Frantic Shanti

The Benefits of Physical Activity During Cancer Treatment and How to Begin

While this isn’t exclusively an exercise blog, if you’ve perused my posts you’ve probably noticed that I’m a huge proponent of exercise for both cancer patients and survivors (well, actually for everyone; but see my important message at the bottom of this post).

The best way to achieve this is to start exercising right now, if you are not yet, no matter what stage of the cancer experience you’re in.

There is a growing body of research that shows the benefits of exercise for cancer folk (I’ve written about it here). But the fact is that only about 17-37% of cancer survivors meet the minimum physical activity guidelines set out by the American Cancer Society (Hirschey et al., 2017, Cancer Nurs) even though doing so reduces the risk of cancer recurrence by 55%, not to mention the improvement in quality of life (Cannioto et al., 2021, J Natl Cancer Inst).

Exercise, the Cancer Fighter. In the not too distant future, your oncologist might hand you an exercise prescription as part of your cancer treatment.

Now, there is a call to include exercise as an adjuvant therapy for cancer for those who are currently undergoing chemotherapy. During the Oncology session of the 7th International Congress of the Spanish Society of Precision Health (SESAP) that took place in Spring 2022, Adrián Castillo García, a researcher at the Barcelona Biomedical Research Institute (IIBB) of the Spanish National Research Council (CSIC), reviewed recent studies regarding the benefits of exercise during cancer treatment, including the potential role that it had in “modulating the tumor microenvironment and immune function.”

You can read a synopsis of his statements here in the section entitled “Exercise as Oncological Therapy” (starting towards the bottom of page 2). Castillo states that physical exercise “has been shown to have the ability to modulate the tumor environment… . This modulating effect translates into an improvement in the efficacy of chemotherapy and other oncological treatments.”

Castillo goes on to say that “prescribing doses of physical activity at an established intensity and volume can be very decisive in combating the tumor microenvironment, but this preliminary evidence must be confirmed in trials on humans to ratify the role of exercise as a treatment capable of improving the efficacy of the main therapies.” (All quotes from the aforementioned synopsis.)

With such promising results, it’s quite possible that future cancer treatments may be a combination of medicine and physical activity.

Ok, so say that you are not an avid exerciser, but motivated by these studies you’re willing to give regular exercise a go. What do you do when you’re already feeling fatigued from treatments?

I wrote about this here, but in a nutshell, the idea is that you need to decide what the right starting point is for you, and this will depend on your previous experiences, both physical and emotional, with a physical activity program. It will also depend on what you can manage at any given time in your treatment.

Starting an exercise program? Make it something that you can do and enjoy, and it will become a life-long habit.

Ask yourself, “what is reasonable for me?” But don’t respond to that with a t-shirt slogan-type answer (“Exercise? I thought you said extra fries?!?”) that immediately shuts down the idea. Admittedly, there may be times during treatment that getting yourself to the toilet without help is a momumental achievement. But that will pass. And exercise will make you feel more in control of your health and better overall.

IMPORTANT: Find what you can do and then do it as consistently as you can.

This may mean starting very simply [always get your doctor’s okay first!]. Choose an activity, duration and frequency, say, brisk walking for 20 minutes a day, three days a week. Follow that pattern for two weeks, then add to it–perhaps another 10 minutes–not to overwhelm yourself, but simply to push the edge a bit (you can always ease off if you need to, give it a week and increase again). If possible, increase some aspect of your program every couple of weeks, as it suits your condition. In the example of walking, incorporate a flight of stairs and gradual upper body movements: first pumping the arms, then hand weights, eventually strength training for both upper and lower body.

The timing is up to you.

If a walking program feels too easy for you, train at a higher level, but remember that the same concepts still apply: (1) consistency, (2) progression, (3) balance in your activities. If you’re interested, read my post about my three “pillars” of fitness.

Most importantly, start, progress gradually and keep it up for the rest of your life.

If your starting point is a standstill, this will take patience. But I PROMISE you, no matter what you can muster, it will still be better than doing nothing.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

I know I already said this, but it bears repeating, especially for cancer patients and survivors: do not start any exercise program without consulting with your medical team first. While I feel that improving your physical fitness is one of the best things you can do for yourself, every body is different and every cancer situation is different. Talk to your doctor and let them know what you’re planning to do.

