations such as breath. Genetics and life experiences contribute to individual capacity for interoceptive awareness.15 That capacity can improve with training. Regular practice develops an attentional habit and capacity to direct attention to interoceptive sensations.16-18 An increased capacity and propensity to direct attention to bodily sensations (interoceptive awareness) promotes emotional and bodily awareness. In other words, we notice how we are feeling when we get triggered, making it more likely we will make different choices, such as stop and take a deep breath, think and then respond, rather than just react.

SELF-REGULATION HELPS MAINTAIN PHYSICAL AND EMOTIONAL BALANCE

Self-regulation is “our ability to control how we feel and act.”19 What self-regulation of bodily tries to do is to maintain homeostasis; and self-regulation of emotional states helps us maintain equilibrium, or balance. Interoception and bodily states are inseparable; interoception and emotional states are inseparable. The autonomic nervous system continuously makes metabolic and vascular adjustments to try to maintain homeostasis (and keep us alive). Conscious awareness of bodily states (through interoception) alerts our mind to make changes in the body or our environment to maintain homeostasis. Good emotional awareness means that someone detects bodily signals and can clearly differentiate how each emotion feels. That awareness enables that person to take steps to alter emotions or situations to maintain, increase, or decrease an emotion.15,19

EFFECTS OF YOGA

Practicing yoga regularly can potentially support change in the way the mind and body function:

  • Inhibiting cognitive, emotional, and behavioral stress responses (such as negative self-appraisal, emotional reactivity, and rumination)
  • Inhibiting autonomic stress responses (such as vasopulminary constriction, inflammation, and muscle tension and pain)
  • Facilitating viscerosomatic processing of sensory– motor signals20

Another theoretical mechanism of yoga effects is that breath regulation (pranayama) during yoga practices improves vagal nerve tone. The vagus nerve contains the main bidirectional perceptual pathway of the parasympathetic nervous system (PNS). Practicing yoga shifts regulatory systems toward optimal homeostasis, reducing allostatic load and correcting underactivity of the PNS and γ-aminobutyric acid systems.21 Allostatic load is the cost to the body of maintaining stability during reactions to chronic stress (such as high blood pressure and elevated heart rate). In this way, yoga supports the functioning of the autonomic nervous, neuroendocrine, hypothalamic-pituitary- adrenal axis, cardiovascular, metabolic, and immune systems and influences emotional states and thought processes.21 

ADVICE FOR PATIENTS WITH CANCER

Yoga interventions are noninvasive, low cost, and can be adapted for people who have functional or other impairments. Selecting an appropriate style of yoga and an experienced, certified instructor will minimize potential risks of harm for people undergoing cancer treatment, including elderly patients and those with limited mobility. Knowledgeable, experienced yoga teachers often offer private sessions adapted for the individual that can be practiced at home. Certified yoga therapists are trained to deliver individualized therapeutic yoga.22,23

Carrie Heeter, PhD is a professor of media and information at Michigan State University. She designs and researches cybermeditation. She is a certified Viniyoga and meditation teacher. Heeter has studied meditation one-on-one for 5 years with her teacher, Marcel Allbritton, PhD.

Rebecca Lehto, PhD, RN is an associate professor at Michigan State University College of Nursing. Her research focuses on symptom management and adaptation to cancer.

