In case you’re wondering why there’s all this mindfulness stuff on a cancer blog, here’s a reason: a recently published article in Science – Translational Medicine (Perego et al., 2020) provides laboratory evidence for the benefits of reducing stress levels for cancer survivors. It has to do with the effects of stress hormones on cancer recurrence.
In this study researchers looked at the cancer cells that are sometimes pushed into dormancy by treatments like chemotherapy. Cancer recurrence may be a result of such cells being activated again at some point in the future.
Perego and colleagues were able to recreate such dormant cancer cells in the lab, then found that they could awaken them again using neutrophils, a type of white blood cell that, under certain circumstances, can be harnessed by tumor cells to aid in their proliferation.
Those “certain circumstances” turn out to involve stress hormones. The researchers found that stress hormone + neutrophils = woken cancer cells. The process is a cascade of events: the stress hormones caused the neutrophils to produce S100 proteins, which in turn created lipids, and it was those lipids that caused hibernating cancer cells to stretch and rub the sleep out of their eyes.
Keep in mind that these studies were conducted in petri dishes (for “proof of concept”) and then in mice, which does not equate to eliciting the same response in humans. In fact, the connection between stress and cancer is still inconclusive in human studies, partly because in the past researchers have noted that some of the coping mechanisms that humans use to deal with stress (smoking, drinking, overeating, etc.) may be the more important culprits that lead to cancer.
Nonetheless, Perego and colleagues were able to show that stress and neutrophils may form a path by which dormant cancer cells awaken in humans, leading to cancer recurrence, and this opens the door to more directed future research. Note, this is certainly not the only way that cancer can recur, but it provides an opportunity to develop drugs that can break the cascade and thereby prevent recurrence in some cancer survivors.
To be clear, this doesn’t mean that if a cancer survivor is stressed out their cancer will definitely come back, because there are a number of intermediate steps that need to take place within that cascade, but this is still a good reason to practice stress-reduction techniques. It might help you remain cancer-free.
If you have access to a university or hospital library, you can look up the original research article using the following PubMed citation (links to abstracts below; once the free full-text PMC version is available, I will link to it here):
Perego M, Tyurin VA, Tyurina YY, Yellets J, Nacarelli T, Lin C, Nefedova Y, Kossenkov A, Liu Q, Sreedhar S, Pass H, Roth J, Vogl T, Feldser D, Zhang R, Kagan VE, Gabrilovich DI. Reactivation of dormant tumor cells by modified lipids derived from stress-activated neutrophils. Sci Transl Med. 2020 Dec 2;12(572):eabb5817. doi: 10.1126/scitranslmed.abb5817. PMID: 33268511.
ZenViewis a sweet little app that has been around for a number of years–I downloaded mine way before I even considered breast cancer as a possibility in my life. Note: I use the iPhone app and cannot recommend an Android version.
ZenView is designed to offer you a respite from a hectic day and it accomplishes this very simply. It provides you with a soothing nature image and the ability to create raindrops in it, as if you were looking into a puddle.
The interface is easy to figure out. Click on the little cross at the bottom right of the screen to bring up a minimalist menu. You can chose from a variety of “themes”, which are basically background images (8 free and 8 with a paid upgrade). Then select the type of rain you’d like: “soft sprinkle”, “light shower”, “heavy storm” and even a “clear sky”, so you can place raindrops on the image with a fingertip and watch the ripples fan out.
If the provided images don’t suit your fancy, you can use your phone’s camera and get a calmer, rainy-er view of your world through its lens. I’ve found that this is a great way to quickly put some space between myself and a real-life stressor.
The raindrop sounds feel immersive, perfect for taking me away from the stress du jour, no matter what rain intensity I choose. And the sounds can be turned off completely if that’s what you need at the time.
I used the free version of ZenView for years and only recently unlocked the premium themes–I was completely satisfied without them, which is one of the loveliest things about this app: the free version is quite enough.
Ultimately, I upgraded to support the developers, particularly since the cost was only $0.99. Given how much I’ve used this little app over the years, I felt that it was time.
I would encourage you to try this out. It’s not a complex app, but it delivers what it promises: a zen view of the world.
Okay, this is going to sound weird, but I’ve found that this really works.
A little background: in the midst of a stressful situation, I struggle with staying present and grounded. While I try to focus on and slow my breathing, that can be ineffective, since my heart is often beating quickly and, you guessed it, focusing on my breath brings me to close to my heart. It’s hard to ignore the pounding.
