Kindness to Cancer Patients

REMINDER: Be nice to other cancer patients and survivors.

It feels weird to write that, because why wouldn’t you? So many of us who have had the cancer experience feel like we want to support and encourage those who come after us. We are driven to help. But that’s not always what happens.

Let me provide an analogy of sorts:

When I was pregnant with my first child, a daughter, I got an enthusiastic positive response from so many other moms. Everyone was ready with helpful tips and good wishes. At the same time, many also started in with stories of their own experiences, often times telling vividly about their struggles and pain and even, “Oh, girls are the absolute worst!”

Some experiences may leave us feeling “unfinished”, needing a kindred spirit to tell our story to. But we need to be aware of whose ear we’re bending.

Why would some women do this? I can only hazard a guess: perhaps because no one wants to listen to difficult stories. Childbirth is a momentous life event brimming with intense emotions that friends and family forget, but the mother in question holds on to because they are tied into so much of her. Her lingering feelings are brushed aside. No one else cares to revisit the labor pains or complications. As a result, tales of the experience are often not expressed until she sees another woman, a kindred spirit, embarking on the same journey.

So, too, with cancer. And it can be a difficult and awkward subject for many, cancer patients or not. Those of us who are breast cancer survivors may want to “talk about it”, and thankfully there are support groups for that. But friends and family may not understand the scope of the emotional fallout. We get comments like, “well, at least you got a nice set of boobs out of it,” and are expected to move on. Conversation over.

And then we see another woman going through this, and it’s difficult to resist inundating her with your own experiences and emotions, all in the name of letting her know that she can get through this, just like you did.

Does it help? Maaaaybe? But as we all know, everyone’s experience is different. What happens is that you’re not “preparing” her for what might come. You’re inducing anxiety in an already stressed-out situation.

I experienced this myself after my diagnosis, when, a week before my surgery, I ran into an aquaintance who had gone through breast cancer treatment several years before. And I know she was trying to offer support and make me feel better, but it didn’t. She made me anxious about my upcoming therapies, including ones that she not gone through herself. While my intent as a newbie was to share about my diagnosis because I felt that she would understand, I ended up being a sounding board for her concerns. Concerns that were valid, definitely, but not appropriate in the context of a very fearful cancer patient.

Offer support without taking over the conversation.

For the record, this was a lovely woman with whom I’ve had numerous subsequent exchanges. There was no ill-will intended. But it’s likely that she didn’t have many opportunities to speak to relate her story to other women, and given the chance, just needed to talk.

And I know that in my exhuberance to show support for other cancer patients, I’ve probably tripped over myself in an attempt to reassure too much. Offer too many hugs. While also trying to be noncommital about outcome. That’s a really messy combination.

So please, let us remember (and by “us” I mean myself!) that sometimes the best form of support for a newly diagnosed cancer patient is simply being there with them and holding space for what they may be going through. They will make their way through the experience, day by day, just like we did. There will be time to talk about the ups and downs of treatments.

But maybe not right now.

Grounding though Contact Points

Lately I’ve been speaking with people who are having a hard time dealing with anxiety, so I thought it would be worthwhile to dive deeper into grounding methods.

For me, hands down, strong neutral physical sensations (with “neutral” being the operative term here) are by far the best ways to pull my head out of swirling thoughts and get back to where I am now on the Earth.

Buttocks and feet are great focal points for drawing attention away from rapid breathing or heartrate.

Currently, I’m focusing on touch points: those places on your body where you are making contact with any surface. This is highly effective because it is well-suited for any situation. You don’t necessarily need to be in a particular position, nor do you need a quiet space. So if you’re in the middle of an exam, sitting in your boss’ office, standing at a podium or walking down the hallway of a hospital, this grounding method can shift you back to the present moment.

The idea is to focus on the sensation of pressure. My suggestion would be to bring your attention to whereever on your body you can sense that contact with a surface, giving preference to places further from areas that might be reinforcing anxiety, such as the chest region and a rapidly beating heart. So, hands, feet and buttocks would be good candidates. If you’re walking, then pay attention to the change in pressure of your steps as you put your foot down and lift it again.

