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Archive for February, 2012

According to the International Journal of Yoga, January 2012 paper, Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients:

It is now recognized that diabetes mellitus (DM) is a lifestyle and psychosomatic disorder in which factors such as sedentary habits and physical, emotional and mental stress play a major role. Modern research has focused on psycho-physiological beneficial effects of yoga as it is more than a physical exercise. It has been reported that even a short life-style modification and stress management education program based on yoga reduces risk factors for cardiovascular disease and DM within 9 days while a systematic review of 32 articles published between 1980 and 2007 found that yoga interventions were generally effective in reducing body weight, blood pressure, glucose level and high cholesterol. 

The  study evaluated the effect of yoga therapy on reaction time, biochemical parameters, and the wellness score of  15 peri and post-menopausal diabetic patients.  The patients participated in a comprehensive yoga therapy program where they received training for a one-hour session three times a week  for six weeks. A post-intervention, retrospective wellness questionnaire was used to evaluate the comparative feelings of the patients after the therapy program. The study was unable to have a control group.

Yoga training reduced the auditory reaction time (ART) from right as well as left hand. According to the paper, reduced ART implies better information processing ability and reflexes. In addition, there were significant improvements in blood glucose levels, low density lipoproteins (LDL), high density lipoprotein (HDL), total cholesterol levels, and triglyceride levels. The patients also reported a greater feeling of well being. The study concluded that yoga therapy can have role in managing diabetes as part of integrative and complementary medicine.

Table 1 in the study gives the sequence and duration times  of yoga asanas and pranayamas used as yoga therapy.

I would like readers to note that these were done under medical supervision and that the same may not be appropriate for everyone. An experienced yoga therapist, along with a medical provider, must be consulted for individual situations. A single program cannot be applied across the board for everyone.

Source: Madanmohan, Bhavanani AB, Dayanidy G, Sanjay Z, Basavaraddi IV. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post-menopausal diabetic patients. Int J Yoga [serial online] 2012 [cited 2012 Feb 27];5:10-5. Available from: http://www.ijoy.org.in/text.asp?2012/5/1/10/91696

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Pooling together the recommendations of readers of this blog (thank you for sharing!) and my own suggestions for outstanding websites on research information regarding complementary therapies, here is a list of seven:

1. www.berniesiegelmd.com (support, positive spirit-based approach)

As a physician who has cared for and counseled innumerable people whose mortality has been threatened by illness, Bernie embraces a philosophy of living and dying that stands at the forefront of the medical ethics and spiritual issues our Society grapples with today. In May 2011, Bernie was honored by the Watkins Review of London, England, as one of the Top 20 Spiritually Influential Living People on the Planet. He continues to break new ground in the field of healing, supporting changes in medical education to “humanize” medical practice.

Source: http://www.berniesiegelmd.com

This is a commercial website that offers support as well. We normally do not recommend commercial websites/products. However, many readers have found Dr. Siegel’s books helpful in developing a positive attitude toward cancer and mortality. His books are widely available at many public libraries and so our readers do not have to purchase anything.

2. www.eckharttolle.com (support, positive spirit-based approach, free online videos of Tolle’s talks, online courses, interviews, newsletter)

Eckhart is a spiritual teacher and author who was born in Germany and educated at the Universities of London and Cambridge. At the age of 29, a profound inner transformation radically changed the course of his life. The next few years were devoted to understanding, integrating and deepening that transformation, which marked the beginning of an intense inward journey. Later, he began to work in London with individuals and small groups as a counselor and spiritual teacher. Since 1995 he has lived in Vancouver, Canada. Eckhart Tolle is the author of the #1 New York Timesbestseller The Power of Now (translated into 33 languages) and the highly acclaimed follow-up A New Earth, which are widely regarded as two of the most influential spiritual books of our time.

This is a commercial website. Again, this blog does not normally recommend commercial sites. However, Tolle is a best-selling author whose books are widely available at most public libraries and readers do not have to purchase them. In addition, the site does offer a considerable amount of free, helpful content.

Source:www.eckharttolle.com

3. www.insightmeditationcenter.org (meditation instruction based on vipassana, audio and printed transcripts)

The Insight Meditation Center (IMC) is a community-based urban meditation center for the practice of vipassana or insight meditation guided by Gil Fronsdal and Andrea Fella.

The site offers support and some free online transcripts and beginner’s classes on insight meditation.