I’ve written before about turning attention to the extremities, in particular the hands and feet, feeling into the sensations there, since they are as far as you can get from your heart and still be in your body.
But most of us are very aware of our hands and even our feet since we get signals from them all day long as we manipulate objects and walk around. It’s not a new sensation. Even digging your nails into the palm of your hands may end up as a stressor of its own (ow!).
However, one place in our body that can still elicit novel sensations is the roof of the mouth. Even for someone like me, who often scratches my palate with hard veggie stems and uses my tongue to feel around up there, the ridges and other surfaces still seem new and unexplored.
Imagine that you’re drawing a topographical map of the inside of the mouth: feel where the teeth sit in the gums, and the hard area to the inside of the teeth traveling deeper in, how that hard ridge drops off into the concave part of the hard palate, curving up and then softening into the soft palate.
One of the supposed benefits of stroking the roof of the mouth with the tongue is that doing so can purportedly stimulate the vagus nerve, and thereby the parasympathetic nervous system, because the vagus nerve rests close to the surface of the inside of the mouth. All of this may have a calming effect, which is exactly what you’re looking for.
It’s also worth noting that in the throes of stressful situations, our mouths tend to dry out. Something to try the next time you’re anxious and cotton-mouthed: elicit salivation by simply thinking about something extremely sour–imagine biting into a slice of lemon. Try that now, visualize it as realistically as you can, and chances are your salivary glands will respond. Mine are just writing about this!
When you are able to focus on bodily sensations you bring yourself back to the reality of the here and now. It removes you from the fear of what may be, and gives you the opportunity to come back to Earth, take a deep breath and carry on.
So next time you are feeling overwhelmed, see if you can allow the novelty of the roof of your mouth to buy you some breathing room.
Oak is among the simplest meditation apps that I’ve tried. While it’s not as stripped down as The Breathing App, it really covers all one would need for a meditation practice.
I love the aesthetics — the app has a soothing watercolor-like look to it that reminds me of a quiet, overcast morning, before the rest of the world has awoken. Navigation is very simple as there are only three basic elements to choose from: meditate, breathe and sleep. However, they’re quite enough.
Meditate offers three meditation options, all customizable in duration, instructor voice (male/female), background sounds and warm up (for those wanting to settle in before meditating). The three types of meditations are (1) Mindful, learning to focus on the breath; (2) Loving Kindness, cultivating compassion and empathy both for yourself and others; and (3) Unguided, with the choice of interval bells instead of spoken cues.
Again, very uncomplicated and accessible. Both the male and female voices have that certain “something” that makes them soothing and easy on the ears. While Oak doesn’t have the expansive meditation libraries that some apps provide, for many meditators what Oak offers will be quite enough, and the ability to customize the meditations creates far more permutations than one might expect.
Breathe is the section of this app that I personally use the most. It consists of three types of breathing exercises: (1) Deep Calm, which has been advocated by Dr. Andrew Weil and has a 4-second inhale, 7-second hold and 8-second exhale; (2) Box breathing, which is a square “box” of inhale-hold-exhale-hold, each segment being 4 seconds long; and (3) Awake, which is a 6-second inhale followed by a brief 2-second exhale.
The number of breaths per “set” for each of these exercises differs, and you are limited to the number of totals sets you can do at a given time. However, this is probably a good idea because it’s important to take breaks when doing prescribed breathing in these ways. Think of it as insurance against passing out.
Sleep offers (1) Relaxing Sounds and (2) Guided Breath. Again, there are options for the background sounds and duration. I enjoy using the sound “elevate” at work, not for sleep (!) but to offer gentle music to even out the frustrations that may complicate my day.
There is also a 10-session course on Mantra Meditation. While I was able to unlock it for free, this may be a temporary benefit (perhaps due to COVID-19?) because the App Store makes mention of the course being available for a small fee. Keep that in mind for the future.
I had not been using a mantra for meditation, but this class helped me choose one and added another dimension to my meditation practice. The narrator’s voice was perfect for this type of lesson. The class is downloadable which leaves you no excuse not to meditate on your next plane flight. Note that I haven’t completed the entire course yet, so I cannot yet comment on its benefits as a whole.
Finally, Oak tracks your progress, including minutes meditated and number of breaths taken. It also shows the number of people meditating and breathing with you. And of course, it shows you your streaks. So, if there were something that I felt I need to gripe about with this app, it would be that it encourages me to focus on streaks. I can get pretty obsessive and competitive about these things, and unfortunately, Oak doesn’t let me turn them off.
