A cancer diagnosis touches every part of a patient’s life. Medical interventions offer hope, but while groundbreaking advances in surgery, chemotherapy, radiation, and immunotherapy have reduced mortality, these treatments are solely focused on ensuring physical survival. What are patients and their loved ones supposed to do when it’s not only their bodies under siege, but also their sense of mental, emotional, social, and spiritual well-being?
Many hospitals have recognized that patients require support in coping with both the physical side effects and the personal challenges of treatment. Rather than racking up antidepressants, sleep aids, and pain relievers, patients are seeking out complementary therapies and support programs that recognize them not only as carriers of a disease, but as humans dealing with a complex range of emotions and needs.
At Pennsylvania Hospital (PAH), the Abramson Cancer Center’s (ACC’s) Holistic Living Challenge provides free access to holistic and traditional Chinese medicine resources. A holistic approach to health care emphasizes the inseparable connection between the mind and body and treats the whole patient, not only their symptoms. Rather than pushing participants into “survival mode” overdrive by focusing solely on “fighting” or “beating” cancer, the program encourages a shift in perspective and a renewed focus on adopting wellness practices and building mental, physical, emotional, and spiritual stamina.
Once a week for seven weeks, patients and caregivers who have been affected by a cancer diagnosis come together in a quiet, cozy room at the ACC to share their experiences, learn self-care strategies, gain a deeper understanding their own needs, and get comfortable with change in pursuit of an improved quality of life. The groups include attendees at different stages of their cancer journeys – some have just completed treatment, others have taken advantage of the ACC’s offerings for a while, and some are caring for a loved one – but are all looking for support as they adjust to their “new normal.”
While the program only runs once in the fall and once in the spring, it has proven incredibly popular. During the final session of the spring program, a group member shared, “I feel like somehow the universe brought this to me at the time I really needed it. I don’t think I could be in this spot if I didn’t come here,” and her words were met with nodding heads and a murmur of appreciative agreement. Every person in attendance also echoed their wish to schedule a reunion, or to just continue the program indefinitely (“You said the number nine was important in Chinese medicine – maybe we could go for nine weeks?” another member suggested).
Spearheading the program are Wayne Mylin, Dipl. ABT, a Shiatsu therapist, and Abby Wetzel, MS, RD, LDN, a clinical dietician. Using Hippocrates’ belief that “Everyone has a doctor in him or her; we just have to help it in its work” as a springboard, each session takes a deep dive into the fundamentals of holistic wellness that we know are important for our health, but that we often ignore when struggling with stressful circumstances.
“The program is all about total-body wellness. The most powerful, efficient, reliable source of prevention and healing is our decision to take responsibility for our health,” Mylin said. “Sometimes it takes a health scare or a level of frustration to kick us into gear, but wherever the motivation comes from, putting the basics first and performing them well makes us active in our own care and enhances our quality of life.”
Paying attention to these fundamentals is not only helpful for patients and caregivers enduring the challenges of cancer, but for anyone whose focus on their own well-being is lacking, whether due to stress, a perceived lack of time or importance, or (as many of us can attest to) laziness.
There are, of course, the basics that have been hammered home by every doctor, gym teacher, and Facebook life coach. Regular movement strengthens the body’s defenses and boosts mood; a nutritious diet provides the energy its needs to function efficiently; and sleep and mindfulness give the body an opportunity to repair itself and rest. Mylin and Wetzel explained the vital importance of creating – and sticking to – healthy daily routines, one step at a time, and offered guidance on how to improve the sometimes complicated relationships we form with exercise, food, sleep, and meditation.
In addition to those relationships, the holistic approach of the program also considers the impact of personal and spiritual relationships. Mylin emphasized that “mindfully assessing the relationships in your life – the nature of them, what they give back to you, what you give them – is so important, especially if you’ve been engaging in them on autopilot.” Maintaining fulfilling connections under any circumstances can be difficult, and particularly when health issues arise, but it’s important to determine if a relationship is causing or relieving stress, draining or renewing energy, and supporting your needs or complicating them.
“Before this program, I had to go one place for a cooking class, another for mindfulness, another for a support group, and so on. Even though [the things I learned] all fit together, it was hard to make those connections on my own,” said a group member. “This challenge puts all of it – the physical, emotional, spiritual, nutritional, and relationship stuff – together. It has been such a valuable learning experience. Life goes on, but it’s a different journey now, and I needed to find time to digest it all, do some soul-searching, and apply these things to my daily life. Now I know how.”
After taking these types of basic self-care strategies for a test run, developing a routine, and ensuring accountability by sharing any goals with those supporting you (and especially with your care team if you, like the group attendees, require medical treatment), the next step is figuring out how to use that newly generated energy.
