Holistic Management of Stress and Fatigue
One of the most difficult parts of living with breast cancer therapies is fatigue. Most women with breast cancer reported that fatigue persists even after the chemo or radiation therapy is over. This tiredness can cause a lot of physical pain as well as stress and cognitive problems. One of the methods to bust this fatigue is to get good sleep. Even a nap could revive and refresh you. A University of California study found that an afternoon nap could boost cognitive power and refresh the napper. Other than napping, most holistic management interventions should be done under the supervision or guidance of experts.
Cognitive-Behavioral Stress Management (CBSM) for breast cancer treatment is a program that combines stress management with relaxation training and involves muscle relaxation, imagery, meditation, and building skills such as coping strategies, cognitive power, and strong social networking. A study suggests that cognitive-behavioral stress management intervention reduced moderate depression and increased generalized optimism in the breast cancer patients. This remained significantly elevated at a 3-month follow up of the intervention.
Another study found that CBSM intervention reduced serum cortisol levels in women treated for stage I and II breast cancer. Cortisol is a stress hormone that decreases the activity of the immune cells that fight breast cancer. So, the less cortisol in your body, the better your body can fight cancer.
Holistic mind-body therapies like yoga and tai chi are similar in their effect to CBSM intervention. In a Swedish study where cognitive behavioral therapy was compared with kundalini yoga, the results indicated that both psychological variables (stress behavior, anger, fatigue) and physiological variables (blood pressure, heart rate, salivary cortisol) showed significant improvements. The researchers didn’t find any significant difference between the two therapies.
Yoga has many benefits mentioned as follows.
- relieves chronic stress and fatigue
- boosts immune system
- regulates endocrine system
- provides flexibility to the body
- relaxes the muscles
- releases free flow of energy in the body
- calms the mind thus reducing fear and anxiety
Suryanamaskar includes a set of 12 dynamic exercises that helps exercise various organs of the body and the pranayama part of the Suryanamaskar ensures free flow of oxygen and energy in the body making you physically and mentally de-stressed and fresh. In addition, it provides all the benefits mentioned above. Apart from Suryanamaskar, there are other specific asanas for each individual with breast cancer. Do not attempt yoga asanas soon after the surgery. Give it some time before restarting yoga practice. You need to seek out a qualified yoga teacher who has worked with breast cancer patients because an inexperienced instructor can increase the risk for injuries.
Meditation, also a component of yoga, may be useful as a way to relax the body and de-stress. Guided meditation is a type of meditation in which you form mental images of places or situations you find relaxing. Mindfulness meditation is based on acceptance of living in the present moment where you focus on your breathing and observe your thoughts and emotions without being judgmental. Transcendental meditation is a type of mantra meditation in which you achieve a deep state of relaxation. A single blind, randomized controlled trial has shown that transcendental meditation could significantly reduce stress and improve the quality of life in older women with stage II to stage IV breast cancer.
Tai Chi is yet another mind-body therapy that has shown potential to help women fight the side effects of breast cancer by improving quality of life and functional capacity. For example, a U.S. study published in the Medicine and Sport Science journal revealed that one hour of Tai Chi thrice a week for 12 weeks exhibited significant improvements in quality of life as well as aerobic capacity, muscular strength and flexibility. Most practitioners of this traditional Chinese exercise who have breast cancer feel that it has helped them have a positive attitude and made their recovery faster. However, you need to consult your physician before beginning Tai Chi.
Music therapy has been used as healing tool for centuries. The therapy may involve listening to music, or performing music, or writing songs, or even discussing lyrics with or without help from music therapist. It is said to influence physical, emotional, and cognitive well being and improve quality of life in women with breast cancer. According to the American Cancer Society, music therapy when used along with conventional treatment can help reduce pain, anxiety and relieve chemotherapy induced nausea and vomiting. It also relieves stress and provides an overall sense of well-being in the cancer patients. The Natural Standard Monograph has given an A-grade (strong scientific evidence for use) to Music therapy for mood enhancement, relaxation, stress and anxiety. A study published in the Journal of the Society for Integrative Oncology suggests that music therapy consisting of three individual sessions led by a music therapist showed significant immediate effects as regards relaxation, comfort, and happiness in women with metastatic breast cancer.
