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).
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.
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.
This is the time of the year that many people make resolutions they hope will catapult their life into a new and positive direction.
So it’s also a good time to encourage people to slow down and consider what they hope to achieve and how they plan to get there.
The New Year’s buzz drives us to dream big and leap high, but with all that emotional energy expenditure, we run the risk of overwhelming ourselves, burning out quickly and falling far short of our lofty expectations. And that may make us feel worse about ourselves.
This year, take a step back and consider: it’s the small changes that you make on a daily basis that determine where you ultimately end up. Consider an ocean liner that turns very slowly. It makes little adjustments in its course, but depending on which adjustments it makes, it can end up in very different places.
The real name of the game is consistency. While the big goal may be the shining light you strive for, consistency paves the way. And mindfulness helps you get there.
Focus on what you can do today. Even this hour. Want to increase your activity level? Get up and take some steps right now. That doesn’t mean sprinting around the parking lot for 10 minutes. It means doing something you wouldn’t have done otherwise. Something that won’t give you side stitches and result in wanting to throw in the towel.
Make little decisions to change something. Make them doable. And then make them consistently.
Maintain your awareness, every day, of what you’re doing and why.
And when those changes have become comfortable, do a little more. Keep your eye on consistency, not quantity.
Establish positive little habits the way you’d spread the seeds for a lovely cottage garden. Because here’s the thing: this is not a race. This is your life. You don’t live your life a month at a time–you live it moment by moment. And that’s the way you make changes.
Any decision that positively affects you remains yours to keep, like a little jewel in a box. Did you go for a walk among trees after lunch instead of hanging out in your office perusing social media? No one can take that experience away from you. Tomorrow, if you have a meeting after lunch and must stay at your desk, the positive effect of that walk will still have taken place.
It’s like a little brick that you can use to build a palace. You collect one each time you’re consistent with a behavior. Play the long game.
And when you remain mindful of your behavior every day, you can also step back and see where you, the human ocean liner, are headed. This makes it easier to correct your course. A short diversion does not need to take you in an unwanted direction. One small correction and you’re back on track.
And that thing that you might have called a “failure” in past years and just given up because you’d figure you’d “blown it anyway”? It would be a temporary side trip. Because you are mindful of where you are and where you’re going.
And that’s how you know you’re going to get there.
I am a believer in the idea that, for developing proficiency in an undertaking, consistency is more importat than what you do on any given day. It is true for workouts and it certainly holds true with meditation too. Exercises, whether physical or mental, need time to show beneficial effects and that requires patience and persistence on the part of the practitioner.
However, there comes a point where maybe what you’re doing, consistently, might need to increase in order to enable you to progress.
When I started out with meditation, I had very little guidance outside that from the Calm app on my phone. The curated daily meditations there lasted about 10 minutes, so that’s how long I meditated. I did so ever single day, true to my perfectionist nature. I earned a gold star for consistency.
At that time, my life was in turmoil–I was only a few weeks out from a cancer diagnosis. Meditation helped me breathe through the early sleepless hours of the morning, when I would wake, feeling frightened, alone and angry.
But it wasn’t until almost a year later, when I started the Mindfulness-Based Stress Management (MBSR) course originally developed at the UMass Medical Center, that I learned how much meditation could do for me. Our “homework” was 45-60 minutes of meditation a day, no joke when you’re used to 10-minute stints.
But during that time, something unexpected happened. As I meditated, somewhere around the 20-30 minute mark, I felt myself settling in and releasing. This, for a bundle of nerves like me, was a novel experience. I don’t think I could have gotten that with 10 minutes a day. But a glorious hour? It was transformative.
Giving myself permission to simply BE for the entire length of time was not easy. There was guilt involved in being “unproductive” for so long, not to mention the difficulty of dealing with intrusive thoughts. But once my monkey mind accepted the fact that all I was going to do for the entire hour was feel into my breath or pay attention to bodily sensations, it started settling down, gifting me with a stillness that I hadn’t experienced during the shorter meditations.
It was the most soothing act of self-care that I had ever allowed myself to do.
So right now I want to clear the air of the “never good enough” idea, by which I mean the concept of, “Oh, you’re only meditating for 10 minutes? You should be doing it longer.” That is a total motivation killer and goes completely against the acceptance that mindfulness teaches. And that’s not what I’m suggesting at all.
There are great benefits to short meditation stints, one of which being that when you “drop and give 2 minutes” of deep breathing, or however else you choose to express your mindful self, you are actually doing a great job of integrating mindfulness into your everyday experience. Remembering to ground yourself in the middle of a hectic moment allows for a respite from the busyness of the day and helps build a mindful life.
But if you find yourself with extra time, such as a day of travel (where you’re the passenger!) or a prolonged sit in a waiting room–jury duty, anyone?–or even the decision to turn off the electronics and retire to bed early, it is well worth giving yourself a nice chunk of extended time to engage in the self-care of turning inward and being still.
