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Integrative Oncology: Synergistic Healing

Chloe Christiansen The QR code above can be opened with an iPhone to view Integrative Oncology Documentary Website and video.

Integrative Oncology: Synergistic Healing

Chloe Christiansen

Main meditation room at the Zen Center

Dedication

To Chloe Atreya and Noelle Morris, for teaching me so that I can teach others.

Acknowledgements

would like to thank Freestyle Academy for giving me the opportunity to do this project. On top of the amazing equipment and software which I got to use, the attention and help from the teachers was priceless. Jason Greco helped me greatly throughout the difficult writing process, giving me advice and perspective which I needed. Leslie Parkinson and Leo Florendo taught me everything I needed to know in order to make a website, a video, and an entire book using software that I had never used. I would also like to thank Gordon Jack for taking the time to give me feedback and advice on my writing, as I could not have made satisfactory revisions without this help.

Left: Crane Exhibit at the Zen Center

Table of Contents 9 10

Preface Introduction

Integrative Oncology

Cancer

Mindfulness

Experiencing Healing

Larger Application

Conclusion

Works Cited

Preface

y goal in producing this documentary is to share the contemporary field of Integrative Oncology through informative research and testimonies of personal experience. When I began the project, I wanted to gather as much information as possible and dive deep into the research aspect of the subject. The challenge then was to express the emotional resonance that accompanies the human experience of going through cancer and the process of healing. I discovered connections I had never anticipated between my documentary subjects, and realized the cyclical relationship between mentality and physicality. Integrative has become a far more meaningful word to me, because I have gained an understanding of how illness, healing, growth, and happiness are interconnected in ways which we cannot see. As a skeptic of mindfulness and meditation, one of my goals in researching the practice was to understand why so many people believe in its power and whether it actually works. I have definitely gained more faith in mindfulness counseling and practice, although I still find it hard to overcome my skepticism and incorporate it into my own life. This project took me beyond the traditional high school curriculum, and I have learned more through this project than any other in my life. It taught me to manage my time, ask for help, reach out to interesting people, prepare for interviews, research a complex subject, use new software, and open myself up to new ideas.

Chloe Atreya in the Zen Center garden

Introduction

ircumstantial happiness is a major challenge in this day and age. There are so many distractions attacking us from every angle that it is hard to look inward and focus on oneself. It is being discovered that the benefits of many human innovations come along with repercussions affecting our planet and our health. One of these detriments to optimal health is the collective group of conditions labeled cancer. Even with the huge amount of intelligence and innovation present in the world, we still havenâ&#x20AC;&#x2122;t found concrete solutions to many of the health problems and causal environmental factors which persist. Societal, interpersonal and health troubles are combined in our everyday lives and the anxiety can be hard to manage. Even in the most prosperous countries successful people are being confronted with life-threatening conditions, cancer being among the most significant of these. Instances of cancer diagnosis have had an exponential increase during recent history. Some causes of cancer, like smoking, are seen as preventable. But some of the causes cannot even be identified or addressed, and many patients are mystified as to the origin of their illness. It is undeniably a partial result of the many abuses that the human populations of years past and present have inďŹ&#x201A;icted on the planet, and this damage is not going away anytime soon; rather, it continues to accumulate, sometimes in compounding feedback loops which we perpetuate. It is now a necessity to rehabilitate and remediate in whatever ways we are able, but it will take time and a lot of change. Many of us may feel we are quickly wasting our lives

away even when we are fortunate enough to have good health. Appreciation for the present generally increases happiness and contentment with life, no matter what situation one is going through. Finding embodiment and mental tranquility can maximize ones experience of life. Sometimes, it takes a good teacher and a supportive community of healing to be able to learn to be present. Everything we do is driven by expectations and future incentives, and to live in the present can feel boring and pointless. But the future will always be one step ahead, and it cannot be held. Truly understanding this perspective and finding comfort within the body allows us to make the daily steps necessary in working towards goals that will benefit us in the future, and assists us in staying focused on what is achievable and necessary today. With a situation as challenging as a cancer diagnosis, any tool to decrease stress and increase happiness is greatly needed by both patients and the people closest to them. Using mindfulness and other forms of healing combined with pharmaceutical cancer treatment, consciousness can be healed along with the body.

