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March 12, 2009
Is There a Connection between the Mind and the Body?
Absolutely. Picture in your mind’s eye the following: You are picking up a firm, bright yellow lemon. Then, you slice it in half, and a few squirts of juice hit your face, and your fingertips get soaked. Bring the lemon up to your nose, and take a whiff. Lick the cut surface of the lemon. Take a bite.
If you noticed an increased flow of saliva in your mouth as you read the description, you have observed how the mind can affect the body. Just thinking about the lemon caused measurable changes in your body. If you had no response, read the paragraph more slowly, concentrating on each phrase, pausing between phrases, really trying to imagine yourself tasting the lemon.
The mind can affect the body, and the body can affect the mind. Pain, fatigue, medications, and hormonal imbalances can affect mood, concentration, and other functions of the mind.
A new field of science, psychoneuroimmunology, is investigating the relationship between the mind and the body. Research is starting to reveal some of the mechanisms by which the mind interacts with the body. It is hoped that we will soon be able to harness and amplify the beneficial healing powers of the mind.
Given that the mind and the body are connected, several questions arise: How much does the mind affect the body? How much can the mind affect the body? Does your mind cause you to develop cancer? Can your mind heal cancer or prevent recurrence?
Are There Different Types of Stress?
Negative stress is stress that makes you feel bad or overtaxes you. Divorce, financial worries, and job insecurity are examples of negative emotional stresses. Starvation and frequent marathon running are examples of negative physical stresses.
Positive stress is stress that energizes you. Projects and promotions are examples of positive emotional stresses. Daily aerobic exercise and a low-fat diet when you need to lose weight are examples of positive physical stresses.
Whether something is a positive or a negative stress for you depends on how you respond to it. What is energizing and fun for one person may be fatiguing and depressing for you.
What If I Have Trouble Sleeping?
Sleep is a state of relaxation that restores your physical and emotional energies. Regular sleep is vital in order for you to function normally while awake. After cancer your usual sleep patterns can be upset by
• medications or changes in medications
•emotional stress, anxiety, or depression
• change in your daily schedule
Good-quality sleep is an important ingredient in recovery. Make changes to encourage regular, good-quality sleep, even if it means taking medication for a while. You can do many things to facilitate good sleep:
•Adjust the timing, dose, or choice of medications that may be keeping you awake, such as decongestants and other cold remedies or steroids.
• Eliminate dietary stimulants such as caffeine in coffee, tea, chocolate, colas, and certain over-the-counter pain medications. This is especially important in the afternoon and evening.
•Do something relaxing to get ready for sleep.
•Arrange your pain medication schedule to control pain when you go to sleep.
•Avoid alcohol at bedtime (it may help you fall asleep but will impair the quality and duration of sleep).
What About Nightmares?
Nightmares, distressing dreams, occur irregularly throughout life. During periods of emotional tension, you may notice an increase in the frequency, vividness, or daytime recall of your nightmares. After cancer this can be related to
• your medications
• uncontrolled pain
•posttraumatic stress (emotional stress following a traumatic event or experience)
Nightmares tend to become more frequent after one’s survival of any traumatic experience. Now that your treatments are over, your subconscious is processing what you went through. Some of your surfacing fears and anxieties may express themselves in nightmares. Remember that they are just dreams, not reality. Nightmares do not predict the future or cause events to occur. If they are persistent or anxiety producing, discuss them with your doctor.
Invariably, all cancer survivors suffer recurrence scares. A lump, a swollen arm, a backache, or a headache can trigger a cascade of thoughts that culminates in the fear of recurrence. This is a normal part of survivorship. You need to have a practiced plan of action of what to do and think when faced with a recurrence scare. An effective plan will minimize unnecessary emotional trauma and help you do the right thing.
First, look at what has triggered the scare, and ask yourself whether it is at all possible that you really do have a recurrence of your cancer. If logic tells you that your problem is not related to a recurrence, you can deal with it as you would with any other non-cancer-related problem.
If, through logical or illogical thought, you have worries or anxieties about recurrence, you need a trusted expert to tell you whether the concern is real and, if so, what must be done. In a good doctor-patient relationship, you can tell your doctor, “I know I’m fine, but I need you to tell me so.” This expert is your regular doctor, either your internist, family practitioner, or oncologist.
If you are having pain that needs attention or are getting worse very quickly, call your doctor immediately. Otherwise, call your doctor’s office during office hours and explain that you have a symptom that is concerning you and that you need to be seen as soon as possible.
If your doctor agrees that there is reason for concern about recurrence, be sure to do the right thing: get more information about the problem. Proceed with whatever evaluations or tests are needed. If you are advised to have a biopsy, proceed. If you do not feel comfortable with this advice, get a second opinion as soon as possible. Delaying a biopsy will not make the problem go away; it may only lessen your treatment options and lessen the chance for controlling or curing a recurrence or a noncancerous problem.
Remember that whether or not you have a recurrence is already determined at the time you notice a problem. Thinking or fearing that you might have a recurrence does not create a recurrence.
Denying that you might have a recurrence does not prevent it. You do not have a choice about whether your current symptom is due to cancer. You do have a choice about whether you get it evaluated. Do not waste time or energy worrying about how much you are worried or afraid. Do not try to figure out whether you are too hypochondriacal or too alarmist. When there is concern about recurrence, you can expect to have some emotions. Reassure yourself that you have a plan of action and that you are doing the right thing.