Source: http://www.insightmeditationcenter.org

4. www.mahasriyoga. com (meditation and breathing instructions; numerous Yoga Nidras, guided meditations, breathing/pranayama online audio tracks)

This non-commercial website has numerous online Yoga Nidras, guided meditations, breathing, and pranayama tracks (including Gujarati tracks). It also features in-depth yoga and meditation book reviews. There is a good selection of  vegetarian, vegan, low-carb, and gluten-free recipes.

Source: www. mahasriyoga.com

5. www.nccam.nih.gov (research)

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government’s lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.

Source: http://www.nccam.nih.gov

This is perhaps the best website for research and evaluations of different therapies.

6. www.pedcam.ca (research and support)

Created in 2004, the Pediatric Complementary and Alternative Medicine Research and Education (PedCAM) Network is a Canadian network that aims at disseminating a wide range of CAM information and building collaborative relationships between researchers, educators, clinicians, and policy-makers, both nationally and internationally. PedCAM is an academic, non-commercial organization, housed within the Complementary and Alternative Research and Education program, Department of Pediatrics, University of Alberta.

Source: http://www.pedcam.ca

7. www.rccm.org.uk

The Research Council for Complementary Medicine (RCCM) is a UK-based charity founded in 1983, dedicated to developing high quality research in CAM. 

Source: http://www.rccm.org.uk

The site provides links to many research journals.

This selection covers research, support and positive approach, as well as free online mind-body therapy audio tracks. Readers do not have to spend hundreds of dollars to have access to excellent guided and mindfulness meditations. Our selection also reflects the global readership of this blog and how patients and families are able to access the best information from around the world.

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Life was good to Sam and Sally (not their real names) after years of hard work as immigrants to the US. The family had moved to a lovely home and Sam was the president of his community’s large local organization. He was organizing big events for the community and involved in many charities. Then came the shattering diagnosis of lung cancer to a man who lived simply but joyfully, never smoked, and drank only occasionally.

His wife, Sally, was totally devastated. They sought the best medical advice and treatments. The oncologists at New York Presbyterian laid out all the options and pros and cons. The couple was also interested in complementary and alternative medicine (CAM) as part of the overall treatment. Their oncologists were all well aware of these therapies and were open and supportive about them.

So along with the best conventional care, Sam added ayurvedic herbal treatments and medicinal teas (not allowed during chemotherapy). The herbs and ayurvedic medicines were sent by family members in India. Every day, Sally gave him freshly squeezed fruit and vegetable juices along with wheat grass juice. She boiled milk with turmeric, a powerful antioxidant. Often, she was up at 4:30 in the morning to get everything ready for him before leaving for work.

In addition, they started practicing various pranayamas including nadi shodhana and bhastrika. There was a practice of appropriate asanas whenever he could do them. The breathing practices of pranayama eased his breathing which became progressively more labored. Asanas made his body feel better.

All these CAM therapies of herbal additions, diet, and yogic practices helped tremendously in making Sam feel better and improving his quality of life as he underwent rounds of chemotherapy. There were good days and awful days. In fact, Sally told me that their oncologists said that faced with cancer, they personally would choose CAM. This is of course a highly personal and individual decision as we have seen our own family members deeply skeptical about adding any non-conventional treatments.

After five years, Sam’s body succumbed to cancer. Throughout the five years, he was loved and cherished by his wife, children, extended family, and friends. The experience of being loved and cherished can be enormously important in healing or coping with a disease like cancer. In turn, Sam never complained while maintaining a cheerful and positive attitude. There was no anger or resentment. Sam accepted life and this made it easier for his family.  Personal attitude can also play a big role in how pain and illness is experienced.

In the end, the cancer was in the body. It never ever affected Sam’s heart, mind, or spirit which were always clear and free.

Many thanks are due to Sally for talking and sharing her painful five years that altered her life forever. As we can see from these personal stories, there are many paths to healing and dealing with illness and cancer.

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A dear friend of mine in Mumbai had breast cancer several years ago. In fact, she is the one who took me to my first yoga class over 30 years ago. In 2007, when I was looking into yoga and cancer, I asked her about her own personal experience. It is hard to talk about intensely personal issues and I am truly grateful to her for sharing this experience.

Yoga really works! It was pranayama and practices involving visualisation that was most effective for me. Radiation (I did not have chemo) can be a frightening and wearying experience. Fear and fatigue dissolve through visualising while tuning in to the rhythm of the breath.

Humour helps! My friend told me to visualise the “rays” as Cupid’s arrows. As regards asanas, it was recommended that no body weight be taken on the arms (for example, downward dog pose) in the first month. But it is most important at the right time to do stretching and raising of the arms because the nerves and muscles feel numb in the area of surgery (and very stiff).

