Living Well with Cancer
Cancer is a profoundly stressful disease. The emotional distress of a cancer diagnosis and the persistent side-effects of treatment can significantly compromise one’s quality of life. According to the National Cancer Institute (NCI), approximately 40% of men and women will be diagnosed with cancer at some point during their lifetimes.
Since the prognosis associated with a cancer diagnosis has markedly improved, the number of cancer survivors in the U.S. increased to nearly 14.5 million people in 2014, with a prediction of almost 19 million cancer survivors by 2024. Still, we can all expect to be touched by cancer at some point in our lives.
When it comes to cancer, there isn’t one specific answer for every case. Decisions for care are personal with multiple factors to consider—type, location and progression of the cancer, genetic make-up of the patient, resources available, and the person’s health and spiritual beliefs. For some, medicine might provide a cure. However, even without a specific cure, more is known today about managing the cancer and still thriving with a chronic disease.
The common wisdom for achieving wellness in our daily lives suggests that we exercise, rest adequately, eat nutritiously, manage stress, connect with others, and find purpose and meaning in our lives. Making a commitment to these lifestyle choices is even more important in the face of cancer—and more challenging because of the symptoms and side-effects of both the illness and its treatment.
Get Enough Exercise and Proper Rest
Cancer-related fatigue (CRF) is experienced by approximately seven in 10 patients. By definition, CRF is neither caused by activity nor relieved by rest, and it interferes significantly with daily life. With such fatigue, how can one be expected to exercise, even while knowing that exercise is beneficial to overall health?
A simple place to start is with gentle movement that you already enjoy—for example, walking, gardening, bicycling or swimming. If you want to explore mind-body options, consider yoga, qigong and tai chi. Qigong (less well known) uses gentle physical movement, breath and meditation to harmonize the body, mind and spirit. The slow moving, moderate-intensity and energy-conserving features of qigong make it an appropriate exercise for cancer patients.
In a study reported in the Annals of Oncology (Oh, 2010), 162 patients with a range of cancers were randomly assigned to either a 10-week qigong intervention or to usual care. The qigong group showed significant improvement over the usual care group in all outcomes measured––overall quality of life, cancer-related fatigue, mood state (specifically anxiety and depression) and inflammation. There were no adverse side-effects.
The authors concluded that qigong is both safe and effective for cancer patients. Whatever exercise you choose will be helpful—as long as you actually participate. With short and regular practice, you accrue the benefits, while pacing yourself to conserve energy. Not to mention, daytime activity encourages a much-needed improved night’s sleep.
Nourish Your Body to Promote Healing
Paying attention to nutrition is especially important if you have cancer because both the illness and its treatment can affect your appetite and the body's ability to tolerate certain foods or absorb nutrients. Malnutrition can occur if you are eating less than your body needs, if you are eating the wrong kinds of foods, or if your body is unable to digest and absorb your food.
Depending on the type of cancer, the prevalence of malnutrition ranges between 15% and 80%, and can contribute to fatigue, diminished quality of life, interruption in treatment and complications after surgery. Consult a professional who is qualified to guide you—for example, Dietitians, Doctors of Oriental Medicine or Naturopaths.
The American Institute for Cancer Research (AICR) website describes many potential cancer-fighting foods. They offer this general advice: Eat a varied diet high in vegetables, fruits, whole grains and beans. Favor brightly colored or strongly flavored vegetables and fruits which are often the best sources of phytochemicals. Stick to food sources––phytochemicals in supplement form might not be as easily absorbed––and avoid processed foods.
In this era of targeted cancer treatment strategies, researchers are studying the effects of manipulating the diet to exploit the inherent differences between normal and cancer cells. Some studies are finding that diets high in fat and low in protein and carbohydrates deprive cancer cells of glucose, making them more easily found and killed by both radiation and chemotherapy.
Manage Stress through Healthy Outlets
The fight-or-flight stress response has evolved as our survival mechanism. When we encounter a life-threatening situation, a surge of stress hormones prepares us to fight or flee. All those surging stress hormones take a toll on the body––increased inflammation (which provides an attractive environment for tumor growth), shortened telomeres (which accelerate aging at the cellular level) and a weakened immune system (less able to defend against tumors and their spread).
We can counteract these damaging effects of the fight-or-flight response by learning to elicit the “relaxation response” (RR). One hypothesis is that mind-body practices (mindfulness, yoga, tai chi, qigong, relaxation, breath regulation) reverse the expression of genes related to stress-induced inflammatory reactions.
Frontiers in Immunology published a review of 18 studies which indicates that mind-body practices are associated with a down regulation of nuclear factor kappa B (NF-kB) genes. This is the opposite of the effects that chronic stress has on gene expression and suggests that mind-body interventions can lead to a reduced risk of inflammation-related diseases (, 2017).
All of these mind-body practices share two basic components. The first is focusing attention through repetition (a word, prayer, phrase, physical activity, breath or sensation in the body). The second is kindly returning to the focus whenever a distraction has drawn the attention away. The common denominator these methods is they interrupt the train of everyday mindless thoughts, disengaging the stress response.
No single method works for everyone, and it might take some exploration and practice before you find the method that feels right for you. Consider exploring this meditation website which contains guided mindfulness meditations on Kindness, Awareness, Rest, and Allowing (KARA), specifically for people who are touched by cancer: ThisIsKARA.com.
For opportunities to learn mindfulness meditation locally, the Sarasota Mindfulness Institute offers weekly meditation sessions, introductory classes and the nationally recognized Mindfulness-Based Stress Reduction (MBSR) eight-week training program.
Forge Connections with Other People
The need for friends in our lives is as essential to our well-being as healthy sources of air, water, food and physical activity. Without relationships, we cannot experience a wholly fulfilled life. A 2001 Duke University study suggested the magnitude of the health risk associated with social isolation is comparable with that of cigarette smoking.
Social isolation has been clinically linked to chronic illnesses such as heart disease and shown to have a significant impact on the likelihood of experiencing illness in general. It has also been shown to have a dramatic impact on the process of recovery from either illness or injury. As social animals, perhaps the reason we suffer illness as a result of social isolation is because feeling isolated causes us to experience chronic stress. For ideas on how to create and nurture positive social connections, visit SocialWellness.wordpress.com.
Might it be this stress—and the harmful hormones associated with stress—that weakens our immune systems and make us sick? A place to begin increasing our connection and social wellness might be to thankfully accept the generous help offered by others. Take small steps toward creating and nurturing positive social connections. Live each moment fully and with purpose. You might find that one small step leads to another.
Nancy is a certified holistic nurse, teaching Qigong, Tai Chi Easy and Mindfulness Meditation in Sarasota. For information, visit SarasotaMindfulness.com.