“Our sense of wellness is directly connected to how effectively we manage our life energy. How much are you exerting on what’s good and wise for you? How often are you participating in activities that align with your goals and make you feel healthy?” Mylin said. “I like to use the bank account comparison, and we’re aiming for a healthy balance.”
For a bank account to have sufficient funds, more money has to be deposited than is withdrawn. Individuals may assign different values to certain activities. Cooking may be relaxing for one person (a deposit), while it may be the worst part of the day for another (a withdrawal). Hanging out with a friend may sound like an energy boost when the plans are made, but stressors the day-of may require you to make time for a nap or relaxing activity before meeting up. Ideally, we all should be living off the “checking accounts” that we contribute to daily, while the “savings accounts” should be reserved for situations that require more stamina like a special event or an unexpectedly stressful situation.
When managed well, the building blocks that create energy – mindful breathing and thought patterns, a nutritious diet, regular exercise, quality sleep, engaging relationships, fulfilled spiritual needs, etc. – can provide a surplus of funds for checking and savings accounts alike. If the accounts run low, though, you will likely be left with an energy deficit that leaves you feeling run down, stressed, and potentially ill. Draining accounts entirely or racking up I.O.U.s after lending energy out to others will cause the penalties to continue escalating. Understanding the effects of different daily responsibilities and situations helps you to balance your “checkbook,” maintain your “accounts,” and better manage your time and energy.
Ultimately, this focus on self-care and energy conservation helps participating patients to regain a sense of agency. They may not have had a say in their cancer diagnosis, but addressing their overall health and wellness holistically provides the necessary tools to regain a sense of physical, mental, emotional, and spiritual balance. This also makes it easier to maintain the identity of a unique human being dealing with cancer, rather that adopting an impersonal, generalized cancer patient identity. It’s not necessary to find some cosmic meaning in cancer, but combining mindful energy usage with a clear sense of identity ensures that meaning and purpose are not lost due to the roadblocks created by impaired health.
As the final session of the spring program came to a close, one group member’s reflection on this point was particularly poignant. “I had decided to retire finally, so things were already shifting and changing. I finally felt like I had everything sorted out, even though I wasn’t sure what I’d do next. Then I got a routine mammogram, and the beginning of my retirement was surgery and radiation,” she said. “I knew I needed something, but I didn’t know what – and it was all of you. I’m still working on practicing patience and mindfulness, and I’m getting better at taking responsibility for my own health, but I feel like I’m going in a new direction. I’m reminding myself that I can stay living as long as my body keeps working. And I will.”
Time Out: Take a Mindfulness Meditation Break
Interested in dipping a toe into mindfulness and meditation, but unsure where to start? You’re not alone. In our “hustle” focused culture that’s constantly abuzz with mounting responsibilities, distractions, and stress, it can seem impossible to quiet your mind and sit with yourself. Mindfulness requires practice, but “If three minutes is what you have, then three minutes is what you do,” Michael J. Baime, MD, director of the Penn Program for Mindfulness, told the Philadelphia Inquirer, noting that it truly is “the best antidote to stress.”
Get into a comfortable position and take a test run with this three-part exercise shared at a Holistic Living Challenge session last spring.
Part 1: Relax in your chair with the soles of your feet on the floor and your eyes closed. Sit quietly for a moment. Gently shift your attention to the tip of your nose. As you breathe in and out, feel the air moving through your nostrils. Envision your breath as a cloud of pale golden light going in and out of your body, flowing past your nostrils. Allow that cloud to relax you and quiet your mind. As your mind wanders in the golden light, bring your attention back to the air flowing in your nostrils – in and out.
Part 2: Move your attention to your chest. Find a place in the center of your chest where your attention can easily rest. As you breathe in and out naturally, keep your attention on that spot. Try to relax that spot. Imagine there’s a lotus bud in the center of your chest. As you breathe in and out, envision the petals opening one by one with each breath. First one petal, then another, until the flower is totally open. Can you feel the expansion in the center of your chest? Imagine the flower evaporating into a soft, golden light.
Part 3: Shift your attention to your feet. What do they feel like against the floor? In your shoes? Envision a white light tinged with gold shining up from the ground in two streams towards your feet. Allow it to rise through your feet, legs, hips, and torso, and steadily rise until it goes through the crown of your head. Let it continue up into the universe until you can’t see it anymore. Envision that same light descending from the farthest reaches of the universe back down to you. As it approaches, let it enter the crown of your head and take a reverse path down through your neck, torso, hips, and legs.
Practice this faster: feel the light coming up through the earth, rising through your body, and ascending through your head into the universe, then down again through your head and body and back into the ground. Practice again, going faster each time. Speed it up to match your breathing. With each inhale, envision the golden energy shooting upward through you, with each exhale, it moves steadily back down. Allow the light to go back into the earth.
When you’re ready, start to bring your focus back to yourself – your chair, your room, your experience. Open your eyes. Feeling mellow?