Introduction

ne method of cancer treatment that has not been a part of western medicinal practice historically is integrative oncology. After finally reaching a consensus from various medical physicians and scientists, a lengthy definition of Integrative Oncology was published in a 2017 study by Oxford University. Essentially, Integrative Oncology combines non-pharmaceutical therapies that are (as of just recently) well researched with traditional cancer treatments. These traditional cancer treatments, which often involve chemicals and radiation, are highly invasive and depletive to patients undergoing them. Integrative Oncology looks to help people address cancer before, during, and after diagnosis and treatment, and to minimize the harmful effects of invasive treatments. With an open mind to alternative medicine, anyone going through, at risk of, or in proximity to chronic illness can increase happiness, health and stability across the board. Chloe Atreya is a medical oncologist and physician scientist in San Francisco at UCSF. She is heading a collaborative between the UCSF Helen Diller Family Comprehensive Cancer Center and the UCSF Osher Center for a pilot research experiment on the positive effects of mindfulness courses (a large aspect of integrative oncology) for cancer patients and caregivers. Dr. Atreya has an impressive educational background, which includes a Bachelor’s Degree in molecular biology from Princeton University as well as a PhD and medical degree from Yale University. As stated in her biographical sketch, Dr. Atreya’s

career goal is to “Optimize care for patients with metastatic colorectal cancer” (Atreya). Dr. Atreya’s current project to “optimize care” involves the new field of integrative oncology with a focus on mindfulness meditation. The goal is to make integrative oncology known and accessible to cancer patients. Dr. Atreya and the members of her team are conducting a pilot study on mindfulness meditation as a method of cancer treatment which can be applied to both cancer patients and their caregivers/loved ones, titled “Being Present”. This is one of the first studies of its kind with integrative oncology being a highly contemporary practice in American hospitals. One of the reasons that mindfulness and other alternative remedies have not been introduced to cancer patients in hospitals is that the research involved in approving them federally is very difficult to evaluate scientifically. The rules surrounding the introduction of practices to hospitals requires certain amounts of quantifiable analysis which demonstrate its benefits. Without scientific data backing the claims to the advantages of mindfulness practices, there is widespread skepticism and disregard for this method of treatment, and until now there has been neither public demand nor medical enthusiasm for meditation and other aspects of alternative therapy. However, with increased popularity and reports of success of mindfulness meditation from practicers and practitioners alike, these treatments have been integrated recently into Western medicine, starting with open-minded medical communities such as those in San Francisco.

Previous page: Chloe Atreya at work

The fundamental goals of the “Being Present” experiment are to make integrative oncology more widely recognized, generate interest in alternative treatments, and most importantly to improve the lives of cancer patients and their caregivers. This applies to patients and caregivers that come into the hospital for treatment and those who cannot access the treatments directly. The “Being Present” study involved giving willing participants eight weeks of intensive meditation courses and then conducting surveys to assess the success of the mindfulness practice on actual cancer patients and caregivers. These classes proved to be highly successful in terms of survey results in which they received a large amount of positive feedback. Dr. Atreya’s team is now using grant money to conduct “Being Present 2.0”, which is focusing on producing a website which will contain mp3 recordings written by doctors of targeted mindfulness courses, one aimed at patients and one aimed at caregivers, as well as offering in-person courses with Donald Abrams, a renowned professor and oncologist at UCSF. He provides various forms of alternative care such as mindfulness meditation, medicinal marijuana, medicinal mushrooms, and therapeutic touch to people suffering from chronic illnesses, and believes that “people, especially those getting cancer treatments, really benefit from having both a Western treatment plan, as well as a whole-person approach. Good nutrition is an important part of the regimen, but other facets include nutritional supplements, physical activity,

yoga, traditional Chinese medicine including acupuncture, and stress reduction with massage, guided imagery, biofeedback and meditation” (Abrams). Surveys will then be conducted following each of these modes of treatment to gather the results in the form of written feedback. The website introduced in “Being Present 2.0” will make the in-demand mindfulness courses available to patients remotely, benefitting cancer sufferers all over the world who may not have access to this niche of treatment within the greater cancer care community. Upon following up with Dr. Atreya a few months into the “Being Present 2.0” project, she and her team had made significant headway with their initial goals. They are on target to hold the first-ever Integrative Oncology Symposium in June of 2018, which aims to bring in speakers from a broad range of departments within the hospital in order to introduce the larger medical community to integrative therapies. They have also decided on two mindfulness instructors from dozens of applications sent in from around the country, and will hold the first webinar in May of 2018. Dr. Atreya explains, “We have approval from the Institutional Review Board, so for any research study that’s involving human subjects you need to get IRB approval to make sure that everything’s done in an ethically sound way...but we just recently got that approval, so as soon as all of the last little technology kinks are worked out we’ll start accruing, meaning that we’ll start enrolling patients into the study. We expect to up and running by the end of this month (April)” (Atreya).