Why I Stopped Believing in Ghosts

So, I have a confession to make.

Throughout my primary and middle school years, I thought I had powerful extra-sensory perception. Actually, it might have even been longer than that, although I’m embarassed to admit it.

I blame my older brother for this. We were in grade school and my grandma had just passed away. Due to the arrival of a number of relatives for the funeral, we were left alone to entertain ourselves. As we turned off the lights for sleep, he and I somehow got on the topic of extra-sensory perception and decided to test it out.

One of us would think of a number and the other would guess what it was. I guessed correctly, over and over again. I would “see” it through my closed eyes as I concentrated. I didn’t miss a single one and my brother was very impressed.

When I was young, my older brother convinced me that my mind had special powers. Well…he wasn’t exactly wrong.

I fell asleep that night believing that my dear grandmother had imparted me a special gift with her passing, and I felt that I had undisputable empirical evidence of it.

In reality, my claim was on shakey ground, but I had already convinced myself that there was something magical there. In fact, I began seeing “evidence” of it everywhere. These couldn’t have possibly been coincidences, could they? I started fearing that if I could see something as a possibility, it would actually happen. As a result, I fought to keep certain thoughts out of my mind. Avoidance, anyone?

Some years later my older brother admitted he had fibbed to me that night, that no matter what number I “saw”, he would pretend that was the number he was thinking about. He thought it would be funny.

But by then, the latent fear of my thoughts was ingrained in me, even though I knew that triggering event had been a lie. What was true, however, was that my mind had always been very powerful. In one instance, I experienced intense pain that I couldn’t explain, lasting several days. While I was vaguely aware that this pain disappeared upon the release of a stressor, I didn’t realize that it was psychosomatic –literally something my mind created that had been expressed in my body.

My mind also had the power to hijack my thoughts, amplifying negative feelings. I was anything but grounded. I managed to plow on, garnering notable academic achievements. But there was always a sense of fear in the background and since it ran unchecked, eventually it overtook me and pointed my life’s path in a direction quite different from that of my peers.

Wish I’d realized way back when that life could “magical” in its beauty without having to be supernatural and out of my control.

Lacking awareness of how my mind operated meant that I didn’t realize why I was making the decisions that I was. It took years, even decades, to understand that so many of the things I had feared originated in my mind, affecting my interpretation of whatever input I was receiving.

Now, after all these realizations and a number of painful lessons, my world is not as “magical” as it used to be, but I am better rooted and grounded. And that feels a lot better.

What about “ghosts”?

When I live in the present, I am safe and secure. Those unexplainable occurences that I attributed to otherworldly origins have become much more explainable. And I’m well-aware of how my mind has twisted meaningless common things into terrible foreboding ones.

