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Mind-Body Medicine and Cancer
Prevention and Treatment
The Role of Emotions, Stress and How to Utilize the
Mind-Body Connection
Integration of Mind-Body Medicine
• Body – Physical
• Speech – Sound
• Mind – Thought Patterns
Mind-Body Relationships and Risks
• Chronic Stress
• Pessimism
• Sedentary lifestyle
Linked to:
• Cancer risk
• Tumorigenesis
• Metastasis
• Cancer mortality
Mind-Body Relationships and Risks
Many cancer patients experience:
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Chronic stress
Anxiety
Depression
Pessimism
(Pre and Post Dx)
Mind-Body Relationships and Risks
Chronic Stress Correlates with:
• Immune suppression
• Upregulated tumorigenic signaling
pathways
• Chromosomal instability & DNA
damage
Chronic Stress is an Immunosuppressant
Chronic stress maintains elevated levels of
stress hormones (Catecholamins and
Glucocortisoids) which:
• Enhance T-2 immunity, allowing cancer cells
to avoid immune surveillance
• Increase suppressor T-Cells in tumor and
surrounding site
• Causes lymphocyte apoptosis through
upregulation of “death ligand” FAS.
Chronic Stress in
Cancer Immunity
• Self-reported chronic stress
correlated with low cytotoxicity of NK
cells against ovarian cancer cells
• Stress-mitigation factors such as
social support, spirituality and humor
correlate with increased levels of NK
cell cytotoxicity in breast and ovarian
cancer patients
Chronic Depression &
NK cell Activity
• Chronic depression in ovarian cancer
patients correlated with decreased
NK cell activity in tumor infiltrating
lymphocytes, vs. non-depressed
patients
Chronic Depression &
NK cell Activity
• Chronically depressed patients with
GI tract cancer showed significantly
fewer NK cells and total lymphocytes
than non-depressed patients
Chronic Stress & Cancer Risk
• Breast cancer risk doubled after
disruption of marriage from divorce,
separation or spouse death
• Severe distress with minimal social
support increased breast cancer
occurrence 9 fold
• Cancer risk higher after 6 + years of
chronic depression
Chronic Stress Promotes Cancer
Progression
• Increases growth, proliferation and
metastasis of tumors
• Reduces host resistance to
recurrence
• Increases tumor vascularization and
vascular endothelial growth factor
levels (VEGF)
Stress Factors on Tumor Biology: Pathways and
Mechanisms
Stress Pathways and Key Influences on
Tumorigenesis
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CRP
Cortisol
Epinephrine
Norepinephrine
IL-6
Galectin-3
Stress, DNA Damage and Tumor Development
• Lowered DNA repair capacity
• Reduced levels of DNA repair enzymes
• Increased DNA susceptibility to
mutation
• Increased rate of DNA mutation
occurrence
• Increased tumor incidence, growth, size
& malignancy
Stress and breast cancer: from epidemiology to
molecular biology
Antonova L, et al. Stress and breast cancer: from epidemiology to molecular biology.
Breast Cancer Research 2011. Center for Cancer Therapeutics, Ottawa Hospital Research
Institute, Canada; Queen's Cancer Research Institute, Kingston, ON, Canada
Abstract
Stress exposure has been proposed to contribute to the etiology of breast
cancer. However, the validity of this assertion and the possible
mechanisms involved are not well established. Epidemiologic studies differ
in their assessment of the relative contribution of stress to breast cancer
risk, while physiological studies propose a clear connection but lack the
knowledge of intracellular pathways involved. The present review aims to
consolidate the findings from different fields of research (including
epidemiology, physiology, and molecular biology) in order to present a
comprehensive picture of what we know to date about the role of stress in
breast cancer development.
Impact of Stress on Cancer Metastasis
• Psychosocial risk factors for cancer
progression/metastasis: chronic
stress, depression, & isolation
• Chronic pessimism/depression
demonstrates stronger correlation to
negative outcome than isolated
stressful events
Impact of Stress on Cancer Metastasis
• Suggests that sustained activation of
stress pathways is strongest
psychosocial risk factor in cancer
progression
Pessimism and Cancer Risk/Mortality
• 238 cancer patients undergoing
palliative radiation therapy followed
for 8 mos.; 70 died by end of study
• Controlling for cancer site and
symptomology, results showed
pessimistic orientation to be a critical
risk factor for mortality among
younger patients age 30-59
Pessimism Shortens Telomeres and
Increases Inflammation
• Chronic pessimism demonstrates a
link to shortened DNA telomeres
• Chronic pessimism correlates with
increases in IL-6, indicating
increased systemic inflammation and
oxidative stress
Pessimism, age, and cancer mortality
Shultz R, et al. Psychol. Aging. 1996 Jun;11(2) 304-9. Department of Psychiatry,
University of Pittsburgh, Pennsylvania, USA
Abstract
Cancer patients (N = 238) receiving palliative radiation treatment
were followed for 8 months; 70 patients had died by the 8-month
follow-up. Controlling for site of cancer and level of
symptomatology at baseline, the authors studied the independent
effects on mortality of pessimism, optimism, and depression. The
findings show that the endorsement of a pessimistic life
orientation is an important risk factor for mortality, but only
among younger patients (ages 30-59). Attempts to replicate this
finding with conceptually related constructs such as depression or
optimism did not yield significant associations for either younger
or older patients, suggesting that negative expectations about the
future may contribute to mortality in unique ways. The authors
conclude that attempts to link psychosocial factors to mortality
should focus on specific psychological constructs instead of
diffuse, global measures that cover many psychological
phenomena and that the role of psychological processes in
mortality may vary dramatically depending on age.
Shortened Telomeres,
Chromosomal Instability & Cancer
• Shortened telomeres with chromosomal
instability promote malignant cell mutation
• 787 patients without cancer followed 10 yrs.
