Posted by: bcconnections | August 15, 2013

Mad Hatter Tea Party

Marita TroboughDon’t be late for this very important date! Alice’s advice from the White Rabbit applies to those attending Breast Cancer Connections upcoming Mad Hatter Tea Party, a free event, on Sat., Aug. 24, 10 a.m. at 390 Cambridge Ave, Palo Alto. The offices of BCC are transformed into a charming tea shop with linens, treats and beautiful dishes.

This promises to be a fun, festive, informative and inspirational event. Women will come away with the feeling that “I can do this.”

When battling breast cancer, many women find themselves at a loss to recover their self-esteem, self-confidence and their sense of being part of a community.  Breast Cancer Connections offers a place where you know there are others who understand exactly how devastating it is to look in a mirror and see a stranger, who is losing her hair (among a host of other complications of seeking a “cure”) looking back at you.

The Mad Hatter Tea Party is one of the many ways Breast Cancer Connections helps women on this precarious journey to find themselves again after being diagnosed with breast cancer. In partnering with Marita Trobough, breast cancer survivor and owner of The Next Step, A Woman’s Boutique in Los Gatos. BCC delivers a very gracious learning event where participants hear a presentation and engage in hands-on demonstrations. Ladies in attendance may try on BCC’s wonderful assortment of hats, wraps, scarves and wigs that have been gently used and donated, and even go home with them.

Twenty-five years ago Trobough lost her mother to breast cancer and celebrated her 5th anniversary of thriving after breast cancer in May of 2013. Trobough founded The Next Step to accommodate the special needs of women who have experienced breast cancer and have had a lumpectomy or mastectomy.

“What I enjoy the most,” said Trobough, when asked about the BCC Mad Hatter Tea Party, “is watching the ladies interact with one another. I love it when ladies come in and are a little timid, but before long they are chatting with each other, trying on hats together…. coming together and getting support. They are able to talk to someone about what is going on that they haven’t been able to talk about. They may be afraid to tell someone that they have breast cancer. But here, BCC understands the fact that you may have night sweats. The fact that your hair was all over your pillow, or in the tub. It gives the ladies a wonderful sense of community. A wonderful sense of a new friendship. They walk out of the tea with their heads held high. Sometimes when you go through this journey it is quite lonely and when you meet up with someone who is in a similar situation … someone perhaps who is 6 months ahead of what you are going through, or 3 months behind you…a unique support system is created…it takes the edge of what they themselves are going through.  So it’s a wonderful time for ladies to get together and have a mini-support group. They learn the different ways to wear a scarf, how to wear a hat, or about the little hair pieces that help with the illusion of having more hair.”

The goal of the Mad Hatter Tea is for the women who attend to feel comfortable and confident and to go out and live their lives.

Breast Cancer Connections is a very special organization because from the minute you call or walk in the door, you are connecting with someone who has walked in your shoes. They are there to talk to you, encourage you, and support you on the journey.

To register for the Mad Hatter Tea Party, call Breast Cancer Connections at 650-326-6686.

Guest post by:  Mary E. Knippel, Author, Speaker, Mentor, and founder of The Unleashed Homemakertm. Is passionate about helping women who have been silent too long to claim their voices, speak up, be heard and go from making dinner to making a difference.

As a journal writer since the age of 11, she knows the enormous power of the written word. A two-time breast cancer survivor, Mary used writing and other creative tools in her recovery and chronicled the healing results in her upcoming book, The Secret Artist-give yourself permission to let your creativity shine.

Using writing as a key strategy to help women at those difficult times when their lives are in the midst of change, she shares what she has learned and helps her clients move from survive to thrive.

Visit her website for free tips on writing and information on classes, workshops and other events.

Posted by: bcconnections | July 19, 2013

Meet Dr. Hildy Agustin

Dr. Hildy AgustinGreetings! I’m honored that BCC asked me to contribute to their Blog to help people deal with the emotional challenges of diagnosis, treatment and recovery from breast cancer.