Feel into these body parts, sensing how the pressure feels against them. You can also bring in sensations such as tingling and temperature. Like an investigator, experiencing these sensations as if for the first time, get curious about their quality. If needed, squeeze the muscles, but then make sure to relax them too, so that you’re not clenching. Then see if you notice a difference in sensation.

Try it right now. Go ahead, I’ll wait…

You don’t need a special place to practice grounding yourself. Where you are right now is perfect.

Did you try it? And did you feel anything? The type of sensation doesn’t matter here. The main goal is to get out of your head, which may be in overdrive. Paying attention to what your body is doing RIGHT NOW helps move you away from thoughts of dread and gives you a handle on your reactions.

Important: as with all calming techniques, this takes practice. It is not a one-time thing that you try, nor is it a pill that you pop and everything settles down. The more you practice this, especially when you’re in a peaceful surroundings, the better you will get at shifting your focus during times of anxiety. Just as with a formal meditation practice, it is consistency that will improve your focus and thereby your abilities.

The added benefit to practice is that you will realize you *can* do it, that it *does* work, and you will build confidence in yourself that you can handle it. So in an anxious moment, you’ll be able to say, “I got this” and bring yourself to a more manageable place.

“That Dragon, Cancer”: Catharsis in Video Game Form

I am always looking for ways to illustrate the complexity of emotions associated with having cancer, or caring for someone who does, as a means of relating it to people without this experience.

An immersive video game called That Dragon, Cancer does this by telling the story of a young child with the disease, in this case, a brain cancer called Atypical Teratoid Rhabdoid Tumor (AT/RT). The game explores the fear, hope, helplessness and fight that we go through when confronting so much uncertainty.

To be clear, this is not a video game in the usual sense, it’s a narrative with mini-game elements, sometimes lighthearted, sometimes dark. We follow the journey of a family as they navigate the rollercoaster of cancer diagnosis, doctor appointments and treatments. Those of us who have been on this path can relate to the tsunami of emotions and information, all rolled up into one overwhelming ball. The game does a good job of representing these feelings.

If you’re interested in experiencing this game with a blind playthrough, this is where you should stop reading. For more information on That Dragon, Cancer, visit the official website here.

WARNING/SPOILER: Because this is a true story, the developer Ryan Green (Numinous Games), along with his wife Amy, could not control the outcome; the game was created to honor the memory of their young son, Joel, by chronicling his battle with terminal childhood cancer.

Little Joel underwent a staggering number of treatments for his brain tumors.

Be aware that there are very distressing parts to this game. Just as cancer patients fight for meaning and claw for hope, so does this family. If you are not in the right frame of mind for this, or are at a painful part of your cancer journey, it might be best to skip this game. When the game originally came out in 2016, it left well-known YouTubers in tears. Everyone can relate to loss; Ryan and Amy made this even more powerful by documenting their son’s journey in recordings made during his treatments. Therefore, when you hear the distressed cries of a young child in misery, those are Joel’s actual cries, and they are heartbreaking. But hearing his delighted giggles helps ease the pain.

It is all very raw and real.

Even in the distress, we experience joy in the life Joel lived.

Losing hope, or clinging to it in the face of insumountable odds, is documented here. The Green family hopes for a big miracle, with Ryan and Amy each heading towards the outcome in different ways: Amy is adamant that Joel will be healed while Ryan is riddled with doubt. There is a very strong Christian influence in this game that reflects the Green’s religious beliefs, with many references to God, Jesus and saving grace through prayer, so those whose beliefs differ may find this element foreign and possibly irritating, and they should decide whether it is appropriate for them. Nonetheless, the game is beautifully done with moments that will make you smile in between tearful episodes and there is value in experiencing it.

Those who expect a movie-style, “deus ex machina” happy ending may be left empty and unsatisfied, but I found the end to be uplifting, inviting in the acceptance of inevitability.

The game also honors the memories of other cancer patients in imaginative ways.

I’ve now played That Dragon, Cancer three times through. The emotions that it evokes are very familiar and I found this game cathartic and validating. As the Green family discovers, if someone succumbs to cancer, it does not mean that their faith was not strong enough. If there’s one thing I’ve learned about this disease, it is that cancer is not picky, it doesn’t care about your desires and it doesn’t play by the rules.