On the other hand, tracking your progress is what allows you to gather badges while developing your meditation and breathing practice, so for anyone who’s interested in seeing visual reminders of their progress, this is a plus.
All things considered, this is a lovely app that you’re not likely to outgrow quickly. With the exception of possibly being charged for the course, everything else is absolutely FREE, which evokes the spirit of mindfulness being accessible to all. It also makes it completely risk-free to download and try for yourself. While I haven’t used Oak quite as much as I have other apps, I really do enjoy it and highly recommend it.
If there were ever a time to open yourself up to being more mindful, it’s in the midst of a global pandemic. We are in foreign territory, in an unsettled state where we’ve lost our footing. Mindfulness can help us find a path through this.
Being mindful is critical now that we’ve got to remain more aware of how we move through space.
There are things that we do automatically. Consider how often you touch your face. Don’t do that! It’s important to notice where your hands are. Are you wearing a face mask? Don’t touch the front of it. When you inhale, you’re creating suction around the mouth and nose, and if you’ve come into contact with viruses, it is more likely that the cloth covering those areas will be contaminated. Remove the mask only using the ties on the back of your head or elastics around your ears.
Going to the store? Be aware of which hand you’re using to do what, even if you’re wearing gloves. Touching door knobs or packages with one hand? Use the other to get your wallet out of your pocket or purse.
What hand are you holding your phone with? Which finger are you touching the screen with? The COVID-19 situation necessitates a focus on what you’re doing. Take a deep breath…and then disinfect everything when you get home.
Living mindfully, in the present, helps us let go of fears surrounding what may happen, and in the midst of unprecedented uncertainty when , most of us have those thoughts. But you don’t have to let them take you over.
Stay grounded in the moment. No one knows exactly what the future will bring, but the possibilities can be scary. Right now, however, you are safe. Feel what part of your body is in contact with the seat or floor. Come down from the frightening thoughts and listen to your breaths. Those imaginings of the future are not happening now. At this moment you are standing or sitting, breathing. Feel into your hands and feet. Can you feel the blood pulsing through them? Feel yourself being supported by the earth. Breathe.
If you don’t yet meditate, this is a chance to start, and it’s a habit that will benefit you for years to come. The good news is that you don’t have to get it “right” the first time. In fact, there is no “right”. There is just consistent practice.
What does meditation look like for you? It doesn’t have to be sitting in lotus position and chanting mantras. There are other ways to meditate. Stay in the moment. Keep your attention on your breath, noticing the quality of the inhales and exhales. When your mind wanders, as soon as you notice your loss of focus, bring yourself back to the breath. Resist jumping down rabbit holes of tempting thoughts. Just stay with your breath. That’s all.
If you need to bring yourself down to a more peaceful state, you can try a more structured breathing technique, such as the 4-7-8 “relaxing breath” espoused by Dr. Andrew Weil: inhale for 4 counts, hold for 7, exhale for 8. It is more important to maintain that ratio rather than to have a count last for a specific amount of time. Do several cycles of this, then return to natural breaths.
Does this feel too forced for you? Your meditation might be listening to a complex piece of music — truly listening to how the instruments blend together, gliding through the different layers of sound — and feeling into the sensations that it invokes in your body.
Perhaps it’s looking at nature through a window, holding a cup of warm tea, immersing yourself in the subtleties and complexities of the world.
Or constructing a jigsaw puzzle, diligently looking for pieces to match a color or pattern. Focusing on the satisfying click when they snap into place. Apparently, this is a stress reducer for many, many people, given how quickly puzzles disappeared from Amazon!
Find your own meditation. Let go of what you think it “should” be and focus on what works for you. There will not be a quiz.
Calm Stress Eating
For those prone to emotional or stress eating, a stay-at-home order can result in weight gain. This is the time to practice awareness of what goes in your mouth. Do you respect yourself with nutritious food or treat your body carelessly? Are you truly hungry or do you eat out of habit or boredom? Are mealtimes a mechanical process for you?
Allow yourself the opportunity to halt other distractions and focus on what you’re eating. In a busy household, this can be difficult, but as with all mindful things, there is no “perfection”. There is simply practice: doing, and doing again.
Look at your food. Savor the aromas. Listen to yourself chew. Taste the flavors. Feel the textures. Close your eyes. Slow everything down. See if you can sense when your hunger has subsided, instead of stopping simply when you’ve eaten everything on your plate.