About me (Hildy Agustin, Psy.D.): Some of you know me as the facilitator of Breast Cancer Connections monthly Thursday night Recovery and Renewal Group or from my previous incarnation as the facilitator of the Recovery and Renewal Group or the Triple Negative  Breast Cancer Support group. I’m also a psychologist in private practice in Menlo Park, CA. In addition to my specialty in helping women with breast cancer, I also work with people who have a wide variety of medical issues, such as cancer, head injury, spinal cord injury, dementia, and chronic pain conditions. I also provide neuropsychological testing for people who have questions related to their cognitive capacity, and evaluate for conditions such as Alzheimer’s or ADHD (so yes, you can count on me to talk about chemo brain and other brain fog topics down the road).

I’ve worked in this field for around fifteen years, and, over this time have generated a lot of insights that I’m excited to share with a wider audience. Working with people with health issues is my passion.  If I didn’t get paid for it, I’d still be interested in having these conversations. I also love to write and share my ideas, and I am looking forward to the dialogue that we will share about a topic that means so much to me.

Let’s get talking about what you can expect from my blog contributions.  While I have a lot of opinions about all aspects of breast cancer diagnosis, treatment and recovery, I’m particularly passionate about talking about the time after active treatment ends, when people have to discover a “new normal” for themselves.  I’ve noticed that when someone is diagnosed with breast cancer, the outpouring of support can be overwhelming (and sometimes, far beyond what is needed or even wanted). But when treatment ends, suddenly, it all stops. No more calls from the nurses to check in, no more casseroles and scarves dropped off at your house, and you no longer receive the solicitous offers to drive you to appointments or listen to your struggles.

In some ways, life can actually be harder when the terrible treatments end.  The loneliness and the fear can be overwhelming. Though the treatment for cancer can be painful, frightening and disruptive, there is also comfort in the sense that you are doing something active to combat the disease, and that all other aspects of your regular life can be put on hold so you can focus on your treatment. When treatment stops, people often expect you to resume “real life” right where you left off, but you may feel like a completely different person.  You might not be ready to dive back into your responsibilities-you might be exhausted, still in pain, and overwhelmed by what just happened. You might worry that without the protection of treatment, the cancer could return at any moment.  In addition, you may have grown close to your treatment team—doctors, nurses, technologists and friends and family who are all working together to battle cancer.  What happens when they all congratulate you on a job well done and leave you alone?

I hope to bring to this blog the same kind of amazing, open conversations that happen every day at Breast Cancer Connections. These conversations aren’t happening frequently enough in the outside world, and I want to have these conversations here on the blog with you. I’ll try to do so with sensitivity, humor and compassion.  I welcome suggestions, feedback, and respectful exploration of differences. Bring your own perspectives of what you’ve learned, and your challenges that you are still trying to figure out. Let’s get some dialogue going about what happens after treatment ends and what you can do to transition successfully to the next phase of life.

social security disability help

Article contributed by Ram Meyyappan, from Social Security Disability Help 

According to the American Cancer Society, more than 200,000 cases of invasive breast cancer are diagnosed every year. Some of the women who suffer from this condition are unable to work due to the symptoms of the condition itself or the symptoms associated with the treatments that are used to address the condition. Being unable to work can cause finances to quickly spiral out of control. Without a means of income, there is no way to pay the bills. Fortunately, if your condition is expected to keep you out of work for at least a year, Social Security Disability benefits can help alleviate some of the financial strain.

How to Qualify for Social Security Disability Benefits with Breast Cancer

The good news is that there is a listing for breast cancer in the SSA’s Blue Book. The Blue Book is a publication that the SSA refers to when deciding whether or not to approve a claim for disability benefits. If you have a condition that is listed in the Blue Book, it can be easier to qualify for benefits than if you do not.

Breast cancer is listed in Section 13.10 of the SSA’s Blue Book. According to this listing, in order to qualify for Social Security Disability benefits due to breast cancer, you must be able to prove that:

  • You have a locally advanced tumor of any size with direct extension to the chest wall or skin or metastases to the internal mammary nodes; or
  • That you have a tumor with metastases to ten or more axillary nodes; or
  • That you have recurrent breast cancer (except for local recurrence that remits with therapy).