REFERENCES

  1. Cancer: In Depth. National Center for Complementary and Integrative Health. 2017 [cited 2017 Dec 13]. Available from: nccih.nih.gov/health/cancer/complementary-integrative-research. Accessed March 29, 2018.
  2. Desikachar TKV. The Heart of Yoga: Developing a Personal Practice. Revised edit. Rochester, VT: Inner Traditions; 1999:244.
  3. Clarke T, Black L, Stussman B, Barnes P, Nahin R. Trends in the use of complementary health approaches among adults: United States, 2002–2012. National health statistics reports; no 79. Hyattsville, MD: Stussman. 2015. Hyattsville, MD: National Center for Health Statistics; 2015. (National Health Statistics Reports). Report No.: 79. nccih.nih.gov/research/statistics/NHIS/2012/mind-body/yoga#pdf. Accessed March 29, 2018.
  4. Desikachar TKV. The Viniyoga of Yoga: Applying Yoga for Healthy Living. 1st Edit. India: Quanda Press Limited; 2001: 391.
  5. Desikachar K, Bragdon L, Bossart C. The yoga of healing: Exploring yoga’s holistic model for health and well-being. Int J Yoga Ther. 2005;15(1):17–39.
  6. Mohan AG, Mohan I. Yoga Therapy: A Guide to the Therapeutic Use of Yoga and Ayurveda for Health and Fitness. Boston, MA: Shambhala; 2004.
  7. Chandrasekaran N. Principles and Practice of Yoga Therapy: A Complete Gguide for Learning and Practice of Yoga Therapy. Chennai, India: VHP Publications; 2012.
  8. Contemporary Definitions of Yoga Therapy – International Association of Yoga Therapists (IAYT). [cited 2017 Feb 5]. iayt.org/?page=ContemporaryDefiniti. Accessed March 29, 201
  9. Greenlee H, DuPont-Reyes MJ, Balneaves LG, Carlson LE, Cohen MR, Deng G, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017 67(3):194–232.
  10. Danhauer S, Sohl S, Addington E, Chaoul A, Cohen L. Yoga Therapy During Cancer Treatment: Clinical insights. In: The Principles and Practice of Yoga in Health Care. Endenburgh: Handspring Publishing; 2016. p. 339–74.
  11. Culos-Reed S, Long R, Walter A, Van Puymbroeck A. Yoga Therapy for Cancer Survivors: Clinical insights. In: The Principles and Practice of Yoga in Health Care. Endenburgh: Handspring Publishing; 2016. p. 375–400.
  12. Buckner RL, Andrews-Hanna JR, Schacter DL. The brain’s default network: Anatomy, function, and relevance to disease. Ann N Y Acad Sci. 2008;1–38.
  13. Killingsworth MA, Gilbert DT. A Wandering Mind Is an Unhappy Mind. Science. 2010 Nov 12;330(6006):932–932.
  14. Mittner M, Boekel W, Tucker AM, Turner BM, Heathcote A, Forstmann BU. When the Brain takes a break: A model-based analysis of mind wandering. J Neurosci. 2014 Dec 3;34(49):16286–95.
  15. Craig AD (Bud). How Do You Feel? An Interoceptive Moment with Your Neurobiological Self. Princeton, NJ: Princeton University Press; 2014.
  16. Farb N, Daubenmier J, Price CJ, Gard T, Kerr C, Dunn BD, et al. Interoception, contemplative practice, and health. Conscious Res. 2015 [cited 2015 Jun 19]. journal.frontiersin.org/article/10.3389/fpsyg.2015.00763/abstract. Accessed March 29, 2018.
  17. Farb N, Segal Z, Anderson AK. Mindfulness meditation training alters cortical representations of interoceptive attention. Soc Cogn Affect Neurosci. 2012;8(1).
  18. Brewer JA, Worhunsky PD, Gray JR, Tang Y-Y, Weber J, Kober H. Meditation experience is associated with differences in default mode network activity and connectivity. Proc Natl Acad Sci. 2011 Dec 13;108(50):20254–9.
  19. Mahler KJ. Interoception: The Eighth Sensory System. AAPC Publishing; 2015.
  20. Gard T, Noggle JJ, Park CL, Vago DR, Wilson A. Potential self-regulatory mechanisms of yoga for psychological health. Front Hum Neurosci. 2014;8:770.
  21. Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012;78(5):571–9.
  22. Find a Certified Yoga Therapist. www.iayt.org/search/custom.asp?id=4160. Accessed March 29, 2018.Dec 16, 2017. Accessed March 29, 2018.
  23. International Association of Yoga Therapists. Educational Standards for the Training of Yoga Therapists. International Association of Yoga Therapists.c.ymcdn.com/sites/www.iayt.org/resource/resmgr/accreditationmaterials/2017_11_Updates-Ed_Stds/2017_IAYT_Educational_Standa.pdf. Published September 1, 2017. Accessed March 29, 2018.

Reprinted from Oncology Nursing News

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Bulk Up Against Breast Cancer

June 26, 2018

woman doing chest press on stability ballResearchers have found that women with breast cancer who have a low muscle mass are less likely to survive stage 2 and 3 cancers. The study titled, “Association of Muscle and Adiposity Measured by Computed Tomography with Survival in Patients with Nonmetastatic Breast Cancer,” appears in the latest issue of the journal JAMA Oncology.

Sarcopenia refers to loss of muscle mass. For this study the team of researchers from the Kaiser Permanente, the University of Alberta, Canada, and the Dana Farber Cancer Institute compared patients who had low muscle mass or sarcopenia when they were diagnosed with stage 2 or 3 breast cancer with women who did not have sarcopenia.

Stages 2 and 3 of breast cancer refer to growing cancer that has not spread to other organs from the site or origin at the breast.The team looked at 3,241 women diagnosed with breast cancer at Kaiser Permanente of Northern California or Dana Farber Cancer Institute between January 2000 and December 2013. Their muscle and fat mass was assessed at diagnosis using CT scans of the abdomen that showed that muscle and fat mass clearly. Sarcopenia was diagnosed in one third of the women (34 percent). It was defined as skeletal muscle index of less than 40. This index was calculated by measuring the muscles at a slice of the abdomen at the lower back (third lumbar vertebra). The square inch of muscle at that site divided by the height of the cross section in meters squared provided the index. For all the patients a follow up of at least 6 years was performed to assess their survival.

What the team noted was that lower muscle mass meant poorer survival. The 34 percent women who had sarcopenia were 41 percent more likely to have died earlier than those who did not. Those with highest amounts of fat were 35 percent more likely to die early than those with a low fat content. Patients who had a higher amount of fat combined with sarcopenia were 89 percent more likely to die earlier finds the study.

