Life becomes a whirlwind after a cancer diagnosis. Suddenly there are countless medical appointments and tests, treatments and scans and follow-ups. And when all that ends, then what?
Survivorship – which the National Comprehensive Cancer Network says begins at diagnosis and lasts a lifetime – is where integrative oncology can make a meaningful difference in health and quality of life, said Shannon La Cava, PsyD, senior director of the Simms/Mann UCLA Center for Integrative Oncology.
“This is about finding control in survivorship,” she said during a keynote address at the recent UCLA Health Women’s Cancer Survivors Conference.
While there may be a lot to juggle in survivorship – continued surveillance screenings and monitoring for long-term physical and psychological effects of the disease, while returning to work and other responsibilities – how we choose to move, eat and manage stress can significantly impact well-being.
Studies are ongoing to define how mind-body interactions contribute to patient outcomes. Research in psychoneuroimmunology – the study of how psychological, neurological and immune systems interact – shows that stress has measurable effects on tumor behavior. In animal studies, stressed mice, in more confined living conditions, showed faster tumor growth than that seen in mice living in more enriched, free-range environments, noted Beth Karlan, MD, a gynecologic oncologist and member of the UCLA Health Jonsson Comprehensive Cancer Center, who also spoke at the conference. In humans, studies show that quality of life and social interactions can influence patient outcomes and survival as well.
It’s normal to be stressed and unsettled by the cancer experience, Dr. La Cava said.
“This is not pathology,” she said. “This is a normative response to having a cancer diagnosis – to having areas of distress emotionally and socially – just being that it’s a change in your day-to-day living. It’s a major impact.”
How can integrative oncology help?
Integrative oncology offers myriad ways to mitigate that distress while allowing individuals more control over their care, she said, through counseling, spiritual care, nutrition guidance and various support groups. Robust evidence shows these modalities improve quality of life and survival odds, and reduce pain, fatigue and symptoms of anxiety and depression.
“This is a complement to biomedical care, not a replacement or an alternative to medicine,” Dr. La Cava said. “The aim is to optimize health.”
The National Comprehensive Cancer Network and the American Society of Clinical Oncology have issued evidence-based guidelines for using integrative modalities to help with pain, fatigue and mood-related symptoms during treatment and survivorship.
Mind-body practices such as yoga, massage, music therapy and guided imagery have been found to provide pain relief, studies show. Yoga and mindful awareness practices, such as Mindfulness Based Stress Reduction and Mindfulness Based Cognitive Therapy, help reduce fatigue and symptoms of anxiety and depression.
“Some of these amazing modalities can reduce symptoms across the board,” Dr. La Cava said. “So you don’t have to do something specifically for each area in which you have distress.”
Everyday choices such as food and movement also make a difference.
Good nutrition supports mental and physical health. Paying attention to how we eat and drink can help ease nausea symptoms, boost energy and help with weight management, she said.
Many studies show that exercise is an effective mood-lifter – and it doesn’t have to mean an hourlong trip to the gym. Walking the dog counts. You could also window-shop with a friend, train for a 5k with a run club or take a group fitness class, all of which allow for socializing and exercising at the same time.
“This is about personalization,” Dr. La Cava said.
Finally, mindset matters, and it’s something that’s entirely up to you, she said.
Referencing the Japanese concept of ikigai, or reason to live, Dr. La Cava noted that this sense of purpose “resides in the realm of small things”: the sun on your skin, your morning coffee.
“It’s really recognizing those smaller things that can give us a little bit of joy and really help us with that idea of purpose,” she said
She also suggested keeping an eye out for “glimmers,” which are essentially the opposite of triggers: tiny moments that make you smile.
“I think that’s something that helps sustain all of us,” Dr. La Cava said, “just to remember that there is that sparkle out there.”
