Oncology Nutrition Connection ❙ Volume 25, Number 3, 2018 ❙ 21
Use of Mind-Body Practices from the Tibetan Bon and Buddhist Traditions by Oncology Patients Laura Galindez, MSW
Laura Galindez, as a separate but equal religion that help mitigate symptoms associated MSW, is a licensed has preserved important aspects with treatment, potentially resulting social worker and the Integrative Oncology of indigenous Tibetan culture. in improved mood, reduction of Patient Navigator for Similarly to Tibetan Buddhism, fatigue, more restful sleep, and the Abramson Cancer Bon incorporates meditation management of pain and nausea.4 Center. Her practice and monastic practices to help Simple yoga asanas or breathing focuses on helping patients and their practitioners seek enlightenment. techniques can be learned and families to connect with integrative oncology Participating in service to others is practiced over and over. Many of services such as yoga, meditation, acupuncture, also seen as a path to deepen one’s these practices are now available and other interventions designed to support understanding of reality, achieve online for free. Guided meditation them in body, mind, and spirit during treatment. dissolution of the self, and reach and yoga videos can help patients She was previously a health coach working 2 with an integrative mental health care team in enlightenment. (ideally) develop a consistent New York City before moving to Philadelphia practice, which will not only o er to continue her work with the oncology Why Mind-Body Practices? support during times of acute stress population. Laura believes everyone can bene t but also act as a preventive measure. from meditation. Contact Laura at [email protected] Outcomes are worse for cancer It may also increase patients’ feelings patients experiencing chronic stress. of well-being by helping them to ntegrative medicine has become Stress is more than just an unpleasant focus on positive, protective things an impactful approach to feeling—it creates a cascade of happening in their lives without oncology care. There are many physiological responses in the denying the more emotionally I body. Using mind-body techniques, di cult parts of their experience. studies that show a signi cant portion of patients are using some patients are actually able to exert Even 10 to 20 minutes per day of kind of complementary medical more control over the activation these practices can be reasonably therapy during or after cancer and deactivation of the body’s integrated into a patient’s day with treatment. These practices vary parasympathetic and sympathetic great impact. widely and may include nutritional nervous systems, which can lead to relaxation of the body and potential Studies Involving Tibetan Practices supplements or herbs, exercise, or 3 mind-body practices such as yoga, improvement in overall well-being. hypnotherapy, guided imagery, Another important bene t of Mind-body practices can help meditation, tai chi, relaxation, these practices is meaning-making. patients achieve more acceptance biofeedback, and creative arts. Mind- Oncology patients experience and integration of contradicting body modalities can help patients distress over why cancer happened emotions, which can reduce distress. manage distress, relate di erently to them. Meaning-making can help Patients often report symptoms of to pain, and provide a sense of patients reframe this experience trauma after their diagnoses. Quality control in one’s care during a time so that they can see growth and of life is a ected by things such as when they may feel out of control.1 positivity from their disease. Some intrusive thoughts or avoidance Even within these categories, there patients experience symptoms behaviors. One study among breast are di erent styles and traditions similar to post traumatic stress cancer patients taking yoga classes from which these practices arise. For disorder after diagnosis, such as during radiation therapy found instance, both yoga and meditation intrusive thoughts and excessively that those who reported more have widely varied styles; and it can avoidant behavior. However, trauma intrusive thoughts during the rst be di cult for patients to determine can also foster psychological growth week of the yoga intervention which type of intervention may be and resilience. Mind-body practices ultimately reported more “bene t best for them at any given time. may increase “bene t- nding” for nding,” or meaning-making, at the This article reviews practices arising these patients as they seek to make three-month mark after treatment sense of what is most often a random ended. The authors speculated that from the Tibetan Bon and Buddhist 4 traditions and how they are being tragic occurrence. the mindful, acceptance-focused utilized for oncology patients today. Also of note, patients can quality of yoga practice may have learn these practices over time as allowed processing of these negative What is Tibetan Bon versus they do not always require travel, emotions regarding their diagnoses Buddhism? attendance at a class, or a purchase. more quickly. As part of the yoga Conversely, barriers such as time, program, the participants were asked The Bon religion comes from the distance, and money may limit to concentrate on their breathing same region as Tibetan Buddhism, patient access to traditional methods without trying to interrupt the ow but it is a distinct religion. There such as psychological counseling of their thoughts. Investigators are overlapping traditions to both or support groups. After an initial suggested that this may have helped learning period, however, patients the patients deal with the trauma of religions, and the current incarnation 4 of Bon is thought to be heavily can apply these mind-body practices their cancer diagnoses more quickly. in uenced by Tibetan Buddhism. at any time. Meditation is accessible Further, a qualitative study The Dalai Lama has recognized Bon whenever and wherever the patient’s involving 28 lymphoma patients needs arise. These practices can also who used a Tibetan yoga program Fall 2017 Volume 20, Issue 2 52 www.integrativeRD.org 22 ❙ Oncology Nutrition Connection ❙ Volume 25, Number 3, 2018