Previous page: Buddha Statue at the Zen Center

Cancer

ancer is arguably the most infamous fatal disease in the world. According to a recent report distributed by the American Cancer Society, 600,920 men and women died of cancer in 2017 alone, and 18,540 of these deaths were people who were younger than 45 (“Cancer Facts & Figures 2017”). 5 billion dollars are spent on cancer treatment and research every year. With this money, new branches of research are being developed and discovered regularly by dedicated scientists and doctors. Some alternative practices which have never been researched or utilized in the medical field have suddenly come of interest in select cities, such as San Francisco, California. Whether cancer can be cured or not and whether a patient can beat it or not, the reality of having cancer is that one does not know what will happen in the future, even the very near future. The fear caused by this uncertainty and impending danger often leaves wounds that go unnoticed. Additionally, fear of cancer recurrence is highly probable in people who have recovered from cancer, and many survivors find it hard to continue ordinary life with the awareness that they could be subjected to illness again. One survivor of breast cancer shared with me the way she felt when she began returning to everyday activities following her illness, explaining, “Ok so my body has produced a way to self destruct, right? So, just because I’ve had surgery– to cut out those cells doesn’t mean it might not feel the need to self destruct again, so I really have to piece that apart and to address that” (Morris). There have previously been very few solutions offered by hospitals to address difficulties like the

one experienced in this explanation. With higher chances of survival for cancer patients due to recent advances in medicine and oncology, there are consequently a higher number of people living with the stress following cancer diagnosis after successfully combating the illness itself. Despite this higher rate of survival, the journal Non-Cancer Mortality among People Diagnosed with Cancer explains, “Compared to the non-cancer mortality in the general population, cancer patients (all cancers combined) were 50% more likely to die of non-cancer causes” (Baade). This is the result of many factors, but essentially the mental and physical aftermath of recovering from cancer leaves survivors vulnerable to other fatal conditions which cannot necessarily be treated with medication. Cancer diagnoses and treatments are directly correlated to mental unrest/illness occurrence. These mental disorders can include stress, depression, and PTSD, among others. One of the most common issues experienced by patients following cancer diagnosis is “distress,” which is defined by the National Comprehensive Cancer network as “a complex, unpleasant emotional experience characterized by compromised psychological, social, and/or spiritual well being” (Carlson). Stress directly correlates to physical ailments as well: it heightens blood pressure, can cause over or under-eating which results in unhealthy weight gain or loss, influences development of issues with alcoholism and drug abuse, and generally impedes self care. In response to this dangerous stress, increasing numbers of doctors are

“Being Present 2.0” Meeting at the Osher Center

turning to alternative medicine for answers. The effects of decreasing stress (which is understandably high in someone suffering a chronic illness) can manifest physically as a result of changes in mentality. Trish Bartley is an author, teacher and mindfulness trainer. She discovered mindfulness meditation when she went through breast cancer. In her first book, MindfulnessBased Cognitive Therapy for Cancer, she writes, “Anxiety can produce symptoms such as shakiness or sweating or palpitations in the chest. Or anxiety may result in automatic bracing against what is most feared, producing tension in the body that causes pain or aching” (46). This passage indicates that stress and anxiety intensify and add to feelings of physical pain, and as one would guess, the physical pain then becomes more of a central focus to the person than the underlying emotional distress which is causing the pain, in turn prolonging the suffering and inducing a cycle of deterioration. Cancer patients typically have a heightened perception and awareness of unusual physical pain, and stress-induced discomfort may lead to speculation that it is a recurrence or occurrence of cancer. This fear obviously leads to increased levels of uncertainty, deepening the cycle of anxiety through harmful rumination. The mental and physical pain experienced by people going through cancer often become intertwined and are at times directly proportional to one another, which Bartley addresses, stating: “Psychological distress has been shown to increase

the experience of pain (Massie & Holland, 1992), decrease overall functioning (Noyes, Holt, & Massie, 1998) and is a major risk factor for suicidal ideation and suicide attempts” (16). This demonstrates that mental pain is often a predecessor to physical pain, and whether unintentional or self-inflicted it may be out of the patient’s control. When mental pain is manifested physically, the physical pain is typically addressed first through medication or topical treatment, without addressing the underlying anxiety or depression which is fostering physical distress. This is one reason that patients have reported feeling revitalized and lightened after mindfulness sessions, because by confronting and accepting their painful thoughts, the physical symptoms are diminished congruently.