Tip: If you’re not used to prolonged meditation sessions, start with an extended guided body scan meditation, readily available free online through YouTube, MBSR websites and apps such as Insight Timer, for a few examples. It will give your monkey mind enough to do so that your thoughts don’t completely wander off, and yet little enough so that you can feel completely into each body part.
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.
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…
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.
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.
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).
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.
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.
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.
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!
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.
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.
Although this is a blog about cancer and mindfulness, I hardly think there is any lifestyle habit as effective as exercise at helping survive cancer. And what better time to discuss this than the start of a hopeful new year?
I’ve been certified as a personal trainer by the American College of Sports Medicine (ACSM) for well over a decade, and although I haven’t actively taken on clients, I’ve had enough time to develop my own fitness philosophy. I must stress, this is a conceptual post and not designed to guide you to specific exercises (although I mention some modalities as examples). However, if you’ve had trouble getting your head around how to maintain an active lifestyle, these ideas may help.
In my experience, there are three critical aspects to a successful exercise program: (1) consistency, (2) progression and (3) balance.
This is the most important concept of my three and worth spending the most time on.
Consistency is the concept that seems to be most difficult for people, and it’s usually the “make-or-break” aspect of fitness. It’s quite simple to get motivated to start a new program, whether it be signing up for classes, planning out home workouts or simply deciding to go for a brisk walk every day.
The hard part is sticking with it. But I can promise you, that’s where the magic is. Be realistic about how much time you have to devote on a daily basis and what your exercise will consist of. This should not be something far out of your realm of experience or else it will be too difficult to maintain. Make it familiar.
For example, if you do not already have a consistent history with a piece of exercise equipment (say, treadmill), do not purchase one under the assumption that the high price tag will surely motivate you to use it. It will not. The greatest workout you’ll get with it is carrying it to the basement or attic after you can no longer stand the guilt of watching it gather dust.
If you can’t maintain your workouts, you will have to go through the “beginner” phase every time you summon the wherewithal to restart again.
That also means going through “beginner soreness”. Honestly, there’s little pleasure in a Groundhog Day-like experience of not being able to get past the little aches and pains you might feel after getting your body into motion again. Don’t do this to yourself.
How to avoid it? Look at exercise as a lifelong habit, not something you do just to “get in shape” for a specific event like a wedding or reunion. Take smaller bites of exercise, something very doable that you won’t dread, especially if you have negative associations with workouts. Set goals like “train 5 days a week” and plan them out, not “lose 15 pounds” or even worse “look better” (what’s that?). It’s more motivating being able to tick off a specific, finite goal than never reaching one that’s vague, arbitrary and even judgemental.
And DO consider it “training”. You are training for living the rest of your life with more ease, maintaining your flexibility, balance, strength and endurance just that much longer. As in the tale of the tortoise and the hare, starting something that seems “not vigorous enough” but that you can see yourself doing, say, every day, in a year will put you miles ahead of someone who started an ambitious and complicated exercise program and burned out in a matter of weeks.
Look at it this way: the trillion-dollar exercise industry is betting on you giving up, and so it always comes up with a new shiny object to tempt you with. Often the program is unsustainable and the promised results are unrealistic. You don’t need that. You need consistency.
Again, decide what you can do and do it regularly. Realize there will be days when it won’t be possible to get it done. That’s okay – no guilt, no shame. But then get right back to it as soon as you can. Think of every workout as something positive and precious that provides you with health benefits that no one else will be able to take away. Each day you exercise is one more step towards establishing a habit that will lead to a lifetime of fitness.
IMPORTANT: Put up a high-visibility calendar where you can mark off your workouts and easily see how consistent you are.
But what if it gets TOO easy? That’s when the next pillar comes in…
Once you’ve established an exercise habit, your body will eventually adapt to what you’re doing. This is a very good thing. It also means that it’s time to change things up a bit, always giving yourself permission to dial back down to what you’d been doing previously if you have a harder time getting going on any given day.
The trick is to maintain consistency while also challenging yourself. For example, if you were doing a walking program, incorporate bodyweight exercises (squats, modified push-ups) that you can do along the way. Climb more hills. Pick up the pace.
If you want to get a PhD, you don’t keep taking freshman-level classes. Challenge is where growth happens. We get an unmistakable sense of satisfaction putting in the work and seeing results.
This is also where your self-confidence blossoms. And that’s exactly the bouyed spirit that keeps you going.
Don’t ramp everything up at once. Add a little at a time, but definitely make it count. Be realistic about whether or not you’re challenging yourself: if you need to push it even more and can do so safely, go for it. If you honestly try but can’t do as much as you expected, halve the amount and try again. Don’t beat yourself up. You will get there. But don’t short-change yourself either.