There are quite enough frightening things in the material world (cancer, wars, having my email account hacked…) that there’s no need to search the paranormal world for their cause.

~~~~~~~~~~~~~~~~~~~~~~~~~

A 2021 survey of 1000 Americans revealed that 2 out of 5 people believe in ghosts. I am not here to contradict their beliefs, and frankly, when I talk of “ghosts” I don’t mean spooks. At the same time, I learned the hard way that my mind wasn’t always reflecting 100% truth. I was compelled to take inventory of what was bouncing around in my noggin and decided that, while I can’t neatly explain everything going on around me, it’s harmful to let my thoughts run wild.

Showing Signs of Stress

One of the benefits of doing a yoga teacher training (YTT) is that there are some interesting side effects that go far past learning about yoga instruction.

It also involves a great deal of introspection, sometimes uncomfortable, but always valuable.

Signs of stress are pretty universal and usually unmistakable.

What I found curious about myself was how, when I was stressed, I exhibited loads of visible signs of stress even if I was aware that I was doing it. It was as if I didn’t want anyone to mistake me for not being stressed when I was.

This made me wonder, was it simply habit? Or was I being a drama queen? Stress does affect me deeply and anxiety is hard for me to shake. It’s possible that I feared not being believed that I was suffering.

Perhaps I needed people to care that I was not okay.

But I came across a recent research article about this that suggested an even deeper reason. UK researchers Whitehouse et al. (2022, Evol Hum Behav) conducted a study in which it appeared that individuals displaying signs of stress came across as more likeable and more likely to elicit support from those around us.

This is curious because often in nature, showing “weakness” may result in a greater chance of being attacked. But apparently it doesn’t work this way in human society. The researchers postulated that signs of stress suggested that the individual might be deemed friendly and not a threat.

I can attest to the fact that seeing someone displaying anxiety immediately triggers a strong empathic response in me, no matter who the person is or what they’ve done. Having suffered anxiety myself, I am immediately drawn into what the individual might be feeling, projecting my own feelings onto them.

And it is very true that I’ve often gone out of my way to look more friendly, less scary, particularly when it comes to people smaller and weaker than I am (I’m 5’11”). I have a drive to appear less threatening. However, this does not necessarily benefit me–does the term ‘doormat’sound familiar? When you lower yourself far lower than is even remotely necessary, you’re not doing anyone any favors.

This explains a lot about my own life and it underscores the importance of being aware of your behavior and why you engage in it. When you run on autopilot you risk reinforcing negative self-beliefs and even generating new ones. Self-awareness is the antidote to that.

So that is what I’ve been musing about. YTT provided me with space from which to reflect on the ways that I behave and feel in certain situations. In turn I can use that information to make much needed changes in my life and get myself unstuck. How about you?

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Original research article:
Whitehouse J, Milward SJ, Parker MO, Kavanagh E, Waller BM (2022). Signal value of stress behaviour. Evolution and Human Behavior; DOI: 10.1016/j.evolhumbehav.2022.04.001

Reader-friendly version:
https://www.sciencedaily.com/releases/2022/05/220515113229.htm

Being in Your Body: A Mindfulness Visualization

I came across a delightful mindfulness visualization on the Calm meditation app, presented by meditation teacher Jeff Warren who credits his teacher, Dan Clurman, with relating the idea of this exercise.

It is an effective and immersive way to ground yourself into the present moment with the emphasis on being in your body.

Imagine that your body is an hour glass and that the falling sand brings awareness as it fills the glass, from the bottom up.

Imagine that you are an hourglass and your awareness is the cool sand that falls from above. First, bring your awareness down into your feet and ankles, feeling into the sensations there, filling up not only that part of your body, but also inviting attention into the space between your feet and around them at the bottom of the hourglass. Feel the level of your awareness rise.

Now invite your awareness to fill up your legs, while still keeping attention on your feet and ankles. Notice how the level of these “sands of awareness” travels up and fills out the space up to your hips. Feel into how that feels, not trying to change anything, but simply noticing any sensations.

In this way, continue to work your way upwards, allowing these “sands” to gradually fill up your body as they empty from your mind. Allow the swirling thoughts to release and drop down to light up your lower limbs, your entire torso, your arms and shoulders little by little. Maintain awareness of the parts of your body that have awakened already, so that as you move along in this way, the sensations in your body build and you feel the liveliness of the present moment in them.

Finally, coming to the top of your head, feel into all the sensations vibrating through your entire body, perhaps gentle tingling in your feet and legs or a subtle pulsing in your arms and hands. Maybe the awareness of movement through your intestines, the beating of your heart and even the areas where your body makes contact with the surface that supports it.

In this way, you bring the whole of your body into the present, not focusing on just one part, but on everything that makes up your physical presence, and also the space around your physical presence, while at the same time relieving your mind of the pressures exerted by thinking. As your body fills, your mind empties and thoughts are replaced by a sense of peace and well-being.

I’ve tried this a number of times and found it to be both grounding and uplifting simultaneously and an effective way to bring myself out of my head and into the here and now. If you’re looking for a different way of engaging in a body scan, give it a try.

~~~~~~~~~~~~~~~~~~~~~~~

Please note that a form of this meditation appeared on the Calm app on April 29, 2022, as an installment of Jeff Warren’s Daily Trip.

While I am a subscriber to Calm, I do not receive compensation for writing about the app. I am simply a very satisfied user.

15 Seconds of Zen in a Teaglass [Video Clip]

I’m neck-deep in juggling my day job and studying for my Yoga Teacher Training final exam, so I’m going to keep this short and tell you about a daily practice that I’ve established, as suggested by one of our teacher trainers.

We were to choose one thing to do consistently, something that was just for us and our well-being. And it was something that we should commit to doing everyday.