Chloe Atreya in the Zen Center

Mindfulness

hat is mindfulness? Mindfulness meditation was introduced in 1979 by Jon Kabat-Zinn to treat chronic illness (Mindfulness). Practicing mindfulness involves attempting to free the mind from all distractions, especially those in the past and future. Being mindful is focusing on the present moment without taking any actions, simply being comfortable existing. Instructors often advise to focus on the feeling of the breath going in and out, and the internal feelings of the body that may go unnoticed otherwise. It is simple in theory but difficult in practice, because there are constantly thoughts and emotions bombarding our consciousness. If the practice is taken up at a time of intense stress, it is additionally difficult to focus on the present moment and remain still. The practice can be related to neurologist Stephen Porges’ Polyvagal Theory, which boils down to “immobility without fear” (Morris) – in other words, the ability to be surrounded by other people and things while remaining tranquil. Mindfulness can also be practiced through eating by focusing deeply on the flavor, texture and feeling of eating a certain piece of food. Despite these practices being very simple, many limits remain around alternative care. In Addressing Fundamental Questions about Mindfulness, author Kirk Warren Brown notes, “Research on the topic is comparatively new to the field of behavioral science but more deeply, mindfulness concerns consciousness, which remains a demanding area of study.” It draws from Buddhist and Hindu ideologies, but does not have a religious foundation. Creating a more

medical perspective around mindfulness makes the practice appealing to a much wider audience. By titling courses and information about the practice as “Mindfulness”, “Mindfulness-Based Stress Reduction”(MBSR), or “Mindfulness Based Cognitive Therapy” (MBCT), practitioners are able to move away from cultural stigmatism or religious barriers and attract a highly diverse group of individuals who could benefit from the services. Using such technical terms also help to remove the stereotypes about meditation and establish mindfulness as a well-researched therapy. However, despite moving away from the culturally descript title, there remains a large amount of skepticism surrounding alternative care, particularly mindfulness. Beyond religious prejudice, until now it has been largely disregarded in the medical community and written off in American society as an ineffective facet of hippie culture. As Nicholas Van Dam, a research fellow at the University of Melbourne noted in his 2018 paper on the limitations of mindfulness, “Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed” (Van). With the introduction of medical specialists educated in mindfulness, its credibility and reliability are increasing greatly. Mindfulness addresses fundamental aspects of our being (for example, what it feels like to breathe) in a nonintrusive way that does not present adverse side effects– what’s the risk in trying? It can prove paradoxical for a skeptic to begin

practicing mindfulness because it is an almost entirely selfdriven practice that requires genuine effort and faith on the part of the skeptic, as opposed to pharmaceutical drugs or other aspects of integrative oncology such as massage. It is then the task of the skeptic to prove the effectiveness of mindfulness to themselves. In the past, mindfulness has been perceived as an imaginary, placebo mode of treatment with unidentifiable results. Yet despite having limited evidence, mindfulness has been shown to alter cognition. In “Does Alternative Medicine Work?”, Lynn M. Scott, a researcher of alternative medicine, writes “Of the alternative medical approaches that have been subjected to the rigors of clinical trials, the one that has yielded the most consistent positive results is the practice of meditation. Acceptance of the variety of health benefits offered by regular meditation is widespread among mainstream doctors and researchers, and clinical evidence has been viewed as potentially revolutionary in the study of how certain lifestyle changes can impact overall health and well-being” (Preface). Mindfulness and meditation are somewhat interchangeable, although mindfulness steers away from the religious or cultural aspect of the practice to make it more accessible, urging practicers to focus on themselves rather than a deity or religious symbol. Scott notes that meditation was found to physically decrease grey-matter density in parts of the brain “associated with memory, sense of self, empathy and stress,” specifically the amygdala. This is some of the only available

evidence of the physical changes in the brain as a result of meditation because it has not been an area of interest for medical physicians until now. Through advances in research and public awareness, mindfulness is making a name for itself in medicine and psychology. In addition to addressing mental illness and symptoms of trauma, mindfulness has been found to decrease feelings of physical pain. This suggests a strong connection between mentality and physical health, and this phenomenon may attest to the importance of integrative oncology for comprehensive healing. In “In Pain? Try Meditation”, CNN writer Anne Harding details a study which found that subjects who experienced a burn after four 20-minute meditation sessions experienced 57% less unpleasantness and 40% less intensity as fellow burned subjects who did not attend these courses, which is a greater disparity than seen with heavy duty painkillers such as Morphine and Oxycodone (Harding). The noteworthy significance of this particular study was that it affirmed the effects of meditation after only 80 minutes as opposed to a multi-week experiment. The effects of mindful exercises are clearly impactful; they do not only benefit people who are suffering mentally with issues of depression and stress, but can also seriously affect experiences and perceptions of pain for those suffering physically.