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From the developer, Numinous Games: “An immersive narrative videogame that retells Joel Green’s 4-year fight against cancer through about two hours of poetic, imaginative gameplay that explores faith, hope and love.” $9.99 on Steam.

Staying Present: Dual Focus Meditation

If you’re new to mindfulness meditation, you might have found it difficult to hold focus on your breath. But the reality is that you don’t need to be a beginner to struggle with this. There are some days that the mind refuses to be still and even a long-time meditator will find themselves carried away by thoughts.

In an effort to help keep my head here and now, I started paying attention to how it was that I lost focus. For me, it happens during the lull between breaths.

The breath remains the main focus.

What is that lull? Well, there’s a very short, almost imperceptible pause between my inhale and exhale. I’m okay during that time because I can focus on the sensations in my chest and belly. That’s not the pause that gives me problems.

It’s after the exhale that I experience a longer pause before the next breath begins, especially if my breaths are slower and deeper, because my body doesn’t require another breath right away. And that’s when I’m more likely to “see something shiny” and my mind wanders off.

But I found that by focusing on my hands during this pause, I could keep my random thoughts at bay.

If you’re having focus issues and would like to try this, all you need to do is consider your focus as cyclic. First, with the inhale and exhale, focus on the breath sensation–choose wherever you feel the air movement most distinctly, such as the rising & falling of your chest, the rushing of air in and out of your nostrils, or similar. It will be different from person to person.

Next, during the pause between your breaths, turn your focus to the sensations in your hands and fingers. There may be some tingling or throbbing, or perhaps nothing discernable. That’s okay. Just see if there’s anything there that you can feel.

Then, when your next inhale begins, pay attention to the breath again.

The main point of this exercise is to stay present during those times that the mind is very active.

It may sound like you’re jumping from one body part to another, but in reality the transition is very smooth. The focus on the hands gives you a place to go until the next breath returns, all the while keeping you present.

When I first tried this, I thought I was “cheating” because I wasn’t staying with the breath. And I had to remind myself that the purpose of this wasn’t to earn a gold star for being the best “focus-on-only-the-breath” meditator. It was to stay with whatever was happening “now”.

Allowing a slight change in focus when my mind is active keeps me present. Staying present calms me more effectively. And that helps me return to the meditation cushion day after day after day.

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There is beauty in the stillness that we experience between breaths. This dual focus practice isn’t meant to pull us away from that. Rather, it gives us a focus for those days when the mind is active and easily distracted, and appreciating that stillness is not available to us.

Sleep: Still the Ultimate Good

Some time back I posted sleep researcher Dr. Matt Kelly’s TED Talk on sleep, which I highly recommend. Now, the American Academy of Sleep Medicine (AASM) has issued a position paper which states unequivocally that “sleep is essential to health”.

As noted in the position paper, “Healthy sleep is important for cognitive functioning, mood, mental health, and cardiovascular, cerebrovascular, and metabolic health.” Anyone who has suffered through the daylight savings time change – that would be most of us – can tell you that even missing out on a single hour of sleep can leave you feeling off for a few days.

Sleeplessness is too often an occurence for too many of us.

And many of us have likely had the experience of sacrificing sleep for school or work projects, adjusting to newborns, or other similar temporary situations, not to mention the occasional middle-of-the-night stress session.

But sleep disruption on a chronic scale has far-reaching repercussions, and has been “associated with an increased risk of mortality and contributes to both the individual risk and societal burden associated with several medical epidemics, including cardiovascular disease, diabetes, obesity, and cancer.”

In particular, shift work has been associated with an increased risk of cancer, due to the persistent disruption of the body’s biological clock, as reported in a recent CDC blog post based on reviews by the National Toxicology Program and the International Agency for Research on Cancer. Data came from both breast and prostate cancer surveys. [The CDC post does outline what shift workers can do to protect themselves.]

I suspect that data from shift workers will reveal the influence of factors other than simply how long one sleeps, for instance, the significant effect of melatonin’s known anticancer properties (Hill et al., 2015, Endocr Relat Cancer; Yi et al., 2017, Oncotarget; Bondy & Campbell, 2018, Int J Mol Sci).

While the studies may be confusing, good sleep hygiene is always important.