I chose making myself a tall glassful of hibiscus tea as my daily practice. As it is, I love tea because the process of making it requires that I pay attention to what I’m doing. While we set up morning (decaf) coffee the night before and the coffee maker is on a timer to brew, tea requires my presence.

Between waiting for the water to boil in the tea kettle, placing the hibiscus petals into the infuser, inserting that into the teaglass, pouring the hot water over it…the process becomes mindfulness meditation. And the best part is the visual reward of watching the vivid colors of the red hibiscus flowers seep through the infuser and into the glass, beautiful swirls of vibrant pink that, even if just for a handful of seconds, fill me with a sense of peace and spaciousness.

Feeling my spirit refreshed, I take a deep breath and return to my day.

Actually, it’s 16 seconds…but 15 sounds like a nicer, rounder number. Sorry about the knocking in the background. Once life calms down I’ll post a better version of this clip.

Permission to Grieve

I feel like I write a lot about loss when speaking of my cancer experience. That may seem like a downer, but truly, cancer treatment is a complicated process in more ways that expected. Bear with me for a few…

There’s so much to lose: lose control of your life, lose your hair, lose your lunch, lose a lot of money, lose time at work, lose your libido, lose your overall quality-of-life. In more extreme cases, lose your spouse and your house. And unfortunately, sometimes lose your life. On some level most of us may feel some sense of loss.

Cancer is complicated because it can bring on a huge sense of loss.

I keep talking about this because it’s not something that’s fun to talk about. Most people don’t know what to say when they find out you have cancer. They’re hesitant to say something to “remind you” of the illness, as if you could forget. Relationships can become strained and awkward.

Interactions with cancer patients often turn into a “rah-rah” fest, with well-meaning friends showering you with “you got this” encouragement. But that’s not always what you need to hear.

I urge everyone who cares about the well-being of a cancer patient to allow them the opportunity to express how crappy things are. To simply listen and not contradict them. Because being insistent that it’s not okay to talk about anything negative creates an even bigger sense of loss for the patient.

Does this sound wrong? We’ve been led to believe that being positive is the only way we should be and that it’s no fun to be around those who are gloomy.

But consider this: would you go to a funeral and try to get the grieving family to “cheer up”? Would you try to tell them jokes and elbow them into smiling? I don’t think you’d be very successful and might be escorted away – at the least your invitation to the meal afterwards would probably be revoked.

Forgo the cheerleading and simply offer an ear and a shoulder.

We know that behaving this way is unacceptable, at least in most cultures (I can’t speak for everyone). Grieving is an important part of the human condition and not being allowed to grieve loss can be very stressful and lead to problems down the road.

So it is for the cancer patient. There’s so much more going on than simply increased doctor visits and medical procedures. Minimizing the impact that this has on their lives may range from feeling unfair to devastating.

