Up to 80% of American patients with breast cancer will undergo complementary therapies to manage anxiety and stress after they receive a diagnosis.
Though there’s no clear consensus on which integrative and alternative therapies work and which are ineffective, more and more medical practices have incorporated practices like mindfulness and acupuncture into their offerings. But a new study published in the Journal of the National Cancer Institute Monographs conducted by several major oncology facilities has examined which therapies benefit patients the most. The answer? Meditation, yoga and relaxation with imagery.
The three methods are known to be calming for those who practice them, and the researchers gave the practices an “A” for treating symptoms of mood disorders that are highly common among people with a recent diagnosis.
To come up with the grade, the researchers parsed through clinical trials conducted from 1990-2013 on complementary therapies paired with routine cancer treatment, like chemotherapy. The researchers then graded each therapy based on efficacy. Acupuncture was given a “B” for controlling chemo nausea, and music therapy also received a “B” for anxiety and stress.
“Women with breast cancer are among the highest users [of these therapies]…and usage has been increasing,” the authors write in their study. “Clear clinical practice guidelines are needed.” The study involved researchers from Columbia University’s Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, MD Anderson, University of Michigan, Memorial Sloan Kettering and more.
The researchers also gave some therapies low grades. For example, healing touch was given a “C” for lowering pain, and aloe vera gel was not recommended at all for preventing skin reactions from radiation therapy. The researchers also point out that while some natural products were shown to be effective, they did not have the safety data to back them up, suggesting more formal research is needed before some of the therapies can be officially recommended.
As patients with breast cancer and other forms of cancer continue to seek other ways to deal with some of the emotional side effects that stem from serious illness, it will become increasingly important for hospitals to find ways to answer their unmet needs—which might include a yoga class.
Meditating for a half an hour each day may ease anxiety and depression, according to a new meta-analysis by researchers at John Hopkins University.
“A lot of people use meditation, but it’s not a practice considered part of mainstream medical therapy for anything,” says Madhav Goyal, M.D., M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine.
Goyal was the leader of a study published online yesterday in the journal JAMA Internal Medicine.
“But in our study, meditation appeared to provide as much relief from some anxiety and depression symptoms as what other studies have found from antidepressants,” Goyal continued.
Goyal and his researchers assessed improvement in symptoms of people with a range of medical ailments, including insomnia and fibromyalgia. Only a minority of those analyzed had been diagnosed with a mental illness.
In what is likely a boon to those who prefer alternative medicine, the study indicates that so-called “mindfulness meditation” — which the authors describe as “a form of Buddhist self-awareness designed to focus precise, nonjudgmental attention to the moment at hand” — may be a promising way to alleviate some amount of pain symptoms, while also providing a stress-relief benefit. And, adding more scientific weight to the practice is the discovery that even after controlling for possible placebo effects, study participants were found to feel better.
The researchers focused on 47 clinical trials performed through June 2013 among 3,515 participants.
“A lot of people have this idea that meditation means sitting down and doing nothing,” Goyal says. “But that’s not true. Meditation is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”
Mindfulness meditation, which emphasizes acceptance of feelings and thoughts without judgment, and which focuses on relaxation of body and mind, is usually practiced for 30 to 40 minutes per day.
Although more research is required to determine if more meditation produces more results, the “meditation programs appear to have an effect above and beyond the placebo,” Goyal says.
Scientists, like Buddhist monks and Zen masters, have known for years that meditation can reduce anxiety, but not how. Scientists at Wake Forest Baptist Medical Center, however, have succeeded in identifying the brain functions involved.
“Although we’ve known that meditation can reduce anxiety, we hadn’t identified the specific brain mechanisms involved in relieving anxiety in healthy individuals,” said Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. “In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief.”
The study is published in the current edition of the journal Social Cognitive and Affective Neuroscience.
For the study, 15 healthy volunteers with normal levels of everyday anxiety were recruited for the study. These individuals had no previous meditation experience or anxiety disorders. All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.
Both before and after meditation training, the study participants’ brain activity was examined using a special type of imaging — arterial spin labeling magnetic resonance imaging — that is very effective at imaging brain processes, such as meditation. In addition, anxiety reports were measured before and after brain scanning.
The majority of study participants reported decreases in anxiety. Researchers found that meditation reduced anxiety ratings by as much as 39 percent.
“This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety,” Zeidan said.
The study revealed that meditation-related anxiety relief is associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex, areas of the brain involved with executive-level function. During meditation, there was more activity in the ventromedial prefrontal cortex, the area of the brain that controls worrying. In addition, when activity increased in the anterior cingulate cortex — the area that governs thinking and emotion — anxiety decreased.
“Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings,” Zeidan said. “Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful.”
Research at other institutions has shown that meditation can significantly reduce anxiety in patients with generalized anxiety and depression disorders. The results of this neuroimaging experiment complement that body of knowledge by showing the brain mechanisms associated with meditation-related anxiety relief in healthy people, he said.
