Complementary Therapies in Cancer Care

An ongoing series highlighting complementary therapies, adapted from The Complete Guide to Complementary Therapies in Cancer Care By Barrie R. Cassileth, MS, PhD

Complementary therapies are noninvasive, non-pharmacologic adjuncts to mainstream treatment. They improve patients’ strength and control of the physical and emotional symptoms associated with cancer and other illnesses. They provide self-help guidance to enhance body and soul at times when one feels vulnerable and life seems out of control. Complementary therapies are used as adjuncts to mainstream care of cancer and other illnesses, not as substitutes. They improve physical and emotional function and manage stress and symptoms of aging, regardless of health status. Complementary therapies are rational, evidence-based practices delivered or taught by trained practitioners. They include mind-body practices such as meditation and self-hypnosis; massage therapies; nutritional counseling; physical fitness, including programs such as aerobic exercise, qigong, tai chi, yoga, and many other practices; music therapy; and acupuncture.

MEDITATION

Meditation is among the most accepted complementary therapies in mainstream medicine. Its origins lie in the work of shamans, or early priests, who meditated while seeking guidance from the spiritual realm. Every major religion in the world has regarded and used meditation as a link to spiritual enlightenment. Hypnosis, especially self-hypnosis, may be seen as a deeper form of meditation. Both have ancient origins in magic and religion.

Meditation gained serious attention in Western cultures in the 1960s. As word spread of Eastern masters able to perform remarkable feats of bodily control and achieve altered states of consciousness, people in Western countries became increasingly fascinated by meditation. Health practitioners and researchers became interested in understanding how the mind could produce physiologic changes in the body. Meditation’s purported ability to achieve physical benefits was a natural springboard for the curiosity and the research activity that continues to this day.

 

What Is It?

Meditation has been described in varying, often extreme terms. Viewed by some as a means of maintaining attention pleasantly anchored in the current moment, it has also been canonized as a catalyst for world peace. As emphasized in most Asian traditions, mental control is the foundation of meditation, and mental control also lies behind the application of meditation as a complementary healing technique. Mental mastery is believed capable of producing physiologic and emotional change. The goal is to improve health in general and facilitate the healing of certain disorders.

Across its many varieties, meditation includes certain common procedures. The meditator sits or rests quietly, usually with eyes closed, in a peaceful environment devoid of distractions. Mental exercises geared to channel concentration and relax the body are performed. The aim is to stay relaxed yet alert. Typically, a point of concentration is selected. This can be an object, a word, a sound, a mantra, an action, or merely the rhythm of one’s own breathing. Many practitioners also adopt a passive, receptive attitude in which fleeting thoughts are disregarded without reflection. Saint Francis of Assisi likened these thoughts to birds flying overhead that should be observed without “letting them nest in the hair.”

 

What Practitioners Say It Does

Meditation is often lauded as a means of managing stress. Stress is now widely acknowledged as contributing to and exacerbating many health problems. Therapies such as meditation have many proponents because these approaches provide effective relaxation techniques that help patients deal with stressful situations.

During meditation people learn to redirect their attention to the present, reacting to neither memories of the past nor thoughts of the future. Preoccupation with past and future is believed to be a major source of chronic stress.

The mental training that meditation provides teaches individuals to be aware of what causes their stress, thereby giving them a sense of control. Control makes the difference between positive and detrimental stress. The benefits of relaxation and stress reduction, in turn, can reduce levels of stress hormones, improve immune function, diminish chronic pain, improve mood, and even possibly enhance fertility. Quieting the conscious mind is believed also to allow the body’s inner wisdom, or “internal physician,” to be heard. That is, meditation promotes the body’s ability to heal itself.

Further benefits attributed to meditation include enhanced immune function in individuals with chronic diseases such as cancer and AIDS. Practitioners also claim success with meditation included as part of the treatment of patients with hypertension and heart disease. It is also considered useful in assisting rehabilitative therapies for alcohol, drug, and other addictions.

Devotees say that with regular, long-term meditation, they experience personal and spiritual growth. They claim richer sensory experiences, greater alertness, and increased mental efficiency—as well as the ability to access deeper levels of awareness. Some even attest to a mystical sense of oneness with God or the universe.