Of course, every patient is different and their reactions will differ too. But I would urge loved ones to err on the side of caution, give their cancer patient the time and space to process and grieve and save the exhuberant “cheering up” for a time when the patient seeks that out.

~~~~~~~~~~~~~~~~~~~~~

Ok, ok, the “loss of body odor” is one loss that’s not so bad!

Another Dual Focus Meditation: Engaging the Ears

In my ever-continuing quest to maintain my concentration during meditation, I’m constantly exploring different points of focus. My go-to still remains the breath, but I’ve written about sharing that spotlight with focus on sensations in the hands as part of a dual focus meditation.

More recently, however, I’ve incorporated more of the senses into my meditation practice (I mean, we have five so why not?).

Urban sounds can provide a constant din that can be used with the breath as a dual focus sensory practice.

In between the inhales and exhales, there’s space during which I’m notoriously susceptible to distractions. Lately, I’ve been working with sounds. I live in the city on a busy street and there’s rarely a lack of noise, so in the lulls between my breaths, my ears turn on and absorb the sounds transpiring outside my window.

The trick with sounds, however, is to allow them to simply be interpreted as tones and refrain from being drawn into naming them. A siren runs the risk of eliciting thoughts of “where’s the fire?” or similar scenarios. For this to work, it’s important to engage our “beginner’s mind” — our brains are quick to match familiar sounds with a story — and divorce the sounds from associations that we’ve made over the years.

If simply shuttling between breath and sound provides enough fodder for concentration, this might not be an issue.

In that case, street noise can be an effective anchor for its variability, its high tones and low tones, as the passing of cars may morph into ocean wave-like sounds.

Meditation music and meditative sounds abound on the internet. Hunt around and you will find a plethora of offerings to use as a focal point.

However, if urban noises are either too intermittent or too difficult to resist spinning tales around, there are many other options for ambient sounds that will work for purposes of meditation. It’s no surprise that platforms like YouTube have a gazillion listings under “meditation music” that may fit the bill. In addition, apps like “myNoise” (and website myNoise.net) provide customizable background sounds to help mask outside noise and maximize ability to stay focused longer.

As the body moves with the breath, sound will remain in the background allowing attention to organically cycle between the two. From personal experience, I’ve learned that juggling between feeling into sensations in the body (breath) and being aware of sounds coming through my ears results in really turning down the dial on my Monkey Mind, which seems to fade to the distance. This dual focus can close the gap through which mind chatter might otherwise intrude.

If you feel inspired, give it a try and let me know how it goes!

Two Simple Tips for Grounding Before Work

I wanted to share two little things that I do with my work setup to help ground me at the start of my day.

First, consider what’s in front of your eyes after your computer boots up? Choose a computer wallpaper to anchor you. Pick a calming scene, one that’s meaningful enough to tweak your emotional state. This is going to be different and personal for everyone. It might be random nature scenes, photos of people you care about, photos from places that you’ve visited, abstract images that you find peace-inducing and the like.

I have this image as my computer wallpaper and imagine how nice it would be to pet her when things at work get rough.

As an example, I currently have the head of a beautiful black panther poking out through lush green leaves as my background. The photo is highly detailed and when I look close at it, I am drawn in by the soft fur around her face, I imagine what it would feel like to scratch her behind the ears and “boop” her on the nose, even imagine her purring in whatever way panthers purr. This wallpaper allows me to slip away into big cat fantasies for a few seconds when I need a break, using all my senses to imagine what it would be like to interact with her.

It’s not just about finding the right image, however. While I currently use this panther as my grounding and relaxation anchor, if I go through a particularly stressful period of time where there’s a lot of anxiety at work, I will change the background to something different after the stress subsides.

Why? Humans tend to be visual creatures and we make strong associations that we’re not always aware of. If you’ve been looking at the same image while you’re close to having panic attacks, it’s time to change the image. Trust me on this one–it has to do with associative learning (think Pavlov’s dogs, except without the salivation).

I did this after going through cancer treatment. Done with chemo? Changed the background. Finished up radiation and herceptin? Changed the background. As much as I liked the backgrounds I was using, it felt great to get something fresh up on my monitors. It felt like a new start and I really needed that.

The second tip I have is equally simple and has the added benefit of being helpful in terms of computer security .

Find a phrase that makes you feel good? Turn it into the passphrase that you type every morning!

Change your password to a passphrase that inspires you or calms you. How would it feel to recite an affirmation or words of encouragement when you log into your work computer every morning? Make it so. It could be an expression of self-worth (iAM-D3$ervinG0fLoVe), a reminder to stretch (r0llY*ur$hou1d3rs) or any other positive phrase (th1s2$hallP@ss-Justbr3@the). It might be that little thing you need to give your day a teensy push in a positive direction.

For additional cyber-protection, stick in a word from another language –perhaps the sanskrit version of your favorite yoga pose?

The above tips are not earth-shatteringly novel concepts, but they are remarkably effective. Give them a try and see if they make your day a little more bearable.

Victims of Our Own Success: Premature Aging in Cancer Patients and What You Can Do About It