According to the AASM position paper, the consensus among different sleep-related organizations is that adults require at least 7 hours of sleep regularly, with the range being 7-9 hours. While this seems straightforward, one meta-analysis (Lu et al., 2017, Biomed Res Int) of 10 studies suggested that sleeping excessive amounts (over 9 hours) was linked to an increased risk of estrogen-positive (but not estrogen-negative) breast cancer for women. At the same time, Xiao et al. (2016, Sleep Med) found that short sleep duration was associated with triple-negative (but not estrogen-positive) breast cancer in black women as compared to white women, suggesting racial disparities in the data, so further research is needed.

Confusing? Yes, this is clearly an area that calls for more study. Some clarification came recently from the publication of the “Million Woman Study”. This was an extensive prospective multi-year study of women in the UK that, you guessed it, found no association between breast cancer and sleep of any duration (Wong et al., 2021, Sleep). Nonetheless, the authors did note some shortcomings of the study, so this question is likely to be revisited.

Take home message? Conflicting studies aside, everyone would agree that good sleep hygiene (see CDC recommendations) is important no matter what your cancer risk. With our lives running 24/7 and sleep schedules constantly being disrupted, we should take a clue from the animals who settle down as the evening begins, like clockwork. We might have advanced as a civilization, but we can’t get past the reality that when it’s dark out, it’s time to hit the sack.

Does Mindfulness Make a Difference?

Yes, yes it does.

I am AWARE.

What used to feel like a jumbled mess of emotions and sensations before, now makes sense to me. Intense feelings don’t come at me as quickly as they used to and there’s more space between a stimulus and my response to it.

There is a PAUSE.

I may still feel overwhelmed by circumstances when something unexpected happens, but now I know what’s happening and can pull myself out of it.

That doesn’t mean that I’m perfectly calm and don’t get frightened, anxious or frustrated. I do. You can see that in some of my posts, because I try to be very honest about what I’m experiencing in the moment. But no matter how deeply I dip into fear, I don’t stay there.

I can find the CALM amidst the CHAOS.

When things get intense, I know how to feel into my body. I recognize the physical sensations and I focus on releasing them. Smoothening them out. Breathing through them.

All those abilities were always available to me, but I resisted calming myself. I am aware that on some level I used to feel that anxiety was a necessary way to express my fear; that it was necessary to descend into fear to express my emotional state to others, so that I would be taken seriously. While it sounds odd to read that now, it was only through learning that I was able to soothe myself that I learned I didn’t need to commit to the torture.

I return to the PRESENT.

When I start thinking about fretful things in my past or fearing the possibilities of the future, I can now recognize that my mind has drifted away and I can pull myself into the present, feeling into my bodily sensations. I can break through the dark tumult that’s enveloping me. And suddenly, the noise is gone and I’m standing with my feet firmly planted in my room. I hear the birds and I find peace.

I know I am SAFE.

I have learned how to feel into my body to help it bring me back to the present and away from fearful thoughts.

I realize that there were behaviors that I engaged in during times of anxiety in the past, like pacing back and forth, that actually soothed my nervous system. Just as rhythmic rocking soothes a child. My body was wise and knew what I needed. When, years ago, the burden of my workload chained me to my desk and prevented me from movement, my anxiety skyrocketed and became almost unbearable. That was a clue, but at that point in my life, I didn’t know how to listen to my body.

Now I know what I must do to calm down and I allow myself to do it. But this change didn’t come about suddenly.

It takes PRACTICE.

Practicing mindfulness meditation when I am at peace allows me to build up the habit that carries me through difficult times. I practice daily. Somedays I can focus on my breath perfectly; other times I lose myself in thought shortly after I’ve begun. Regardless, I don’t give up. Even the “bad meditation” days are better than no meditation at all. Each session strengthens my mindfulness habit.

Every day. No matter what. It makes a difference.

Is It Metastasis or Menopause?

Ever get the funny feeling that something’s wrong?

Like things are a bit “off” but you can’t be sure? I’ve been dealing with that ever since I got off letrozole, an endocrine therapy for breast cancer with a reputation for being difficult to take.

As of this posting, I’ve been off letrozole for 117 days exactly–yes, I’m counting. I’m still shaking off side effects like stupid-crazy joint stiffness, but at least I can tell things have improved.

That’s not what I’m talking about here.