 

Beliefs on Which It Is Based

The major foundation for the popularity of meditation, especially as a benefit to personal health, is the belief that the mind can cause changes in the body. Many cultures, particularly in Asia where meditative strategies have long been included in health regimens, have relied on this idea for millennia. A more recent underlying belief is the idea that stress itself has harmful effects on the body. Because meditation emphasizes mental training and relaxation and imparts a sense of control, it is considered a potent agent against stress and anxiety. That is part of the reason why meditation has gained widespread acceptance as a valid, beneficial medical therapy.

 

Research Evidence to Date

Many studies have documented the correlation between meditation and the reduction of stress, anxiety, and panic states. Research documents the relaxation response produced by meditation and prayer, a response involving decreased heart and respiration rates and eased muscle tension. Meditation has also been shown to help control negative thinking and assist people in managing potentially stressful situations in a calm fashion.

Research evidence shows that meditation helps decrease chronic pain. Meditation performed regularly over an eight-week period reduced participants’ pain by as much as 50 percent.

 

There’s Meditation and Then There’s Transcendental Meditation

During the rise in popularity of meditation in the 1960s, Maharishi Mahesh Yogi, a physics scholar from India, developed a version of the practice called transcendental meditation (TM). TM is based on ancient Indian practices and is similar to other forms of meditation such as Zen, yoga, progressive relaxation, and other means of eliciting deep relaxation, but promotional materials claim that TM also teaches mastery of the forces of nature, enabling students to become invisible, walk through walls, fly unassisted, and develop “the strength of an elephant.” Devotees claim that TM is the vehicle for enlightenment and even world peace.

Accepting these beliefs is not prerequisite to benefiting from the practice of TM. Its physiologic benefits, which are shared by other types of meditation and are not unique to this particular approach, are well documented. But flying through the air? Becoming invisible? These aspects likely don’t make sense to most of us.

 

What It Can Do for You

The relaxation, stress reduction, and pain relief benefits of meditation are well documented. It has been found to reduce lactic acid, which is associated with anxiety. Mainstream medical practitioners often recommend meditation as an adjunct to conventional treatment or as a preventive health measure.

Meditation can ease muscle tension, lower oxygen consumption and heart rate, and, with practice, decrease blood pressure. Therefore it is often recommended for patients with hypertension or heart disease in conjunction with dietary and other positive lifestyle changes. Regular practice of meditation can enhance one’s sense of control and improve self-esteem. Meditation can also promote spiritual growth, calm, and serenity.

 

Where to Get It

Assistance with meditation is available from practitioners, including psychiatrists and other mental health professionals, stress reduction experts, yoga masters, and clinics at many major medical centers and local hospitals.

Many organizations offer related services and information as well as audio recordings that teach meditation. A relatively recent recording called The Eight Minute Meditation was a popular success, and it introduced many people to the benefits of meditation. You can also teach yourself meditation with self-paced online tutorials and programs and attend classes to learn the relaxation response.

In 1975 Dr. Herbert Benson, a professor at Harvard University, published a book called The Relaxation Response in which he described meditation for relaxation and decreased stress and offered instruction in the practice. Dr. Benson’s books, lectures, and classes remain popular for people of all types, healthy and ill. Most have found his teaching helpful and rewarding, and for many it has been life-changing. The Benson-Henry Institute for Mind Body Medicine courses at Harvard Medical School remain an important focus of research and education.   _

Barrie R. Cassileth, MS, PhD, is Laurance S. Rockefeller Chair and chief of the Integrative Medicine department at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City. She has an extensive medical leadership career and is a recognized authority on complementary therapies and integrative medicine in oncology. Her work includes more 170 publications in medical literature, more than 40 medical textbook chapters, and 22 books for physicians, patients, and families. She was a founding member of the Advisory Council to the US National Institutes of Health Office of Alternative Medicine, now the National Center for Complementary and Alternative Medicine; she previously served on the National and the NY-NJ Regional Boards of the American Cancer Society and on multiple national and international committees. She is a staunch opponent of cancer quackery. She is founding president of the Society for Integrative Oncology. Since joining MSKCC in 1999, Dr. Cassileth has established prototypic research, education, and clinical programs in integrative medicine. Her most recent book, The Complete Guide to Complementary Therapies in Cancer Care: Essential Information for Patients, Survivors and Health Professionals, was published in 2011 by World Scientific Publishing Company.