Cross section showing formation of breast cancer. Image Credit: BlueRingMedia / Shutterstock

Cross section showing formation of breast cancer. Image Credit: BlueRingMedia / Shutterstock

The researchers speculate that this result could be interpreted in another way – those with a more aggressive cancer may die early and the cancer itself may have led to loss of muscle mass early on during the cancer diagnosis. It is likely that those who had more muscle mass initially at the start of the study are also more likely to survive the muscle loss that the cancer would eventually cause and thus survive longer. As such muscle loss related to cancer progress is associated with 20 to 30 percent deaths. Researchers also suspect that women who have a higher muscle mass are in general leading a healthier lifestyle which improves their chances of survival.

The authors of the study recommend a healthy body weight with adequate muscle mass for all women to have a better chance at survival of any disease including breast cancers. For this a healthy diet, lifestyle and regular exercise seems to be the need of the day. Experts suggest that to build muscles resistance training, weight training and strength training might be necessary.

Source:

https://jamanetwork.com/journals/jamaoncology/fullarticle/2677300

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Safely Exercise Outside When it’s Hot and Humid

June 26, 2018

Being outdoors is great for mind, body and soul, just be sure to adjust for current weather conditions.

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Shrimp Salad with sun-dried Tomato Vinaigrette

June 26, 2018

From our friends at the American Institute for Cancer Research and Katie McCurdy, Sous Chef of Bloch Cafe, Wexner Medical Center, Ohio, comes this colorful Shrimp Salad with Sun-dried Tomato Vinaigrette.

Shrimpshrimp with tomato Salad with Sun-dried Tomato Vinaigrette

Ingredients:

  • 1/2 cup frozen corn (no-salt added)
  • 1/2 cup cherry tomatoes (sliced in half)
  • 1 Tbsp. extra virgin olive oil, divided
  • salt and freshly ground black pepper
  • 1 head romaine lettuce
  • 8 oz. shrimp (thawed, tails trimmed)
  • 2 Tbsp. red wine vinegar
  • 1/4 cup extra virgin olive oil
  • 1 1/2 tsp. prepared mustard
  • 1 Tbsp. chopped sundried tomato
  • 1 clove garlic, roughly chopped
  • 1/2 medium avocado

Salad (makes 2 servings):
Per Serving: 310 calories, 17 g fat (2.5 g. saturated fat), 23 g carbohydrate, 22 g protein, 11 g dietary fiber, 670 mg sodium.

Sundried Tomato Vinaigrette (makes 3 servings):
Per Serving: 170 calories, 18 g fat (2.5 g. saturated fat), 2 g carbohydrate, 0 g protein, 0 g dietary fiber, 35 mg sodium.

Prep Time:15 minutes

Cook time: 20 minutes

Directions

  1. Preheat oven to 450 degrees F.
  2. On sheet pan place corn and halved tomatoes and toss with 2 teaspoons oil until evenly coated. Season with salt and pepper (you can also add some granulated garlic for more flavor.) Roast about 10-15 minutes or until tomatoes begin to tighten up.
  3. Chop lettuce to desired leaf size.
  4. In sauté pan add 1 teaspoon oil and heat to medium high.
  5. Add shrimp to pan and season with salt and pepper.
  6. Once shrimp has tightened up and turned pink (approximately 4 minutes.) Remove from heat.
  7. In a small bowl, whisk together vinegar, mustard, sundried tomato and garlic. When well mixed, slowly add the oil in a small stream; the dressing should bind together and look uniform throughout with no separating of oil and vinegar. Season with salt and pepper.
  8. Slice avocado in half and remove pit. Cut slices while still in the skin and scoop out with a spoon.
  9. Arrange lettuce on plate or bowl and top with roasted tomato and corn and avocade. Drizzle with vinaigrette and top with shrimp.
*AICR partnered with the James Cancer Center at the Ohio State University to bring you this recipe. As part of the James’ Garden of Hope program, patients and survivors receive education and coaching about healthy eating that aligns with AICR’s recommendations.

 

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The Inova Peterson Life with Cancer Family Center [VIDEO]

April 21, 2009

The Inova Peterson Life with Cancer Family Center is born thanks to the generosity of the community. Watch and learn more about Peterson Life with Cancer and its benefit to the community and the lives of the many people it serves

Peterson Life with Cancer Family Center, also known as “Carolyn’s House”, dedicated on April 7, 2009, is a free-standing resource center for cancer patients and their families. The new 16,000-square-foot facility combines the comforts of home with a place for cancer education and support of cancer patients and survivors at no additional cost. It is the only health system affiliated resource center of its kind in the Northern Virginia region.

The Family Center features a cancer information center, comfortable classrooms,  private and group counseling rooms, children’s and adult art therapy studios, a large exercise room for classes specifically designed for cancer patients, a teen lounge, a reflection garden with a waterfall, and a large dine-in kitchen for healthy eating cooking demonstrations.

Partially funded by the generosity of patients, survivors and community members, the Family Center offers a variety of education and support programs for anyone affected by a cancer diagnosis.

The Family Center is located at 8411 Pennell Street, Fairfax, VA 22031.

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