Support for the study was provided by the Mind and Life Institute’s Francisco J. Varela Grant, the National Institutes of Health grant NS3926 and the Biomolecular Imaging Center at Wake Forest Baptist.
Co-authors are Katherine Martucci, Ph.D., Robert Kraft, Ph.D., John McHaffie, Ph.D., and Robert Coghill, Ph.D., of Wake Forest Baptist.
Individuals with no experience in meditation who participate in mindful meditation training sessions for as little as 4 days show changes in specific brain mechanisms that correlate with a reduction in anxiety, a new imaging study shows.
“There is plenty of evidence that meditation can improve a host of issues, such as pain and cognitive function, and anxiety is perhaps at the top of the list,” explained lead author Fadel Zeidan, PhD, a postdoctoral research fellow in neurobiology and anatomy at Wake Forest School of Medicine, in Winston-Salem, North Carolina.
“But what we’ve been able to do is to correlate, through imaging, changes in specific brain regions that are related to anxiety, even in a cohort of people with no anxiety or depression.”
The findings were published online April 24 in Social Cognitive and Affective Neuroscience.
Buffer to Anxiety
For the study, Dr. Zeidan and his colleagues recruited 15 healthy volunteers with normal levels of anxiety and no experience in meditation to participate in 4 20-minute training sessions to learn the technique for mindful meditation.
This involves a focus on breathing and a conscious acknowledging of distracting thoughts and emotions, combined with a decision not to react to them.
“You’re trained to focus on keeping a very straight posture and the sensations of the rise and fall of your chest and abdomen as you breathe,” Dr. Zeidan explained.
“If your mind becomes distracted, you acknowledge the distraction, let it go, and focus back on the breathing. You are regulating your emotional responses.”
Before and after each meditation training session, the participants, who included graduate students and faculty, received brain activity imaging with pulsed arterial spin labeling magnetic resonance imaging (MRI).
The participants also were administered the State Anxiety Inventory, a 20-item subscale of the State Trait Anxiety Inventory, before and after the brain imaging.
While the participants reported meditation-related reductions in anxiety ratings by as much as 22%, the MRIs showed anxiety relief to be associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex (vmPFC), which show decreases in activity when anxiety is present.
The vmPFC is also implicated in the alteration of contextual evaluation of affective processes, the authors write.
“Activation in the vmPFC is associated with modulating higher-order affective appraisals, including cognitive regulation of negative emotions.”
In addition, reports of greater anxiety correlated with greater default-related activity (ie, posterior cingulate cortex) on MRI, “possibly reflecting an inability to control self-referential thoughts,” the authors write.
The brain mechanisms related to the reduction of anxiety through mindful meditation in healthy people have never been identified, so the findings help confirm that the changes do occur, said Dr. Zeidan.
“It shows that mindful meditation can be sort of this buffer to anxiety. After just a brief training, you can reduce this ruminative thought process, change your attention, and change the context in how you respond to things,” he said.
Amit Sood, MD, director of research and practice in the Mayo Complementary and Integrative Medicine Program at Mayo Clinic, in Rochester, Minnesota, said that such changes are not unexpected over such a short period.
“I’m not surprised to see the correlations with reductions of anxiety in 4 days — other studies looking at brain structure have reported seeing these changes after just 4 to 6 hours of training,” said Dr. Sood.
“What I would be surprised to see, however, is if they were still doing it on their own after 6 months,” he noted.
“People can learn it quickly, but then they forget. A change in habit requires a lot of effort. People have to carve out the time in their busy days, and what tends to happen is will power depletion.”
The study demonstrates, however, the potential payoff, he added.
“I wouldn’t call this a landmark study, but it does validate the overall theme we’re seeing in this field,” Dr. Sood said.
“It adds another bullet point of how we can understand emotional and brain states, and eventually this may help us better classify people based on what is actually happening in the brain, beyond their displayed symptoms.”
You know that yoga is good for your body—it increases flexibility, tones your muscles, massages your internal organs, and even helps your body detox—but now new research is showing it may be seriously good for your brain, too! In fact, it might sharpen your brain even more than other exercises.
According to research by the Exercise Psychology Laboratory at the University of Illinois, a single 20-minute Hatha yoga session can improve brain function better than moderate to vigorous aerobic exercise.
In the study, researchers measured the reaction times and accuracy on cognitive tasks of 30 female participants after they’d done yoga for 20 minutes, and after exercising for 20 minutes on a treadmill. After doing yoga, the women were better able to focus and process information quickly and more accurately. They were also better able to learn, hold and update pieces of information than after the aerobic exercise.
The reason? Breathing! According to Professor Neha Gothe, lead researcher: “The breathing and meditative exercises aim at calming the mind and body and keeping distracting thoughts away while you focus on your body, posture or breath….Maybe these processes translate beyond yoga practice when you try to perform mental tasks or day-to-day activities.” The breathing and meditation also helps calm anxiety and reduce stress, which can also help cognitive function.