by Dr. Keith I. Block
The initial shock of the cancer diagnosis is nothing less than earth-shattering.
As many patients have told me over the years, the diagnosis can impact your whole being with terrifying force, leaving you grief-stricken and traumatized.
About half of all cancer patients experience clinically significant anxiety and depression. And in many cases, according to some studies, the emotional distress associated with this disease lingers for years, adversely affecting one’s sleep, energy, and mood.
Such research has opened the door for including stress reduction techniques—meditation, mindful breathing, guided imagery, yoga, hypnosis, and other practices—into the cancer treatment setting. Indeed, numerous studies have demonstrated that these so-called mind-body therapies can improve mood, coping, and quality of life for people with cancer, while also lessening pain and toxicities associated with chemotherapy and radiation treatment.
But the stress of battling cancer is far more than just a quality-of-life issue. In fact, it can also impact your survival! Researchers at University College London recently evaluated research on the relationship between stress and cancer survival. Based on a meta-analysis of 383 studies, the researchers conclude that greater emotional distress and poor coping styles were significantly linked to poorer cancer survival and higher cancer mortality, as published in the August 2008 issue of Nature Clinical Practice Oncology.
Moreover, at least four randomized clinical trials have demonstrated a significant favorable impact on survival. In the most famous of these studies, 91 women with metastatic breast cancer were randomly assigned to a one-year weekly session of “expressive-supportive group therapy,” which included training in self-hypnosis. Ten years later, those patients who had received the “expressive-supportive group therapy” showed significantly better survival than the other group. This particular mind-body approach gives patients the support and opportunity to address the emotional impact of their illness and treatment, as well as any changes in their self-image, relationships, roles and activities.
Another of these intervention studies examined a carefully structured support group program for malignant melanoma patients that included stress reduction practices and educating patients about a healthy diet and lifestyle. After six years of observation, the patients in the intervention group showed a significant increase in survival.
In the most recent study, Dr. Barbara Andersen and her colleagues at Ohio State University’s Comprehensive Cancer Center showed that an intervention program that teaches patients how to cope with breast cancer reduced their risk of dying of the disease by 56%! The patients were observed for an average of 11 years following their participation in the mind-body program. In addition, the women in the mind-body program were 45% less likely to have a recurrence compared to women who didn’t participate. In June of this year, Andersen reported that the benefits of the program persisted even after recurrence. Among women who had a recurrence, those in the mind-body group had a 59% reduction in the risk of dying from breast cancer compared to the women who didn’t participate!
It should be mentioned that in contrast with these favorable findings, four other randomized clinical trials have failed to show a survival effect of support groups and other mind-body interventions. In short, the “score” is now tied four to four.
One might well ask, Why the mixed results? I suggest it could be the type of intervention that spells the difference. Every support group is unique, and the same can be said for other mind-body interventions and the way they are delivered and received. There is little doubt that well-designed psychotherapy and support group programs can help patients feel less isolated, and less anxious and depressed. Many of my own patients who have attended these programs have spoken of feeling that they have a whole new lease on life. For me, such benefits alone are sufficient proof of the immense value of mind-body interventions.
One of the hidden benefits of getting involved in a well-run support group is the sharing of problem-solving strategies as well as health-related information. Many patients say the support group experience enables them to dissect and resolve specific problems that have been causing them some distress. Other group participants have spoken of how they felt encouraged to strive harder for their treatment goals, and to generally take better care of themselves. This ripple effect adds a hidden yet powerful dimension to the concept of group support.
It seems a very tall order to expect that support groups or mind-body therapies alone could bolster survival. In this vein, I believe the interaction with lifestyle factors such as nutrition and physical activity could be key to the success of mind-body therapies. Some mind-body interventions are too narrowly focused on the mind, adopting a kind of “mind over cancer” mentality. This single-focus perspective overlooks the fact that a well-nourished, physically fit body is far better able to minimize emotional distress and promote a peaceful state of mind. Which can serve as an important reminder that the whole is far greater than the sum of its parts.
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Keith I. Block, MD, is an internationally recognized expert in integrative oncology. In 1980, he co-founded the Block Center for Integrative Cancer Treatment in Skokie, Illinois, and serves as its Medical and Scientific Director. He is the author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment.
Dr. Block is currently Director of Integrative Medical Education at the University of Illinois College of Medicine at Chicago. Additionally, he is the Scientific Director of the Institute for Integrative Cancer Research and Education, where he has collaborated with colleagues at the University of Illinois at Chicago, the University of Texas M.D. Anderson Cancer Center in Houston and Bar Ilan University in Israel.
Dr. Block is also the founding editor-in-chief of the peer-reviewed journal, Integrative Cancer Therapies (ICT). In 2005, he was appointed to the National Cancer Institute’s Physician Data Query (PDQ) Cancer CAM Editorial Board, on which he continues to serve today.