So this isn’t the kind of news you want to see. But there’s still hope…

A scientific journal article from 2017 (Cupit-Link et al., 2017, ESMO Open) describes the toll that cancer treatments can take on the patients subjected to them.

After being told you have cancer and deciding to proceed with the treatments that will offer you the best chance of survival…it’s disheartening to learn that many of those same treatments can accelerate aging, causing damage to your DNA, heart disease, hearing loss, cataracts, liver and kidney diseases, brittle bones, lowered immune response and other cancers (!) among other issues, depending on the type of cancer and treatment (see WebMD article).

The treatments that can save our lives from cancer may hasten our demise from age-related factors.

This is a problem resulting, ironically, from the success of treatments and extended lifespan of cancer survivors. Back when cancer was deadly with a low survival rate, no one was too concerned about the state in which survivors were left in; simply surviving the cancer was enough. Now that people are beating their cancers at greater rates, quality of life has become a much bigger issue.

While the most striking detriments are seen in childhood cancer survivors, accelerated aging occurs in most former cancer patients.

Doctors and researchers are taking note. At the time of this scientific article’s publishing in Dec 2017, there was already discussion on how to “de-escalate” cancer treatments as a way to decrease the amount of cellular damage to patients.

On a personal level, I chose an effective drug for my HER2+ breast cancer (Herceptin) over a more effective drug (Perjeta) that carried a risk of greater cardiotoxicity. I made that decision because although I was terrified of cancer, I was also afraid of what lasting effects the drug would have on me once the treatments were over.

Cancer treatments are strong but healthy living can help mitigate their negative effects.

But even if you didn’t have the opportunity to make such a choice, there’s still something that you can do. The authors of that 2017 paper noted that cancer survivors can take back some control over their health by adopting or continuing those healthy lifestyle habits that should sound familiar by now: not smoking, limiting alcohol, exercising regularly and eating a healthful diet.

To that, I would also add, managing your stress levels, the importance of which has been demonstrated on a cellular level, and getting optimal amounts of sleep.

Improving longevity is a hot field for research as scientists work to determine what aspects of one’s lifestyle show the greatest promise in keeping the body young. This topic is complex and new data is coming in on a regular basis, so I won’t delve into details here, but it stands to reason that being sedentary and eating a high-sugar, high-processed diet is not going to do you any favors.

Just as cancer treatments may have a negative effect on overall health, you can win back some lost ground by making healthy, informed decisions on diet and exercise. No one wants to limit their cancer treatment options, so this is one form of insurance that you can give yourself. No matter what else happens, a healthy lifestyle will benefit your quality of life. And that is an improvement that is yours to keep.

Making Space Through Breath: A Visualization

I’ve posted previously about the sensations I’ve experienced in the midst of anxiety, as if the stressor is right in my face, raw and unescapable.

Combatting this feeling has been my number one priority, since anxiety overtakes me before I even know it, triggering my fight-or-flight response. Once my sympathetic nervous system gets going, getting it “back in the box” can be difficult, possibly taking days, depending on the intensity of the stressor.

Anxiety can make us feel like we’re trapped and suffocating.

My current strategy is to create protective distance for myself in a very simple way. And it consists of visualizing an expansion of the space around my body.

It goes something like this: Imagine you are inside a deflated balloon. If you are experiencing tighteness in your head or chest, this serves as an effective analogy, particularly if your balloon is constricting you. Without letting your mind be consumed by the tightness, allow yourself to acknowledge the stressor that surrounds you.

Then, taking a deep breath in, exhale through pursed lips and inflate that space around you. Imagine how it feels to expand the balloon and release that clinging sensation. Feel the fresh air moving against your skin as the space around you continues to broaden.

Maybe you begin with the area around your head first, as if creating a bubble around it allows oxygen to flow freely, then move the expansion towards the torso, protecting and releasing the heart, lungs and other vital organs.

Or perhaps begin with the chest if that’s where the constriction feels greatest. Anxiety can squeeze your breath, so focus on mentally removing that weight from your sternum and ribs, visualizing an expansion of the free space around your chest with a deliberate slowing of breath. This takes some work, a back-and-forth between imagining space expanding around you and your breath taking advantage of the room that it has.

If your chest is mired too deeply in anxiety, turn your attention to your extremities, starting with the feet and hands, getting a foothold there and allowing the sensation of space to move slowly towards the center of your body.

The idea is to E-X-P-A-N-D the space around you, dispelling the feeling of closeness and suffocation that results in the wild urge to flee. Note that this is not avoidance of the stressful situation. You are acknowledging its existence…and then creating room so that your brain has space and time in which to think, to know that it’s protected from words and sensations and fearful possibilities. To know that it’s safe in the “now”.

Try this the next time you have a quiet moment. As with many of these techniques, it is helpful to practice in times of calm, to feel into what that sensation of space feels like. The more we practice, the clearer and more familiar that sensation becomes, and we can draw upon that feeling during stressful times.