I’ve taken a few rides in the MRI tube already. Not in any hurry to repeat that.

Right now I’m having some “really intense” memory and focus issues. I’ve put “really intense” in quotes, because I talk in superlatives so that my concerns are taken seriously. It’s a bad habit, especially when speaking to an oncologist, because it’s a sure way to end up in an MRI tube. Again.

In the past, my oncologist suggested that my memory problems might have been related to anxiety and not the medications I was on. That’s quite possible, although it’s hard to tease apart “anxiety” and “med side effects”. I mean, simply being told you have cancer causes an immediate spike of the Stress-O-Meter. For someone as anxiety-prone as me, it’s like I’m constantly red-lining.

Now I’m off the endocrine therapy and my memory and distractibility seem to have gotten even worse. What I had before wasn’t like THIS.

It’s kind of like saying, “This hurts. I think I’m being hit on the head with a hammer.” But then you actually get hit by a hammer, and think, “WHOA, now THIS is being hit on the head with a hammer!”

If thoughts are beads on a string, my beads are dropping off at a constant rate, leaving me wondering what I was about to do three seconds ago. And getting distracted by shiny objects. Couple that with having to learn a complex new financial system for work (grrrrr, Larry Ellison), not having helpful documentation to do so and having to go through that while being mainly confined to my bedroom for over a year…yeah, it’s a mess.

I am not being rational and I know it. But I’m still on high alert and dialing my fears down is going to take time.

Because my breast cancer was HER2+–which has been associated with metastases to the brain–my anxious little self immediately thinks, “Wait, maybe this is cancer’s spread stealing my thoughts???” I think that I will forever be jumping to that as the first possibility.

That’s not completely unreasonable, either. According to “Medical News Today”, memory problems are listed as one of the symptoms of brain metastases, along with headaches, stroke, seizures, confusion, dizziness…okay not really experiencing any of those.

And the Mayo Clinic metastasis website asks: what are the most likely causes of my symptoms? So, I admit, a brain tumor probably isn’t, given all the other more likely possibilities: menopause, work stress, loneliness, lack of purpose…and *cough* listening to Twitch video streams while I’m trying to focus.

So really, these memory issues could be a completely normal effect of menopause, but in the cancer context the possibilities are frightening. It takes a lot of perspective to be able to look at what’s going on and realize that it’s not aberrant or dangerous. I feel like an idiot for jumping to the worst conclusions, but here I am…

It’s a survivor thing.

Mindful Games I Love: Meditating with “Playne”

I didn’t think I needed a video game to help me mediate.

In the description for “Playne” (on the Steam platform), the developer states that the game is designed to help you establish a meditation habit. While, I thought it would be uninteresting for someone who already had a solid habit, the reviews of the game were very positive and the concept seemed inviting, so I decided to give it a try.

After a week of meditation, saplings have emerged.

I had no idea that it would have such an impact on the quality of my meditation. While I often listen to ambiances (such as through the “MyNoise” app and website) and use guided meditations (“Calm”, “Insight Timer”) or similar auditory cues (“Unwind”), what I didn’t have was a visual representation of my meditation practice as it progresses over time. “Playne” supplies that.

“Playne” has three modes: Story, Sandbox and Evolve. This post is about the Story mode, as that’s the one most people start out with and the one I’m currently working on. Sandbox allows to you build your own meditation spaces and Evolve can only be unlocked after 100 days of meditation (I’m still in the 50s).

You have a small selection of meditations to choose from with the emphasis being on learning to sit with yourself.

The game starts out on a semi-barren island with only a tiny flame in a campfire, a stone lantern, several rocks and Sensei Fox to keep you company. There are both guided and unguided meditations to choose from and as you meditate everyday, the fire grows taller and seedlings sprout and grow. With consistency, you unlock different story chapters, which wise Fox relates, gain the ability to change the weather, and most importantly, grow the island into a beautiful meditation retreat. All it takes is patience.

There is a breath bubble to guide your breathing if you wish, and also a ring that serves as a countdown timer. Both can be turned off if they are distracting or unnecessary.