If you can get documented medical evidence proving that your case of breast cancer meets the above criteria, you will be able to prove that you qualify for benefits under this Blue Book listing.

If your condition does not meet the criteria listed above, you will need to try to qualify for benefits based on a vocational allowance. This can be more complicated and may require the help of a Social Security Disability attorney.

Applying for Social Security Disability Benefits

When you apply for Social Security Disability benefits you will be asked to fill out an application form and provide a form that documents your daily activities and how your condition affects them and a copy of your medical records. This information can either be submitted online or at your local SSA office.

When filing you application, you will have to decide whether you want to apply for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. SSDI benefits are for individuals who have a strong work history and have paid into the Social Security system consistently. SSI, on the other hand, is a needs-based program that does not take your work history into account.

Unfortunately, over 65% of disability applications are initially denied. Those that are denied have to go through an appeal process in order to be approved. The best chance you have of being approved for benefits is at the 2nd stage of the appeals process, the disability hearing. Approximately 55-60% of claimants are awarded benefits at the hearing stage.

If your claim is denied, you should consider hiring a disability attorney or advocate to help you with your claim. There is no upfront cost to hiring an attorney. These attorneys are only paid if you are successfully awarded benefits.

Unemployment Benefits vs. Social Security Disability Benefits

An individual cannot qualify for both unemployment and disability benefits at the same time. In order to qualify for unemployment benefits, one must be medically capable of working and actively looking for work. In order to qualify for disability benefits, one must be medically unable to work for at least year or longer. Since the requirements for each program are contradictory to one another, one cannot receive both benefits at the same time.

For more information on breast cancer and disability benefits, please visit:  www.disability-benefits-help.org

Posted by: bcconnections | May 30, 2013

Acupuncture for Lymphedema

By Rebecca Olson, Life Science Research Assistant, Stanford Cancer Institute and Breast Cancer Connections Volunteeracupuncture

For thousands of years, traditional Chinese acupuncturists have sought to improve health by altering the flow of vital life energy through the body. Tiny needles are inserted at specific acupuncture points along “Qi” channels to restore health and well-being. Western acupuncture follows a more conventional physiological model; needles are placed near specific anatomical features like peripheral nerve junctions. Acupuncture is widely accepted for chronic pain relief, and is now being explored as a promising alternative treatment for lymphedema.

Lymphedema is a distressing life-long condition affecting thousands of breast cancer patients.  This condition often occurs after radiation therapy or surgery, in which lymph nodes are damaged or removed. When the lymph system is functioning properly, lymph fluid flows through a network of vessels and nodes before returning to the bloodstream. Damage to the lymph network results in fluid buildup in soft tissues and causes painful swelling in the affected limb.

Existing treatments involve combinations of physical therapy, massage therapy, and self-care regimens, all of which are designed to manage the symptoms of fluid accumulation in the affected arm. Pressure garments and compression devices can be worn to promote lymph flow and reduce painful swelling. There is no curative treatment for lymphedema and these conventional treatments are marginally beneficial. Most patients still experience constant discomfort and must avoid many activities feared to exacerbate their condition.

A pilot study performed at the Memorial Sloan-Kettering Cancer Center analyzed acupuncture as an alternative treatment for lymphedema. Nine women with chronic lymphedema after breast cancer surgery received acupuncture twice a week for 4 weeks. Four women showed at least a 30% reduction in arm swelling, which was indicated by difference in size between affected and unaffected arms. None of the participants experienced infection or adverse events.

For lymphedema patients, the benefits of this treatment method are twofold; acupuncture can reduce pain and lessen swelling. Carefully placed needles are known to ease pain by inhibiting the transmission of nerve impulses and triggering the release of pain-relieving hormones. The clinical trial reports a statistically significant reduction in arm swelling, which is likely due to an acupuncture-induced anti-inflammatory response. In such a response, signaling molecules called cytokines are released to rouse the vascular system. As lymph fluid drains from inflamed tissues and returns to the bloodstream, limb swelling is reduced.