You owe it to yourself to be evaluated as soon as possible. You deserve to minimize the physical and emotional impact of any problem through early evaluation.
• not every cough or lump is a sign of cancer
•you owe it to yourself and those people who care about you to get evaluated at the earliest opportunity, which will influence the impact of the findings
• even if it is recurrence, you can be treated again
Recurrence is not a death sentence.
For many people, it helps to imagine receiving good test results. Training yourself to stop bad-outcome scenarios in their tracks will not change the outcome, but it will definitely change the experience you have waiting for tests and evaluations to be completed. If things do not turn out well and your greatest fear is again realized, you will deal with your recurrence then. If everything turns out okay, as many times it does, you will have saved yourself much anxiety and disruption.
It helps some people to imagine bad test results and then plan how they will handle bad news, practically and emotionally. Thinking through contingency plans for work and home in case the biopsy is positive seems to offer some people a sense of control over the anxiety of the unknown. Imagining bad results makes others feel that if they think the worst, it will not happen. This is a paradoxical way of using magical thinking for comfort, but it is effective for some people.
Do what feels best to you. You may have to try different ways of coping with fear and anxiety to find the style that works best for you.
Depression is a state of emotional dejection and withdrawal. It is marked by
• loss of self-confidence
• change in appetite
• change in sleeping pattern
• loss of libido
• loss of interest
• loss of ability to concentrate
• somatic complaints such as a headache or stomachache
Depression after completion of cancer therapy can be due to or worsened by
• chronic pain
• chronic fatigue
• sleep deprivation
• hormonal imbalance
• chemical imbalance
• emotional stress
• feelings of helplessness
• resurfacing of old, unresolved problems
• loss of self-esteem
• unresolved grief or anger
• flare up of an underlying mood disorder
Depression is a symptom, like pain or nausea. Although a positive attitude and a solid faith can often help prevent or offset depression, they cannot always do so. Depression indicates that something is wrong, not necessarily that something is wrong with the way you are handling your situation.
Some women who have uneventful pregnancies and deliveries, and who are prepared and thrilled to receive this addition to their family, suffer from depression after they get home. This so-called postpartum depression is believed to be due to the effect on their brain of the drastic chemical and hormonal changes following delivery. Not all new mothers get depressed. Not all new mothers with depression are suffering from postpartum depression; some may have good reason to be depressed (the pregnancy was not wanted, the baby is not well, and so on). But it helps women who do suffer from genuine postpartum depression to learn that the depression is real, is due to chemical and hormonal changes beyond their control, is not due to their having a bad attitude or adjusting poorly, and is treatable.
Most cancer survivors have legitimate reasons to feel depressed (losses, strains, ongoing problems). However, depression can persist even after the survivor has grieved losses, accepted limitations, and resolved problems. Even if you have an ideal positive attitude and exceptional coping skills, the physical changes caused by chronic stress and/or the aftereffects of treatment may increase the risks of your becoming depressed. Thankfully, this depression usually responds well to treatment (medications and/or counseling). Understanding the physical nature of depression will spare you unnecessary suffering from this treatable aftereffect.
If you feel depressed, remember that you may be doing everything right to maximize your recovery from cancer treatment and yet have undergone physical changes that cause persistent depression. Similarly, someone with diabetes can take every measure to keep his blood sugar under control, can be very well adjusted to the changes and limitations required by his disease, and may nevertheless still need insulin, because his chemistry has been changed by the loss of insulin-producing cells.
Among the many different types of depression are manic-depressive disorder, major unipolar depression, and seasonal affective disorder (SAD). It is important that your doctor evaluate your depression because an accurate diagnosis increases the chance of revealing a reversible cause and beginning effective treatment.
Should I Be on a Special Diet?
Your diet is an important part of recovery from cancer and should be chosen with care. The healing process continues for weeks to months after treatment is completed. Your diet provides the resources your body needs to promote healing. When your body is repairing damaged tissues and clearing toxic substances, there is an increased requirement for
Sometimes additional dietary specifications are required to deal with
• constipation or diarrhea
• drug interactions with dietary substances
• heart or kidney problems
If I Was on a Low-Cholesterol Diet before I Was Diagnosed with Cancer, Should I Resume It?
After cancer treatment is completed, the top priority in choosing your diet is selecting foods that will promote recovery from your cancer and the cancer treatment.
Fat-restricted diets have a long-term goal of decreasing the risk of hardening of the arteries in people at risk. Before you are concerned about long-term goals, you need to focus on the immediate task of recovery. Letting your cholesterol be too high for a few months will have less impact on your overall health and your life than not getting adequate nutrition for healing after cancer treatment.
If you were on a low-cholesterol diet before your cancer, have your cholesterol profile rechecked. If your doctor feels that your test results indicate that you still need to modify your intake of fat, this can be done as long as your weight is not too low and your diet provides adequate fat-soluble vitamins.
Is Low Cholesterol Associated with an Increased Risk of Cancer?
Some studies suggest that extremely low blood levels of cholesterol are associated with an increased risk of certain cancers. This is preliminary information. It may be a statistical association with no cause-and-effect relationship. Or it may be that the cancer causes the extremely low cholesterol.
If you have low cholesterol, do not try to raise it in hopes of decreasing your cancer risk. There are no data to indicate that raising your cholesterol has a beneficial effect on cancer risk.
If you have high cholesterol, the long-term benefits to your health of lowering it to a normal level outweigh any potential risks.