Create a Calming Space
Now that we’re sheltering in place, it’s not as easy to overlook cluttered spaces. Living in the midst of disorder can be very stressful, but trying to balance remote work and childcare, or beating back concerns about no longer having a job, while trying to maintain a cleaning routine is also anxiety-provoking. There is nothing normal about the situation we are in, so allow yourself the latitude to prioritize.
Mindfulness takes the drudgery out of cleaning. Stop and look. Breathe. Decide what you can take on and then go for it. Focus on one spot and stay present as you work on it. Set a timer for ten or fifteen or thirty minutes and see what you can get done within that time. I guarantee you that you will find yourself in a better place than if you hadn’t done anything at all.
This is not a punishment. It’s an opportunity to create a positive environment in which to ride out the pandemic. I spent Easter Sunday bleaching my kitchen, which seems so antithetical to what we expect to do on a holiday. But for me it was a gift, being present and scrubbing counters and appliances bit by bit, no expectations. Yes, there are still many loose papers on the dining room table, but when I enter the kitchen, I breathe a sigh.
I could say, “it’s not enough,” but you know what? It is more than enough. It’s a semblance of order in a situation that felt out of control, just as the COVID-19 situation is out of our control. We all need some grounding, and I promise you, a clean, uncluttered room lowers stress levels. When I went into the kitchen to get coffee this morning, I thought I was in heaven.
This sense of calm is still with me, even as my son has decided to bake cookies…
There have been times when things in my life have gotten intense and I feel the walls closing in on me (cancer, I’m looking at you). Those are the times that I need to back off and give myself space to breathe. Being a very visual person, one of the methods I’ve employed is finding an image and associating a calm mind with it.
This becomes my safe space. Whether you prefer to call it your “calm space”, “sacred space” or even the oft-ridiculed “happy place”, the idea is the same. Find the visual elements that you find soothing and comforting — perhaps a place in nature, a place from your past where you felt safe, even a fantasy land that you create for the purpose. Real, imaginary, familiar or visited only in your mind, it doesn’t matter. What matters is that it resonates with you.
When I did this most recently, in the preparatory phase for Eye Movement Desensitization and Reprocessing (EMDR) therapy sessions to help with anxiety that I’d never been able to shake, I made a new Pinterest account to collect images.
I highly recommend this for anyone going through stressful times. We all need a buffer between ourselves and this hectic, unpredictable life, and this is one way to do that. Collecting and pinning these images is relaxing in itself!
I have always been drawn to natural settings with lots of greenery, so I searched for elements such as gardens, greenhouses, water, hanging vines, flowers and fish. This is a place created exclusively for me.
It is is easy to find many images that capture the feeling I’m after: a sense of closeness and security in a place of natural beauty, where I can be alone (unless I chose to let someone else in), a space impenetrable from the outside.
The sound of running water is luxuriously soothing, and the vibrant color of koi brightens everything. The above image may have been at the side of a house, but in my mind, it could be a hidden corner that only I can access.
Not all spaces have to be confined, as this vine-covered path above illustrates. It provides room to wander and breathe deeply while still feeling secluded.
Your calm space can be made up of different images that show different elements of it. Each space needs a portal through which you enter, so why not make it magical?
Once I had gathered a variety of images that evoked the feeling of grounding and peace that I sought, it was time to name it: one word (or phrase) that enables me to conjure up my calm space. I settled on Halcyon, but realized later that it didn’t give me what I needed (I’m picky about words and their meanings). Then I came up with Elysium, as it suggested an other-worldly place in the heavens.
I thought that name fit perfectly. Except that as we continued in the preparation phase for EMDR, I had a hard time maintaining focus on one particular image. I had chosen so many! So I thought about what I really needed.
It was breathing space. A place to pause when things come at me too quickly. Ironically, after pinning so many glorious images on Pinterest, I returned to a photo that has served as the background for my two monitors at work. When I arrive in the morning and log in, this image grounds me and I find myself taking a very deep breath, like a sigh:
This image speaks to me. It combines nature with a sense of spaciousness, yet feels secluded enough to impart a feeling of security. And my name for it? Sanctuary. So simple and to the point, and yet encompassing so many different emotions and meanings for me.
The next step has been feeling into the sensations that this calm space evokes. What does that feel like in my body? And then holding onto that feeling, saying the name, imagining the setting. You can “charge” the image with meaning in this way ( à la Pavlov).
The associations that are formed in the process create a sense of calm that I can draw upon to center and ground myself during periods of high stress. It’s not a pill to end all woes, but it can be a powerful tool for dropping yourself down into a more peaceful state. I encourage you to give it a try.