reported their experiences of “living at the end of the study. Investigators References in a paradox” when trying to make noted a medium e ect (d=.52) for meaning of their cancer journey. meaning-making for the caregivers.7 1. Complementary, alternative, or Both the control group and the Cancer patients often report integrative health: what’s in a name? yoga group were asked to respond compromised cognitive functioning National Center for Complementary to qualitative questions about their post treatment, sometimes referred and Integrative Health website. personal psychological experience to as “chemo-brain.” This can be very https://nccih.nih.gov/health/ of their cancer diagnosis, at 1-week distressing for patients and can integrative-health#cvsa. Updated and 3-months post intervention. All impact both their functioning and June 28, 2016. Accessed November patients voiced chronic uncertainty quality of life long after treatment 23, 2016. and fear of death or recurrence, while is completed. A pilot study using 2. Bon. ReligionFacts website. simultaneously expressing gratitude Tibetan Sound Meditation was http://www.religionfacts.com/ and newly found meaning, purpose, completed to guide future research bon. Published March 18, 2015. and value in their lives.5 However, on the cognitive rehabilitation Updated October 28, 2016. Accessed the patients who participated in the of breast cancer survivors. This November 15, 2016. 7-week Tibetan yoga class reported unique style of meditation involved 3. Chaoul A, Milbury K, Sood AK, a greater sense of acceptance and the participants’ creation of vocal Prinsloo S, Cohen L. Mind-body meaning in their lives than the sounds during the meditation (ie, Ah, practices in cancer care. Curr Oncol control group.5 The authors also Ohm, and Hoong), included guided Rep. 2014;16(12):417. doi:10.1007/ reported that the yoga participants imagery of colors, and focused s11912-014-0417-x had improved measures on several participants’ thoughts on increasing 4. Chandwani KD, Thornton B, indicators of sleep quality. This is desired protective emotions such Perkins GH, et al. Yoga improves relevant to the oncology population as love, peace, and joy. These three quality of life and bene t nding in as sleep disturbance is a very components were felt to enhance women undergoing radiotherapy common side e ect, and poor sleep the attention-training aspect of for breast cancer. J Soc Integr Oncol. can result in disturbances in both this speci c practice as opposed 2010;8(2):43-55. psychological and physical health.5,6 to other meditation styles. The 5. Leal I, Engebretson J, Cohen L, While most research in women who participated in the et al. Experiences of paradox: a supportive cancer care focuses on meditation practice reported better qualitative analysis of living with the patients, caregivers themselves cognitive function, cognitive ability, cancer using a framework approach. often su er a great psychological mental health, and spirituality. Psychooncology. 2014;24(2):138-146. burden resulting from their The meditation group showed doi:10.1002/pon.3578 signi cant role in supporting the improvements in processing speed 6. Cohen L, Warneke C, Fouladi RT, patient. Often, caregivers feel guilt and short-term memory as well.8 Rodriguez MA, Chaoul-Reich A. for performing any kind of self-care More research is needed to con rm Psychological adjustment and sleep while their loved one is su ering. the clinical application of the e ects, quality in a randomized trial of the However, caregiver well-being is as not all of the ndings were of e ects of a Tibetan yoga intervention important because the caregiver’s statistical signi cance. in patients with lymphoma. Cancer. ability to cope can directly impact 2004;100(10):2253-2260. doi:10.1002/ the patient’s ability to cope and vice Take Home Message cncr.20236 versa. Meditation is an intervention 7. Milbury K, Chaoul A, Engle R, that can serve both patients and their There are many di erent et al. Couple-based Tibetan yoga caregivers; encouraging them to mind-body practices available to program for lung cancer patients practice together can help overcome patients from numerous, equally and their caregivers. Psychooncology. the barriers of time and feelings of valid traditions. It follows that there 2015;24(1):117-120. doi:10.1002/ guilt. To this end, another research will also be limitations in trying to pon.3588 study looked at the e cacy of a generalize outcomes from studies 8. Milbury K, Chaoul A, Biegler K, Tibetan yoga practice on couples on “yoga” or “meditation.” As each et al. Tibetan sound meditation for in which one partner had a lung practice has large variation in cognitive dysfunction: results of a cancer diagnosis and the other was styles, how do patients choose the randomized controlled pilot trial. the primary caregiver. The couples ‘best’ one? Ultimately, the best Psychooncology. 2013;22(10):2354- attended two to three weekly method will be the one that the 2363. doi:10.1002/pon.3296 sessions for 6 weeks. Together, they patient is successful in practicing practiced both guided meditations regularly. Techniques that can t along with a Tsa Lung movement into patients’ lives with minimal series. Tsa Lung movements are an barriers such as cost, distance, and ancient Bon contemplative practice time will be the ones that are the with gentle movements and speci c, most helpful. For cancer patients coordinated, breathing patterns. experiencing emotional and physical Dietitians in In this study, the patients again distress, gentle yoga and breathing Integrative reported improvement in meaning- techniques from the Tibetan and Bon nding and spiritual well-being, Buddhist traditions may be helpful in and Functional especially impactful considering the managing unwanted symptoms and Medicine poor prognosis of some lung cancer improving quality of life. a dietetic practice group of the patients. The caregivers also reported ® Academy of Nutrition signi cantly less fatigue and anxiety and Dietetics Fall 2017 Volume 20, Issue 2 53 www.integrativeRD.org