You are given the ability to chose the length and type of your meditation. In addition, you can regulate inhales and exhales (the length of which you can designate) with a breath bubble, keep track of your meditation time with a minute-ring, enable a journaling option (known as “thought pages”, which you can either keep or burn in the fire if preferred), and mark each instance that you become aware that your mind has wandered (as I enthusiastically wrote about here). There are different places on the island to meditate, and as you accumulate more days, you not only get more weather options to chose from, but also access to elements such as birds, fireflies, Aurora Borealis and butterflies. These are quite lovely and make your “Playne” even more inviting.

Be forewarned that there is the temptation to mark your progress and count achievements. I understand why, from the viewpoint of a game, this is necessary but it does go against the concept of mindfulness. On the other hand, I’m really looking forward to flowers and butterflies!

Now for the potential downside: As much as I enjoy all the offerings, there are a few parts of the game that seem antithetical to mindfulness meditation. The game keeps track of “effort”, you gain “achievements” and note your “progress”. As do other meditation apps/games, “Playne” maintains a record of your streak, and depending on your settings, if you don’t log in to meditate with “Playne” on a given day, you run the risk of having the flame in the campfire go out. While I know that this is done to encourage daily meditation, it is also somewhat problematic, as the whole idea of mindfulness is non-striving. I feel that too much emphasis on achievement in the context of a meditation practice goes against being mindful of the present.

Over 50 days into this, my Playne has grown significantly.

Being of a naturally competitive nature, I was reluctant to turn my practice into one where I would be clinging to achievements. Nonetheless, there are enough positives to this game, and it has benefited my practice so much, that I have been learning to let go. That in itself is a significant improvement!

Yes, it’s unlikely that I will risk breaking my streak, but that’s pressure I can live with.

Reservations aside, I am really impressed with the game. I will write about the Sandbox and Evolve modes when I get to them, and post more images as my “Playne” grows. Additionally, there is a virtual reality (VR) option that I am looking forward to playing with. For anyone starting out with meditation, “Playne” offers a solid platform from which to develop and maintain a consistent meditation habit.

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In addition to “Playne”, I am also using other mindfulness media on a regular basis (my favorite ones are here). That makes for a lot of checking in with electronics, unfortunately. I’ve gotten to the point where I meditate about a half-hour to an hour-plus every day. While it’s a priority in my life, there are days that it’s a struggle to find time for it all. Introducing “Playne” has added to this, and the last thing I need more of in my life is stress.

Sometimes I combine “Playne” with other apps to take advantage of the “Playne” ambiance while doing my favorite guided meditations. More recently, however, I’ve also used “Playne” as a way to emphasize unguided meditation, and that has allowed my meditation practice to mature and expand beyond the confines of a computer program and into the rest of my day. That is one of the greatest benefits of this program and the main reason why I have found it so valuable.

Endocrine Therapy: Getting to the Heart of the Matter

Looks like visiting a cardiologist after stopping aromatase inhibitors for breast cancer was a good idea after all.

The letrozole (aromatase inhibitor) that I’d been taking has been associated with cardiovascular effects, and since I was feeling progressively worse from the medication, I wanted to make sure that everything checked out okay.

With the improvement in surivorship comes an increase in the diseases that come about from cancer treatments. The longer people live, the more long-term effects take their toll.

It seems like the American Heart Association (AHA) agrees with my concerns. An April 26, 2021 statement by the AHA underscored the complicated picture of cancer treatments, in this case hormonal therapies for breast and prostate cancer. As stated in the article by Okwuosa et al. (2021) published in Circulation: Genomic and Precision Medicine, “As patients with hormone-dependent cancers continue to live longer, CVD [cardiovascular disease] has emerged as a leading cause of mortality and morbidity among survivors of these cancers.”

Ironically, breast and prostate cancers are some of the most common cancers in women and men, in addition to having some of the most effective treatments. The number is of breast and prostate cancer survivors is growing. Part of the success of treatment is expressly due to the development of hormonal therapies for long-term (5-10 year) use. At the same time, the increase in CVD problems is a result of this success, because as cancer survivors age they experience greater amounts of age-related cardiovascular events than do non-cancer surivors.

So, what do you do when the treatment that’s increasing your chances of beating cancer may also be increasing your chances of a cardiovascular event? Isn’t that one of the many problems with cancer? If your treatment works well, then that opens the door to having it work “too enthusiastically”, possibly with long-lasting negative effects.

