What To Do When a Loved One is Diagnosed with Cancer

As a first year medical student, one of my worst fears came true. My mom was diagnosed with cancer. It was terrifying to think of potentially losing her, and my mind was racing with all of the terrible side effects that the chemotherapy, surgery and radiation might cause her. 

Fortunately, she made it through the treatment with flying colors, and is still here today living her best life. It’s because of her diagnosis that I selected the field of radiation oncology for my career. 

One thing I remember from that time was having the strong urge to do something. What could I do? How could I help? Was there something I could do that would actually make a difference?

The number one thing I would recommend doing for your loved one who has received a cancer diagnosis is to introduce them to the concept of mindfulness during their treatment and recovery.

We know that the mind can help heal the body, so by spreading this knowledge you can actually improve your loved one’s experience of their treatment, and their outcome!

Recently, I was able to discuss with my mom her approach during treatment. She has a strong faith, and there was a lot of prayer! Also, I’d like to share with you today her mindfulness technique that she used when receiving radiation treatments. You can pass this along to your loved one.

Mindfulness exercise for radiation treatment:

On the treatment table, close your eyes and relax, focusing on slow deep breathing, extending the exhalation longer than the inhalation. You may choose to say a prayer asking for God’s healing power, and asking for wisdom and skill to be with the techs and medical team. Once the treatment begins, visualize a shining ray attacking the cancer cells (and only the cancer cells) specifically sparing any normal cells nearby. Zap, zap, zap…each cancer cell or group of cells wherever they are hiding are destroyed by the ray. Healthy cells are left unharmed. Imagine your own immune cells being recruited in and gearing up to join the ray in the fight against the cancer cells. All the while, remain present with your breath.

You may choose to share the exercise with a loved one who is heading into radiation therapy. You may also consider providing a gift for your loved one, such as a personalized meditation pack to be used during their treatments or some private coaching sessions with me. Head to my website for more information:

Feature Publication: Psychologic interventions improve survival in breast cancer

On occasion, I am going to highlight a scientific study that I find interesting, helpful or exciting. This week I am discussing a trial published in the journal Cancer in 2008. (1) It is titled “Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial.”

Isn’t it amazing to learn that psychologic interventions (which included mindfulness techniques) not only improve quality of life, but also extend survival?!

In this study, 227 patients with breast cancer who had undergone surgery and were preparing for subsequent treatment were randomly assigned to psychologic intervention with periodic assessment, or assessment only.

What was the intervention, you might ask?

The interventions were conducted in small groups and directed by 2 psychologists. The groups met for 4 months of weekly sessions, followed by 8 monthly sessions for a total of 26 sessions (39 therapy hours) over 12 months.   The goals were reducing stress, improving mood, altering health behaviors and improving adherence to cancer treatment.

Strategies included:

  • progressive muscular relaxation for stress reduction
  • teaching problem solving skills
  • identifying supportive friends and family for help
  • teaching assertive communication techniques
  • increasing daily activity, such as walking
  • improvement of dietary habits
  • advice on managing treatment side effects.

In two separate publications, it was reported that the patients receiving the interventions had improvements in all endpoints compared to the control group. These included psychologic, behavioral, health, immunity, and survival.

Patients who regularly attended the intervention sessions had a reduced risk of breast cancer recurrence and lower risk of dying from breast cancer. They also had reduced risk of death from all causes. This was independent of known predictors of breast cancer progression, such as lymph node status, receptor status, histology and others.

In the paper’s discussion, it is noted that patients in the intervention arm with the greatest reduction in distress were those who practiced the progressive muscular relaxation daily, and remembered (daily) that continued stress could adversely effect their health. They learned that stress could be controlled/reduced by using the mindfulness technique they had been taught. Other publications have also shown that uncontrolled stress results in poorer survival in cancer, possibly via hormonal and immune mediated pathways.

If you have cancer, this paper highlights why you should add a daily mindfulness exercise to your routine. I have 2 free progressive muscular relaxation sessions on my website for you to try (Day 1 and Day 7): www.jointhecircleofhope.com/meditations.

Four Common Meditation Myths

As I began to teach meditation and recommend it to my patients, friends and colleagues, I noticed a lot of common misconceptions that were often holding people back. This blog is dedicated to debunking these myths.

You must sit a certain way.

Let’s be honest. When you think of meditation, one of the first things that comes to mind is a Buddhist monk with eyes closed sitting bolt upright, legs twisted into a pretzel and hands on knees serenely pointing triangles towards the sky. If you thought you had to sit in a certain position to meditate, you are not alone.

As I’ve deepened my practice, I’ve come to find that the most important thing about positioning the body for meditation is to be comfortable.

Beyond that, any position is acceptable. Many people practice meditation lying down, or even walking. Eyes can be open or closed. Your experience of the moment is the focus, and if you are distracted by discomfort in your body, it will likely only take away from the experience.

You must spend a lot of time.

It does not take long to begin to notice the benefits of meditation. In fact, in one study in a pediatric population, children were led through a mindfulness exercise for 5 minutes before a medical procedure. Even with this minor intervention, a decrease in perceived stress during the procedure was noted.

Within your life, benefits are noticed for practicing as little as 5-10 minutes per day. In other words, you do not need to commit hours upon end to notice the benefits of your practice. You can spend less time than you do scrolling through your social media accounts!

You must not think/possess the ability to clear your mind.