In the past, acupuncture has not been recommended as a treatment for lymphedema due to infection risk and other adverse events. The pilot study demonstrates that a qualified practitioner can minimize infection risk by using disposable needles and appropriate sterilization methods. Further clinical studies with more participants may reveal acupuncture to be a remarkable option for lymphedema patients.

 

For more information visit:

http://nccam.nih.gov/health/acupuncture

http://www.lymphnet.org/lymphedemaFAQs/overview.htm

http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/Patient/page1

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171073/

http://onlinelibrary.wiley.com/doi/10.1002/cncr.28090/abstract

Posted by: bcconnections | April 12, 2013

California’s Breast Density Law

Effective April 1, 2013, California State Law SB 1538 requires radiologists to inform women if they have dense breast tissue on screening mammography.  Under the new law, about 50% of women will receive the following statement with their mammogram results:

“Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer.

This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.”

What does it mean to have dense breasts?

Breasts are composed of a mixture of fat, glandular tissue and fibrous tissue.  If breasts have little fat but a lot of glandular and fibrous tissue, they are considered dense.  Currently, breast density is qualitatively classified by radiologists into four categories:

  • Almost entirely fatty (10% of women)
  • Scattered areas of fibroglandular density (40% of women)
  • Heterogeneously dense breasts (40% of women)
  • Extremely dense breasts (10% of women)

breast-density-scan

Women with breasts categorized as heterogeneously dense and extremely dense are required, under the new law, to receive notification of this classification.

The implications of having dense breasts are two-fold.  First, the sensitivity of mammography is lower in dense breasts.  Cancer can be masked in dense breasts because both cancer and dense breast tissue appear white on a mammogram.  Second, women with dense breasts have an elevated risk of getting breast cancer.  If a woman has heterogeneously dense breasts, her risk is 1.2 times greater than a woman with average breast density, and if a woman has extremely dense breasts, her risk is 2 times greater.

Having dense breast tissue does not mean that a woman should stop getting yearly mammograms.  Instead, she should speak with her doctor about her risk factors and discuss whether other screening modalities would be appropriate complements to mammography.  These tests include breast MRI, breast ultrasound and 3D mammography.

Sources/More Information:

Breast Density.info

Stanford Breast Density

American College of Radiology

State Senator Joe Simitians’ website

Posted by: bcconnections | April 1, 2013

Breast Cancer Follow-Up Care Guidelines

doctor and patient

Routine follow-up care is important for breast cancer survivors who have completed active treatment.  Six years after its last update, the American Society of Clinical Oncology (ASCO) has re-reviewed its recommendations on breast cancer follow-up care.  After considering 14 new publications, the committee concluded that no revisions to the previous guidelines are needed.  The following is a summary of ASCO’s recommendations for breast cancer follow-up care, as well as a summary of tests that are not recommended.

KEY RECOMMENDATIONS:

  • Regular medical history and physical exam

- every 3-6 months for 3 years after primary treatment

- every 6-12 months for years 4-5

- annually year 6 and beyond

  • Patient education about signs/symptoms of recurrence
  • Referral to genetic counseling when appropriate

- Ashkenazi Jewish Heritage

- patient history of ovarian cancer

- history of ovarian cancer in any first or second degree relative

- history of breast cancer before age 50 in any first degree relative

- two or more first or second degree relatives with a history of breast cancer

- patient or relative with a history of bi-lateral breast cancer

- family history of male breast cancer

  • Monthly breast self-exam
  • Mammography, for women treated with lumpectomy

- 1 year after the initial mammogram, but no sooner than 6 months after radiation therapy

- yearly thereafter (unless otherwise indicated)

  • Regular pelvic exam

 NOT RECOMMENDED:

The following tests are NOT RECOMMENDED for routine follow-up care of asymptomatic patients:

  • Routine blood tests (i.e. complete blood counts or automated chemistry studies)
  • Chest X-rays
  • Bone Scans
  • Liver Ultrasound
  • PET Scans
  • CT Scans
  • Breast MRIs
  • Tumor markers (i.e. CEA, CA 15-3, CA 27.29)

 

Source:  “Breast Cancer Follow-Up and Management After Primary Treatment:  American Society of Clinical Oncology Clinical Practice Guideline Update”

