Combination Therapy

Combination Therapy

Mind-body techniques may not cure cancer, but they make living with it a whole lot easier

By Peg Tyre
Newsweek, September 27, 2004

Mary Peterson stands in a conference room at the Dana-Farber Cancer Institute in Boston with her arms stretched above her head. As her instructor intones directions, she visualizes energy pouring into her liver, leans against a wall, then lets out a resounding exhalation. Peterson, who has metastatic breast cancer, receives regular chemotherapy. She and three other women are also taking part in another form of cancer treatment called qigong, an ancient Chinese movement and meditation technique. So far, she says, qigong has reduced her muscle pain and anxiety. Her cancer, which has spread to her liver, is under control for now.

Qigong, says Peterson, has given her "a wonderful sense that I'm participating in my own recovery." And she's not alone. These days tens of thousands of cancer patients are using mind-body practices like conscious relaxation, talk therapy, music therapy, visualization, tai chi, qigong and prayer to help them deal with their disease. Eighty percent of cancer patients report using some kind of complementary medicine, a category that includes mind-body techniques as well as nutritional supplements and other holistic approaches. And no wonder. Scientists have found that mind-body practices help patients sleep better and cope with the pain, anxiety and depression often associated with traditional cancer treatments. Recent research has shown that mind-body practices can subtly enhance a cancer patient's immune system, too. While there's no evidence to suggest that yoga practice can defeat melanoma, cancer patients say they're eager to do everything they can to stay as healthy as possible.

Among doctors, skepticism is gradually giving way to support. For decades data-driven oncologists ignored the largely untested mind-body practices. But in the last few years, "patients have made it clear that they were eager to try it. And oncologists began looking for ways to combine it with the best medicine possible," says Dr. Barrie Cassileth, chief of integrative medicine at Memorial Sloan-Kettering Cancer Center in New York. Of the nation's 26 major cancer centers, 14 now offer complementary-medicine programs, mostly in the form of nutritional counseling, support groups and instruction in guided imagery. Cassileth recently helped found the Society for Integrative Oncology in order to bring together top oncologists and alternative practitioners working with cancer patients. The group will hold its first international conference this fall. Lorenzo Cohen, head of integrative medicine at the M.D. Anderson Cancer Center in Houston, predicts that mind-body techniques will soon become as much a part of standard cancer care as chemotherapy or radiation. "In the not-so-distant future," says Cohen, "oncologists will send patients to learn tai chi or yoga the way cardiac specialists now send patients to stress-management courses after they've had a heart attack."

Although many of these techniques have been around for thousands of years, scientists have only recently been exploring how they can be used in the fight against cancer. In 1989 research efforts got a boost when Stanford University psychiatrist David Spiegel published a much-ballyhooed study showing that terminal cancer patients who attended support groups were not only happier but actually lived 18 months longer than those who didn't. Almost overnight, cancer-support groups sprang up around the nation. That initial burst of enthusiasm waned quickly, though, as follow-up studies found that mind-body techniques had little or no effect on survival rates. What did improve markedly, however, was the patients' attitudes. In a five-year study published in The New England Journal of Medicine in 2001, doctors at the University of Toronto found that breast-cancer patients who attended weekly support groups and talk therapy in addition to undergoing conventional chemotherapy reported much less anxiety and pain than patients who went through standard treatment without such help.

Quality of life became nearly as important as quantity of life for Mary McGovern, a former international-health-care consultant who was diagnosed with chronic bladder cancer in 1999. Within five years McGovern had had two relapses and multiple rounds of chemo. She left her job and lost touch with many of her friends. Her blood pressure rose, and she began suffering from headaches, back pain and depression. In desperation, she enrolled in a course for cancer patients at the Mind/Body Medical Institute in Boston. There she learned conscious relaxation, visualization and the benefits of keeping a journal. At first McGovern, a no-nonsense woman, didn't see how writing down her feelings would make her feel better. "My first reaction was, 'You can't be serious'," she says. But after 14 weeks, her blood pressure dropped and her headaches and backaches improved. "These therapies," says McGovern, "helped me live with the uncertainty of having chronic cancer."

Researchers say McGovern's gains aren't just in her mind. Repeated studies have shown that conscious relaxation and meditation can counteract stress by lowering heart rate and blood pressure, and reducing levels of the stress hormones cortisol, epinephrine and norepinephrine in the bloodstream. They also enhance immune function. In a study published this month, researchers at the Ohio State University Comprehensive Cancer Center observed 227 breast-cancer patients for 10 years. Scientists found that the patients who received regular relaxation training and attended therapy and a support group had higher T-cell function than those who didn't participate in mind-body training.

Motivational speaker Maureen Murray of Pittsburgh says she doesn't need a bar graph to convince her of the power of prayer. When she was diagnosed with breast cancer four years ago, she was terrified. Shortly before her surgery, a friend gave her a prayer chain—a schedule of people who prayed around the clock for her recovery. Although there's no science to show that prayer can extend survival, Murray felt comforted and began her own deep, regular conversations with God—and it helped. Last year the Oncology Nursing Society published her book of prayers for breast-cancer patients, "You Are Never Alone." "I want my book to give cancer patients a little serenity," says Murray. And along with lifesaving drugs, a little serenity may be exactly what the doctor ordered.

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