It still comes down to healthy behaviors.

The AHA statement paper cited here stresses the importance of communicating with your oncological team about CVD risk factors and possibly requesting a referral to a cardiologist, having appropriate tests conducted (ECG/EKG, echocardiogram), and–in my opinion the most important thing the survivors themselves can do–modify lifestyle (diet, exercise, smoking cessation, etc.) to maximize your chances of a cardiovascular event-free survivorship.

While it may be frustrating to think of entering into an “out of the frying pan, into the fire” scenario with a potential leapfrog from cancer to CVD, nothing is written in stone. You can make an effort to protect yourself and avoid being a statistic. Focusing on healthy living will benefit you in many ways and is guaranteed to improve your life, no matter what your risks.

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Link to the AHA statement:
Okwuosa et al. (2021) Impact of Hormonal Therapies for Treatment of Hormone-Dependent Cancers (Breast and Prostate) on the Cardiovascular System: Effects and Modifications: A Scientific Statement From the American Heart Association. Circ Genom Precis Med,
DOI: 10.1161/HCG.0000000000000082

Link to a reader-friendly version:
People Taking Hormonal Therapy for Breast Cancer Have Higher Risk of Heart Disease, Monitoring Recommended, https://www.breastcancer.org/research-news/higher-risk-of-heart-disease-for-diagnosed-people-taking-hormonal-therapy

Grounding Through the Fingertips: Hand Steepling

Note: this is another grounding technique, by which I mean a way to retain focus on what is happening in the “now” rather than getting lost in memories of the past, which we cannot change, or succumbing to fears about what may happen in the future. It’s not a woo-woo magical technique. It’s merely being mindful about what is currently taking place so that you can respond appropriately and maintain your composure.

During acute stress, we need to bring ourselves back to the present quickly. By doing so, we are able to clear our heads of the “what-ifs” and “you shouldas” that cloud our thoughts at those times.

But what’s the fastest way to do that? For me, it’s definitely focusing on the fingertips. Each fingertip has approximately 3,000 nerve endings, more than any other part of the body (except the most intimate). When you touch something, all those nerves start firing.

You can take advantage of this sensitivity to ground yourself.

Channel Benedict Cumberbatch’s Sherlock and put your fingertips together.

This is what I do: I “steeple” my fingers (thumb against thumb, index finger against index finger, etc.) as if I were Star Trek‘s Mr. Spock contemplating a complex situation. The fingertip pressure immediately commands attention from my fearful mind in the same way that a boss displaying that hand gesture would command an employee’s attention. Taking deeper breaths, I rub my fingertips against each other in a circular motion. The movement enables the nerve endings on the fingertips to keep firing as the sensation continues. Or I can bounce my fingertips off each other, or keep them together but flex the fingers to create a pulsing motion.

Closing my eyes accentuates the emphasis on sensation and makes maintaining focus on it easier.

Yes, this seems so simple, but it’s also quite effective. By placing our focus on the fingertips, we take our attention away from more reactive parts of the body like the chest area, where the heart might be beating fast and ribcage expanding and contracting with rapid breathing. Feeling into those areas might only serve to reinforce the heightened emotions that we’re experiencing.

The hands lie further away from that commotion, and that distance between the chest and our fingertip sensations enables us, if even for a short while, to get some perspective. Think of it as the anxiety not being “in your face”.

We can use body sensations as anchors to help stabilize us through anxious times.

Sometimes, when I close my eyes, all I “see” is that sensation of fingertip to fingertip, as if it’s the only thing that exists. I can play with this, imagining that I’m holding something between my hands, and that the sensation I feel is actually the feeling of that object against my fingers. It can be a pane of glass or even a beach ball. It all depends on what my brain is willing to accept at the moment. It’s a relaxing mental exercise.

As with many things related to mindfulness, it’s helpful to practice this fingertip pose when we’re in a relaxed and meditative state to connect the sensation to a feeling of calm, enabling it to serve as an anchor when our emotional seas are rough. The more we practice, the stronger that association, and the more effective the grounding response when we use this technique in the midst of anxiety.

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Fun fact: body language experts consider steepled fingers to be an expression of confidence. That might be the little boost you need when you’re navigating a stressful event!