 

Posted by: bcconnections | March 18, 2013

FDA Approves New “Smart” Breast Cancer Chemotherapy Drug

By Rebecca Olson, Life Science Research Assistant, Stanford Cancer Institute and Breast Cancer Connections Volunteer

TDM1The FDA recently approved a breakthrough cancer drug that represents an exciting new direction in breast cancer treatment. T-DM1 (Kadcyla, Roche) is the first “armed antibody” on the market. This novel antibody-drug conjugate allows for the targeted delivery of chemotherapy to cancer cells without producing concurrent toxic effects on normal cells. The T-DM1 conjugate consists of a stable linkage between the well-known antibody trastuzumab (Herceptin) and the chemotherapeutic molecule DM1 (emtansine)1. This new drug holds great promise for many patients with HER2-positive breast cancer, and has opened the floodgates for a new wave of cancer research.

Chemotherapeutic drugs cause damage by impairing cell division, and produce cytotoxicity in fast-dividing cells like those in tumors. Many other types of cells are susceptible—including those responsible for hair growth and intestinal lining—leading to severe side effects. T-DM1 was developed by Roche (Genentech) and represents a major step in the creation of safer chemotherapy drugs.  Trastuzumab (Herceptin) works by binding to the HER2 protein on the surface of tumor cells, slowing the cell’s growth and marking it for destruction by immune cells2. With T-DM1 treatment, the trastuzumab antibody still binds the tumor cell but also delivers a toxic chemo payload. “Kadcyla is an antibody-drug conjugate representing a completely new way to treat HER2-positive metastatic breast cancer, and it helped people in the EMILIA study live nearly six months longer,” said Hal Barron, Roche’s chief medical officer and head of global product development3.

The EMILIA study specifically looked at a patient population of 991 women with metastatic or locally advanced HER2-positive breast cancer. These patients had previously been treated with a standard treatment regimen of Herceptin and a taxane chemotherapy, but had stopped responding to therapy. Half of the women received T-DM1 and the other half received another HER2-blocking drug, lapatinib (Tykerb) in addition to the chemotherapeutic agent capecitabine (Xeloda)4. T-DM1 recipients survived longer without disease and experienced far fewer side effects than those who received the standard of care. Incidences of low platelet count and increased liver enzyme levels were higher with T-DM1; side effects that were higher with lapatinib plus capecitabine included diarrhea, nausea, vomiting, and low red blood cell count. In addition, and particularly important to patients, treatment with T-DM1 is not associated with significant hair loss5.

T-DM1 is currently FDA approved as a second line therapy for HER2+ metastatic disease, but ongoing trials will determine its use as a first line therapy and perhaps in early-stage breast cancer. In short, T-DM1 is a promising new therapy for patients with advanced breast cancer. It is the first such antibody-drug conjugate explored in breast cancer, and will certainly shape future research into exciting new cancer treatments.

References:

  1. www.ncbi.nlm.nih.gov
  2. www.ncbi.nlm.nih.gov
  3. www.fiercebiotech.com
  4. www.roche.com
  5. www.targetedhc.com
Posted by: bcconnections | March 8, 2013

Tips to reduce your exposure to BPA

canA report issued last month by the federal Interagency Breast Cancer and Environmental Research Coordinating Committee called for increased funding of research aimed at determining the environmental causes of breast cancer.  The report concludes that reducing exposure to environmental risk factors is key to preventing the disease.  One such environmental factor under scrutiny is Bisphenol A (BPA).
BPA is a synthetic estrogen that is used to make polycarbonate plastics and the epoxy linings of food cans.   BPA can leach out of plastics and linings, contaminating food and beverages.  There is rising concern, based on preliminary laboratory studies, that exposure to BPA might be linked to a variety of health problems including obesity, infertility, and breast cancer.  Human studies investigating the link between BPA and breast cancer are lacking.  Despite its potential health risks, the FDA still allows BPA in food cans.