Yoga Nidra, the book Love Medicine & Miracles by Dr. Bernie Siegel, and Eckhart Tolle‘s The Power of Now are worth reading. But the greatest healing comes from letting go; I mean resolving old hurts through forgiveness, of others, and most importantly forgiving oneself. You have to do a mental turning away from old conditioning (ever so difficult), but the feeling of GRATITUDE for being alive and receiving so much kindness or abundance is the way to healing.

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Mind-body therapies that include yoga, meditation, relaxation techniques, and guided imagery can help significantly in several ways and reduce stress. I would like to begin with, “Cancer Care for the Whole Patient”, a 2007 report written by the Institute of Medicine (IOM). The report offers guidelines and recommendations to medical caregivers. Here are abstracts:

Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. 

The burden of illnesses and disabilities in the United States and the world is closely related to social, psychological, and behavioral aspects of the way of life of the population. (IOM, 1982:49–50)

Health and disease are determined by dynamic interactions among biological, psychological, behavioral, and social factors. (IOM, 2001:16)

Because health … is a function of psychological and social variables, many events or interventions traditionally considered irrelevant actually are quite important for the health status of individuals and populations. (IOM, 2001:27)

According to the paper cited below and in previous blog posts, sustained stress has negative consequences on health because of its “profound” psychological, behavioral, and physiologic effects. Therefore it makes sense to decrease stress and help patients adjust to cancer treatment, the complications that occur, and the adverse reactions that are suffered. There could be implications in improving future health as well.

Yoga, meditation, relaxation techniques, and guided imagery are among the mind-body therapies that are now mainstream. An analysis of 116 studies (Journal of the Society of Integrative Oncology report) found that mind-body therapies reduced anxiety, depression, mood disturbance, and improved coping skills in patients.  In addition, there is further evidence to support the use of these therapies for hypertension, insomnia, nausea, reduction in procedural pain, decrease in stress hormones, and an improvement in immunity in cancer patients.

In a study that used a seven-week Mindfulness-Based Stress Reduction (MBSR) for breast and prostate cancer patients, there was a significant decrease in the cortisol and inflammatory cytokines levels versus the control group. The positive effects continued for 6-12 months after the training. MBSR includes meditation, yoga, and group dynamics.

In another yoga-based study on breast cancer (stage O-II) in India, 83% of women were undergoing radiotherapy and no chemotherapy. The study found improved quality of life, increase in natural killer cell toxicity and decreased inflammatory cytokines and cortisol levels in the yoga group versus the control group. Yoga included stretching, breathing, and meditation.

Similar results were found in a breast cancer study in India where women received yoga versus supportive therapy as they underwent conventional treatment which included chemotherapy. In the yoga group there was a significant decrease in the frequency and intensity of nausea related to chemotherapy. Patients reported better quality of life, mood, the natural killer cells were significantly higher in the yoga group and there was less DNA damage versus the control group.

These mind-body techniques need to be practiced regularly and as patients see the positive effects they feel a greater sense of control over their lives. They may be able to create a positive cycle that could be helpful in coping and treatment. Mind-body therapies can potentially transform the meaning of cancer and mitigate the stress it invariably brings.

Source: “Evidence-Based Clinical Practice Guidelines for Integrative Oncology: Complementary Therapies and Botancials”, Journal of the Society of Integrative Oncology, Vol 7,  No 3 (Summer) 2009, pp: 85-120

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The table below summarizes the ways in which complemetary and alternative medicine (CAM) may be helpful. The table is this blog’s compilation based on the information in the paper cited below.

Acupuncture   pain, nausea and vomiting due to chemotherapy
Energy therapies magnetic field therapy, reiki, Healing Touch, qi gong are not fully understood—may help reduce stress and pain
Massage and reflexology   anxiety, pain
Mind-body therapies meditation, guided imagery, expressive arts (art, dance, music), cognitive-behavior therapy anxiety, mood disturbance, chronic pain, quality of life, fatigue, nausea

It is arguable whether physical activity falls under CAM or not and it is for this reason that it is being added separately in this post. Physical activity may be recommended for quality of life, physical functioning, emotional well-being, fatigue, cardiovascular fitness, muscular strength, and body composition.

Clearly, people should seek out highly qualified and experienced individuals for all these treatements.

 Source: “Evidence-Based Clinical Practice Guidelines for Integrative Oncology: Complementary Therapies and Botancials”, Journal of the Society of Integrative Oncology, Vol 7,  No 3 (Summer) 2009, pp: 85-120

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