However, music therapy is not recommended in those who do not like music therapy because this might have a reverse effect and may result in agitation or more stress. Again, the music should reflect your personal preference to have the desired effect. Lastly, do not listen to music at high volume, it may damage the ears and lead to hearing loss.
- Travis et al. Gene-environment interactions in 7610 women with breast cancer: prospective evidence from the Million Women Study. The Lancet, Volume 375, Issue 9732, Pages 2143-2151.
- Beral V, et al. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2003 Aug 9;362(9382):419-27.
- Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002 Jul 20;360(9328):187-95.
- Hamajima N, et al. Alcohol, tobacco and breast cancer--collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer. 2002 Nov 18;87(11):1234-45.
- Harvie M, Hooper L, Howell AH. Central obesity and breast cancer risk: a systematic review. Obes Rev. 2003 Aug;4(3):157-73.
- Kruk J. Lifetime physical activity and the risk of breast cancer: a case-control study. Cancer Detect Prev. 2007;31(1):18-28. Epub 2007 Feb 12.
- Harvie M, et al.Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women''s health study. Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):656-61.
- Mueller PS, Plevak DJ, Rummans TA. Religious involvement, spirituality, and medicine: implications for clinical practice. Mayo Clin Proc. 2001 Dec;76(12):1225-35.
- Choumanova, I., Wanat, S., Barrett, R. and Koopman, C. (2006), Religion and Spirituality in Coping with Breast Cancer: Perspectives of Chilean Women. The Breast Journal, 12: 349–352.
- Winzelberg, A. J., Classen, C., Alpers, G. W., Roberts, H., Koopman, C., Adams, R. E., Ernst, H., Dev, P. and Taylor, C. B. (2003), Evaluation of an internet support group for women with primary breast cancer. Cancer, 97: 1164–1173.
- Spiegel, D., Bloom, J.R., and Yalom, I. (1981). Group support for patients with metastatic cancer. A randomized outcome study. Arch Gen Psychiatry 38(5): 527-33.
- Helgeson VS, Cohen S, Schulz R, Yasko J. Group support interventions for women with breast cancer: who benefits from what? Health Psychol. 2000 Mar;19(2):107-14.]
- Chlebowski RT, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women''s Intervention Nutrition Study. J Natl Cancer Inst 2006, 98:1767-1776.
- Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, Yount SE, McGregor BA, Arena PL, Harris SD, Price AA, Carver CS. Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol. 2001 Jan;20(1):20-32.
- Cruess DG, Antoni MH, McGregor BA, Kilbourn KM, Boyers AE, Alferi SM, Carver CS, Kumar M. Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosom Med. 2000 May-Jun;62(3):304-8.
- Granath J, Ingvarsson S, von Thiele U, Lundberg U. Stress management: a randomized study of cognitive behavioural therapy and yoga. Cogn Behav Ther. 2006;35(1):3-10.
- Nidich SI, Fields JZ, Rainforth MV, Pomerantz R, Cella D, Kristeller J, Salerno JW, Schneider RH. A randomized controlled trial of the effects of transcendental meditation on quality of life in older breast cancer patients. Integr Cancer Ther. 2009 Sep;8(3):228-34.
- Mustian KM, Palesh OG, Flecksteiner SA. Tai Chi Chuan for breast cancer survivors. Med Sport Sci. 2008;52:209-17.
- Hanser SB, Bauer-Wu S, Kubicek L, Healey M, Manola J, Hernandez M, Bunnell C. Effects of a music therapy intervention on quality of life and distress in women with metastatic breast cancer. J Soc Integr Oncol. 2006 Summer;4(3):116-24.
- What Causes Cancer? - (http://www.cancer.org/Cancer/BreastCancer/OverviewGuide/breast-cancer-overview-what-causes)
- Evaluation of the current knowledge limitations in breast cancer research: a gap analysis - (http://breast-cancer-research.com/content/10/2/R26#B108)
- Limit alcohol consumption - (http://www.wcrf-uk.org/preventing_cancer/recommendations/alcohol_and_cancer.php)
- Science Translational Medicine: Iron Regulation Linked to Breast Cancer Survival Rate - (http://www.aaas.org/news/releases/2010/0805sp_cancer.shtml)
- Nutrition for Breast Cancer Patients and Survivors - (http://www.hopkinsmedicine.org/avon_foundation_breast_center/treatments_services/nutrition.html)