For tips on how to reduce your exposure to this chemical, visit these links:

Posted by: bcconnections | February 22, 2013

The sentinel lymph node biopsy and neoadjuvant chemotherapy

Sentinel lymph node biopsy (SLNB) is an established technique to accurately assess the status of the axillary lymph nodes in women who undergo surgery for breast cancer.  This technique often spares women from a full axillary lymph node dissection.  For women who have chemotherapy prior to surgery (neoadjuvant chemotherapy), however, it is unknown whether the SLNB accurately reflects the lymph node status.

The ACOSOG Z1071 trial investigated the accuracy of the SLNB post-neoadjuvant chemotherapy.  The trial enrolled 756 women with clinically positive lymph nodes who underwent chemotherapy prior to surgery.  At the time of surgery, a SLNB was performed, followed by removal of all of the axillary lymph nodes.  SLNB correctly identified the nodal status in 91.2 percent of patients.  In 12.6 percent of patients, the SLNB was negative, but disease was found in other axillary lymph nodes.  This false-negative rate is higher than the 10 percent false-negative rate considered safe by the study standards. Better accuracy was obtained when three or more sentinel lymph nodes were identified, and when the SLNB was performed with both a blue dye and a radioactive tracer.  In a related trial, the SENTINA trial, the false-negative rate for a sentinel lymph node biopsy performed after neoadjuvant chemotherapy was 14.2 percent.

Sources:

“The role of sentinel lymph node surgery in patients presenting with node positive breast cancer (T0-T4, N1-2) who receive neoadjuvant chemotherapy – results from the ACOSOG Z1071 trial.”  Oughey JC et al.  The San Antonio Breast Cancery Symposium, 2012, Abstract S2-1.

“Sentinel lymph node biopsy before or after neoadjuvant chemotherapy – final results from the prospective German, multiinstitutional SENTINA-trial.”  Kuehn T et al.  The San Antonio Breast Cancery Symposium, 2012, Abstract S2-2.

Posted by: bcconnections | February 7, 2013

The Healing Power of Yoga

By Rebecca Olson, Life Science Research Assistant, Stanford Cancer Institute and Breast Cancer Connections Volunteer

Yoga BeachThe ancient practice of yoga originated in India some 5,000 years ago and has evolved into a discipline with well-documented healing effects. Yoga practice enhances physical, mental and spiritual well-being, and is proven to have significant clinical outcomes in patients struggling with cancer (Woodyard 2011).

The common view of yoga generally involves a variety of poses and stretches. The word “yoga” is derived from a Sanskrit root “yuj” which means union, or yoke, to join, and to direct and concentrate one’s attention. Modern yoga is a form of mind-body fitness that involves a combination of muscular activity and an internally directed mindful focus on awareness of the self, the breath, and energy (Woodyard 2011). Physical exercise is combined with traditional elements of Hindu philosophy to unite the body and mind.

Relaxation and meditation are the core elements of yoga practice. Most yoga classes conclude in ‘Savasana’ pose, a time spent laying relaxed on your yoga mat, calm and at peace. In my own yoga experience, mental relaxation and tranquility were difficult concepts to embrace. At the end of an evening class I would lay stretched out on my yoga mat in Savasana, reflecting on the worries and problems of my life. The concept of relaxation would fade to a distant memory behind the whirring of my preoccupied mind. Until one evening, my yoga instructor quietly offered one simple statement that stilled my busy thoughts:

“Know that you’ve done enough today…that you have enough…you ARE enough.”

I began to understand that the power of yoga comes through acceptance. To practice yoga is to unite the fragmented body and mind and regain the feeling of wholeness. Yoga is self-empowering; it teaches that healing comes from within, and shows the student how to play an active role in their journey toward health (Woodyard 2011).

Receiving a diagnosis of breast cancer and undergoing treatment can create a high level of sustained emotional distress. Whether newly diagnosed or a long-term survivor, many cancer patients struggle with symptoms of pain, anxiety, depression, and fatigue. These individuals suffer from widespread impairment in physical, emotional, social, and spiritual well-being over  long periods of time (Smith and Pukall 2009).