Most importantly, unlike high school PhysEd class, you’re in charge. That also means you’re responsible for your own progress. Some workouts will be better than others, but always remember, doing anything is STILL better than binge-watching Netflix with a bowl of chips on your lap. Congratulate yourself for making the decision to exercise!
Hey, why not watch Netflix while marching in place? It still counts so write it down!
So let’s assume that you’re being consistent and gradually increasing the duration/intensity of your workout. That’s perfect, but there’s one more pillar to consider…
In this case, I don’t mean balance as in being able to hold tree pose throughout your entire lunchbreak. I mean are your workouts well-rounded? I’ve seen runners do little else but run. If this is you, incorporate some variety into your life. Your running will improve if you are also training for strength and flexibility.
Here’s a simple analogy for balancing out your workouts: imagine getting a massage regularly, but on only the left side of your body. That side will feel great, but you’re missing something. Your right side needs some love too. Eventually that imbalance will affect you negatively.
Exercise programs are best when they are a melange of endurance, conditioning, strength work and staying limber. It is extremely tempting, once you become adept at an exercise modality, to keep at it at the exclusion of everything else. After all, you’re an expert in it. But you’re also opening yourself up to injury and that’s something no one needs.
Take the time to explore different modalities. Often a type of exercise (say, yoga) can cover a number of bases, but you will still need to supplement with other exercises to stay truly well-rounded. Even strength training (which I consider critically important, btw) can have a cardio effect, but much will depend on how your workout is structured.
Do some research but don’t over think this. Just make sure that you are supporting all your body’s needs. Taking the runner’s example again, strength training will help you maintain muscle mass that you might lose from too much running, and it, along with flexibility and mobility work, will help prevent overuse injuries.
This doesn’t mean that you have to significantly increase the number of workouts you do, just that you have to be creative in what you add to your exercise session. The idea is to incorporate what else your body needs to keep it humming optimally. And then, write it down.
Bottom line when you’re just starting out? Move. Even if you don’t really know what exercise you “should” do, just find a way to move. Dance. Wave your arms over your head. Break up sedentary times as much as possible. If you sit for an hour, stand up and walk in place for three minutes, swinging your arms. Don’t be afraid to work up a sweat.
Then keep doing it.
Above all, make it pleasant, so that you look forward to exercise as a break from those things in our environment that keep us sedentary. The human body was meant to move. That is its natural state. Give it the opportunity to do what it’s supposed to do, then let it recouperate and nourish it with healthy food. The idea is to start now and keep going for the rest of your life.
Being an avid exerciser enable me to recover from cancer treatment much more quickly. Up until my last couple of infusions, I was rowing and lifting weights within a week after each chemo (mine were spaced three weeks apart). In an out-of-control situation like cancer, exercise was one constant that made me feel like I still had a grip something, and that made the whole experience better.
I meditate. It is a daily habit that I engage in with the best intentions, but I am a victim of my wandering mind. Some days are better than others, most days I struggle with distractions.
Often, I can be halfway through a sit before I realize that I’ve been clenching my jaw or tensing my brow or gripping some other part of my body, thinking I’ve been relaxed but I’ve been kidding myself.
There are times that I’ve managed to stay with my breath, and then start getting excited that I’ve stayed with it that long, and then start imagining how I might look, staying with my breath…and of course, then I’m no longer meditating.
So it goes, day in, day out. Everyday, once or twice a day, or maybe even more. Some days feel like a complete waste, like I’ve got a freeway running through my head and have no idea what I’m doing.
But once in a while, I get a few moments of golden light. They may just flicker in and out, but when I look back at those moments I know everything flowed.
And those mindful sessions make all the other ones worth the effort. Every time I pause before reacting. Each time I recognize my body’s physiological response to a stressor. When I remember that I don’t have to respond with anxious energy. That I get to chose what happens inside my head. That I can just say, “Sh-h-h-h.”
That I can stand back and observe the storm without getting sucked into the whirlwind.
I meditate and often don’t do it well. But I still meditate. As of this posting, 1,380 days in a row, originating with the most frantic breaths shortly after my cancer diagnosis. Even through chemo, when I thought I wouldn’t make it through the night. Sloppy meditation sessions that seemed to be going nowhere.
Those imperfect meditation sessions have changed over time, imperceptable on a daily basis. Perhaps they have worn away a few rough edges the way constant drops of water oh-so-gradually wear away a stone. And just as an indentation forms where the drops hit, so meditation has molded a little basin for me, a bit of extra space in my mind that provides just that much more breathing room.
I am still at the very start of my mindfulness journey, so imperfect and stumbling. But even with the little that I have achieved, I am light-years ahead of who I was before I started, wide-eyed with fear and not knowing how to stop the rush of emotions.
It was terrifying then because I didn’t realize what was happening. Now I know, and that makes all the difference.