- Baseline telomere length significantly shorter in patients
who later developed cancer than those who remained
cancer free
• Aggressive tumors demonstrated stronger
link to shortened telomere length
Mind-Body Interventions
Body-Speech-Mind:
Solutions to improve health
and quality of life
Mindful Meditation
Mindful Meditation is a common term used
to describe mindfulness-based meditation
practices such as:
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Shamatha (“Calm Abiding”) meditation
Vipassana (“Insight”) meditation
Zen meditation
Yoga and Qi Gong
Benefits of Mindfulness Based
Stress Reduction (MBSR) Methods
Reduces:
• Cortisol
• IL-6 and pro-inflammatory cytokines
• Systolic blood pressure
• Anxiety, depression and stress
Benefits of Mindfulness Based
Stress Reduction (MBSR) Methods
Improves:
• NK cell activity
• Antioxidant activity
• Brain function
• Quality of life
Mindfulness-based stress reduction and cancer: a
meta-analysis
Ledesma D and Kumahano H. Psychooncology 2009;18:571. Department of Stress Science and
Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku,
Tokyo, Japan
Abstract
Objective: This meta-analysis was conducted to investigate the
effects of mindfulness-based stress reduction (MBSR) on the
mental and physical health status of various cancer patients.
Methods: Ten studies (randomized-controlled trials and
observational studies) were found to be eligible for meta-analysis.
Individual study results were categorized into mental and physical
variables and Cohen's effect size d was computed for each
category.
Results: MBSR may indeed be helpful for the mental health of
cancer patients (Cohen's effect size d=0.48); however, more
research is needed to show convincing evidence of the effect on
physical health (Cohen's effect size d=0.18).
Conclusion: The results suggest that MBSR may improve cancer
patients' psychosocial adjustment to their disease.
Meditation and Yoga Improve
Telomere Function
• Positive psychosocial effects of
meditation and yoga can increase
neuroendocrine factors which
promote healthy telomere function
• Regular practice decreases stressinduced cellular dysfunction, via
increased telomerase activity
Intensive meditation training, immune cell
telomerase activity, and psychological mediators
Jacobs TL, et al. Psychoneruoendocrinology 2011;36(5):664-81. UC Davis Center for
Mind and Brain, Davis, CA, USA; UC San Francisco Department of Psychiatry, San
Francisco, CA, USA; UC San Francisco Department of Biochemistry and Biophysics, San
Francisco, CA, USA; UC Irvine Department of Cognitive Science, Irvine, CA, USA; UC
Davis Department of Psychology, Davis, CA, USA; Department of Psychiatry and
Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD,
USA; Santa Barbara Institute for Consciousness Studies, Santa Barbara, CA, USA; UC
Davis Medical Center M.I.N.D. Institute, Sacramento, CA, USA
Abstract
Results: Telomerase activity was significantly greater in retreat participants than in controls at
the end of the retreat ( p < 0.05). Increases in Perceived Control, decreases in Neuroticism,
increases in both Mindfulness and Purpose in Life were greater in the retreat group ( p < 0.01).
Mediation analyses indicated that the effect of the retreat on telomerase was mediated by
increased Perceived Control and decreased Neuroticism. In turn, changes in Perceived Control
and Neuroticism were both partially mediated by increased Mindfulness and Purpose in Life.
Conclusions: This is the first study to link meditation and positive psychological change with
telomerase activity. Although we did not measure baseline telomerase activity, the data suggest
that increases in perceived control and decreases in negative affectivity contributed to an
increase in telomerase activity, with implications for telomere length and immune cell longevity.
Further, Purpose in Life is influenced by meditative practice and directly affects both perceived
control and negative emotionality, affecting telomerase activity directly as well as indirectly
Healing Body
Mind-Body exercises improve
physical, mental & emotional
health
Benefits of Yoga
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Shown to:
Reduce chemo-related nausea and emesis
Decrease plasma TNF alpha levels following
cancer surgery
Improve cardio-performance/vitality
Improve physiological functioning
Reduce cortisol
Increase melatonin production
Improve psycho-spiritual well-being &
quality of life
Benefits of Qi Gong
Medical Qi Gong shown to:
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Reduce inflammation
Reduce cortisol
Reduce pain
Lower anxiety and stress
Improve emotional well being and
quality of life
Physical Activity &
Cancer Risk/Progression
Moderate, regular exercise:
• Critical in cancer prevention and risk
reduction
• Important and now widely
recommended in cancer treatment
Healing Speech
Mind-body benefits of breathwork, chant and sound
Benefits of Meditative Breathing, Chant,
Mantras
Increases:
• Parasympathetic activity
• Cerebral blood flow to right temporal
lobe
Decreases:
• Pulse rate
• Respiratory rate
• Blood pressure
• Limbic brain activity
Healing Mind
Meditation &
Neuroplasticity Effect
Long-term Meditation Practitioners
Show:
• Larger hippocampal and frontal
volumes of gray matter
• Increased cortical gyrification
Correlates with:
• Positive emotional
regulation/response control
• Positive mental state
• Increased introspection
• Heightened awareness
• Increased compassion
Healing Qualities of Mind
• Focused and calm
• Spacious and insightful
Connect with Our Heart
• Love and Compassion
Tonglin
• Taking others
suffering on the
path
• Exchanging
suffering with
love and
compassion
-Essence -Expression-Manifestation-
The Unfolding of our Being:
Physiological Perspective
The healing power
of the mind
• In diagnosis
• In treatment
Integrative Approaches
to Cancer Care Summary
• Key Principles
– Integrate patient wellness with fighting
& preventing cancer
– Keep treatment dynamic & changing
– Incorporate Mind-Body methods &
approaches
Thank you!
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