Culos-Reed and colleagues reviewed the clinical significance of yoga in cancer therapy across 25 published works. Cancer survivors who practiced yoga demonstrated clinically significant improvements in health-related quality of life.  Clinically significant outcomes included reduced anxiety, depression and stress, as well as improved mood and sleep (Culos-Reed et al. 2012). Another study investigated the effectiveness of yoga in breast cancer patients through a randomized controlled trial. In comparison to a control group of 584 women, a group of 544 breast cancer patients participating in yoga reported greater quality of life, increased emotional, social, and spiritual well-being, and reduced distress and fatigue (Moadel et al. 2007). Other studies report positive effects on physical parameters such as lowered blood pressure and altered cortisol levels (Woodyard 2011).

The physical effects of therapeutic yoga can be traced to the body’s classical “fight or flight” response. The body deals with physical or psychological stress by firing up two major neuroendocrine systems called the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). When triggered, these systems rapidly increase levels of the stress hormone cortisol, resulting in widespread effects throughout the body such as increased heart rate, reduced digestion, and immune suppression. Repeated firing of the HPA axis and SNS and heightened cortisol can produce a state of hypervigilance that takes a severe toll on overall health. Chronic stress increases blood pressure, heart attack and stroke risk, vulnerability to anxiety, depression, and immune weakness.

Regular yoga practice can counteract the severe physical injury created by chronic HPA/SNS activation and heightened cortisol. A review by Ross and Thomas describes the physical effects of therapeutic yoga:

“Numerous studies have shown yoga to have an immediate downregulating effect on both the SNS/HPA axis response to stress. Studies show that yoga decreases levels of salivary cortisol, blood glucose,  as well as plasma rennin levels, and 24-hour urine norepinephrine and epinephrine levels. Yoga significantly decreases heart rate and systolic and diastolic blood pressure. Studies suggest that yoga reverses the negative impact of stress on the immune system by increasing levels of immunoglobulin A as well as natural killer cells. Yoga has been found to decrease markers of inflammation such as high sensitivity C-reactive protein as well as inflammatory cytokines such as interleukin-6 and lymphocyte-1B” (Ross and Thomas 2010).

In the Western world, yoga is now widely regarded as a holistic approach to health and is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine (Woodyard 2011). Yoga is not a cure for cancer, but can promote healing and substantially improve overall wellness in cancer patients. In teaching one to unite the mind, body, and spirit for health and self-awareness, yoga can bring about a sense of peace.

Surya Namaskar (the Sun Salutation) is a familiar sequence of eight poses that express the essence of Yoga. The second pose of the Sun Salutation is the upward salute, in which the feet remain rooted to the earth while the arms reach upward to infinity and the heart opens toward the horizon. The Sun Salutation exemplifies the true purpose of yoga: to be grounded while simultaneously stretching into the vastness of the unexplored self. To do yoga is to be fully rooted in the present while embracing the endless possibilities of the future (Rosen 2013).

REFERENCES

Culos-Reed, S. N., M. J. Mackenzie, S. J. Sohl, M. T. Jesse, A. N. Zahavich & S. C. Danhauer. “Yoga & cancer interventions: a review of the clinical significance of patient reported outcomes for cancer survivors.” Evid Based Complement Alternat Med, 2012, 642576.

Moadel, A. B., C. Shah, J. Wylie-Rosett, M. S. Harris, S. R. Patel, C. B. Hall & J. A. Sparano. “Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life.” In J Clin Oncol, 2007, 4387-95.

Rosen, R.  “Here Comes the Sun. That most familiar of asana sequences, Surya Namaskar (Sun Salutation)  is as rich in symbolic and mythic overtones as it is in physical  benefits.”  Yoga Journal, Cruz Bay Publishing, Inc., 2013.

Ross, A. & S. Thomas. “The health benefits of yoga and exercise: a review of comparison studies.” J Altern Complement Med, 2010, 16, 3-12.

Smith, K. B. & C. F. Pukall. “An evidence-based review of yoga as a complementary intervention for patients with cancer.” Psycho-Oncology, 2009, 18, 465-475.

Woodyard, C. “Exploring the therapeutic effects of yoga and its ability to increase quality of life.” International Journal of Yoga, 2011, 4, 49-54.

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