This is one of the most common misconceptions that I hear. If you can’t clear your mind, you are incapable or bad at meditation. Quite the contrary! As you practice meditation, thoughts are welcomed as a part of the flow of the present moment experience. The more you fight against them, the more frustration builds. Resisting and battling your thoughts is counterproductive. Instead, opening to your thoughts from a detached place of observation, nonjudgment and acceptance naturally results in a more calm and peaceful state of mind.

“The towns and countryside that the traveler sees through a train window do not slow down the train, nor does the train affect them. Neither disturbs the other. This is how you should see the thoughts that pass through your mind when you meditate.”

Dilgo Khyentse Rinpoche

Mindfulness meditation is difficult/I wouldn’t know how to do it.

Have you ever sat silently upon the beach, completely enthralled with the beauty of the rising sun, heard the sound of the waves crashing, felt the sand between your toes, in awe of the beauty of nature? Or maybe you’ve rested quietly at the peak of a mountain, observing the soft flutter of snow gently building upon the vast landscape and towering evergreens? If so, you have meditated. Mindfulness meditation does not have to be a complex process. Simply paying attention now is all that is needed.

Please comment below if you have other thoughts about meditation that are holding you back from starting your practice. I’ll do my best to address them!

Exploring the Science Series: Meditation for Pain

Chronic pain is defined as pain lasting more than 3 months.  Unfortunately, it is extremely prevalent. In the United States, 20% of adults suffer from chronic pain, with 8% experiencing debilitating pain. For all of my Australian followers (yes, I’ve noticed you and thank you for reading!), the numbers are very similar.  There is slightly more prevalence for females, and increasing prevalence with age (31% in females age 80-84). There are an estimated 5-8 million Americans with chronic pain currently on opioids. 

If you are someone experiencing pain, what can be done? 

Of course, my answer is predictable. Meditation! 

Let’s review some of the relevant literature.

If you are in pain, your body is trying to tell you something. It’s yelling, “HEY YOU! OVER HERE!! PAY ATTENTION TO ME!!!” Although some types of meditation practices may teach you to ignore pain, or become immune to it, others may actually help your body to heal the pain.

You’ve probably heard of the “placebo effect”  (For those of us in medicine, it’s the “annoying” ever-present factor in clinical trials that mucks up our results. Haha.) The placebo effect is a beneficial effect of a placebo drug (a sugar pill) that cannot be attributed to the placebo itself, and is therefore attributable to the patient’s belief in the treatment.

Trials in patients with chronic pain have been done comparing opioid pain medication with placebo. Roughly half of patients taking a placebo notice a greater than 30% improvement in their pain level. Furthermore, 35% of patients taking a placebo noticed a greater than 50% improvement in their pain level! These sugar pills are powerful stuff! (1)

The placebo effect is a display of, right there in black and white published in the scientific literature, the POWER OF THE HUMAN MIND. It’s truly remarkable.

So…sugar pills can reduce pain via the mind-body connection, but does meditation? 

The answer is yes. A multitude of studies have shown that meditation reduces pain, and the effect is even greater than that of placebo. Here are a few examples:

John Kabat Zinn, the pioneer of mindfulness who created Mindfulness Based Stress Reduction (MBSR), published a study in 1985 showing that a 10-week MBSR program resulted in statistically significant reductions in present-moment pain, negative body image, inhibition of activity by pain, and mood disturbance (specifically anxiety and depression). Pain-related drug utilization decreased, and activity levels and feelings of self-esteem increased (2).  In theory, this type of meditation may help to decrease pain by guiding participants to be more versed at experiencing only the physical quality of pain without the mental overlay of negative thoughts and judgment, which subsequently lessens the perceived pain intensity.

Second, a study in veterans with chronic pain by Dr.’s Nassif and Norris showed that during the first few weeks of meditation practice, pain actually increased.  The pain was brought to consciousness and more fully experienced (instead of ignored or medicated). Subsequently, with continued practice, the pain lessened and for some even disappeared by 8 weeks of practice (3).

There are many more examples, but let’s switch gears a bit.

We know that meditation reduces pain… but, how?

 Activation of different neural pathways: A team of researchers led by Dr. Zeidan in 2015 performed a study comparing mindfulness meditation with placebo and showed that mindfulness meditation resulted in greater pain relief than placebo.  It was associated with greater activation in brain regions associated with the cognitive modulation of pain, including the orbitofrontal, subgenual anterior cingulate, and anterior insular cortex.  These are different neural pathways than are activated with placebo (4).

Thalamic gating theory: There is a theory of pain called the thalamic gate theory which hypothesizes that the brain can be in a receptive state to receive incoming pain information (gates open), or can be in a blocked state (gates closed).  This is best illustrated in traumatic injuries, when patients are under stress and often don’t register the pain associated with a severe injury until they are away from the threat. At the time of threat/greatest stress, the pain gates are closed as a protective mechanism to allow the person to escape the threat. Once the threat is gone, the gates are opened allowing the pain to be experienced. Attention on the experience of pain in the body has been shown to be a critical element in activating the body’s ability to heal itself.

Physical changes in brain structure: Another mechanism through which meditation is seen to achieve positive results for pain is through the neuroplastic properties of the brain, as mentioned in my previous blog. The structure of the brain can change through meditation. There is a bulking up of areas that are important for pain processing, resulting in higher pain tolerance (5).

In sum, although the mechanisms aren’t fully fleshed out, we do know that meditation works to lessen, and sometimes eliminate pain. 

If you’d like to implement meditation into your routine for chronic pain, I’d suggest starting with a progressive full body relaxation once per day, like the number one and seven meditations listed here: www.jointhecircleofhope.com/meditations