Previous page: The Zen Center in San Francisco

Experiencing Healing

veryone follows a different path when it comes to healing. True healing requires more than palliative care; in fact, it goes beyond curative care. This is where spirituality and the necessity to rehabilitate the consciousness come into play. One person who has experience with many forms of healing is Noelle Morris. Morris is a bodyworker specializing in massage therapy and counseling for people suffering from trauma, specifically childhood trauma. Her office is in Menlo Park, California, where her clients come to her looking for relief from PTSD and from the physical ways in which their trauma manifests, such as chronic stress, tension and fatigue, and Morris facilitates people’s process of finding embodiment. She has also had clients come to her during and after their cancer treatment, and the way in which she conducts sessions has many similarities to the practices and theories behind the mindfulness aspect of integrative oncology. Morris is labeled an integrative healer due to the fact that she combines the traditional psychotherapy approach with the nonstandard aspect of massage therapy to address problems stemming from trauma. When I asked Morris to describe to me the end goal of her practice, she told me: “Well, the short is: to discover their own body as a resource. And that could be to experience the body then provides stability, is orienting, even as a source of pleasure. But safety, containment, all these elements, it’s to facilitate embodiment.” She noted, “The operative words are regulation and resilience in their life, or their energetic being

and body” (Morris). Morris describes the body as her “path,” and entered her career by following her passion and personal interests. Her time spent outside her bodywork is occupied with other somatic activities, especially dance. Somatic activities refers to activities relating to the body, but not the anatomical structure of the body that is often referenced in Western medicine. Instead, it refers to the inward feeling of existing within the body. Morris has been dancing for over 25 years, and although she is classically trained in ballet, she currently focuses on sacred dance forms, specifically classical Indian dance. This practice ties into her fascination and appreciation for the body, and helps Morris to feel grounded in herself. Her counseling and massage draws clients’ attention to what they are experiencing in the present, despite primarily addressing issues from childhood, as she described to me over tea during our interview. I asked Morris whether her practice focused mainly on the past trauma or on the body itself, and she replied, “Well it’s interesting you named mindfulness because the work is done, at best, in the present moment. So it’s not really talking about, ‘You know last week, this thing happened where…’. It’d be like, ‘So right now, as you’re speaking about that event of last week, I’m noticing that your breath got really shallow, are you aware of that too?’. ‘Oh, yeah’. ‘How about staying with that sense of your breath, and we see what happens next’. So we’re really working present time with the phenomena as it’s occurring, which includes the body” (Morris). This quote substantiates Morris’s knowledge of integrative healing and

Previous page: Noelle Morris

connects closely to the methods used in mindfulness when addressing trauma related to cancer. Morris experienced an arduous journey of healing in her own life when she went through breast cancer. Because of her enhanced awareness of herself and understanding of different modes of healing, Morris was likely more equipped to handle the extreme pressure of going through the illness. She used these strengths to understand her own boundaries during her treatment and assert herself in the process, sometimes despite the doctors’ opinions. She explained, “I wasn’t just going to be like ‘here, you can do this surgery to my body, but I’m not really ready for this surgery’. I waited ‘til I was ready to elect this procedure for my body. So I needed to slow it down. So I was really glad that I was able to exercise that and do that” (Morris). During her treatment Morris opted to provide herself with various forms of alternative healing. There was a mindfulness course available at the hospital in which she received treatment, but it was not covered by her insurance so she had to pay full price. One of Dr. Atreya’s end goals through the “Being Present” projects is to provide the mindfulness services of integrative oncology to those who need them at an affordable price, gathering necessary funding from philanthropy and donation and offering online courses for free. Had the “Being Present” programs been available, Morris would have benefited financially from this resource in her healing. Other than financially, another challenge for Morris during her treatment was to fit alternative healing into her busy schedule. Despite perceptions that patients going through cancer spend this time in a peaceful state of

convalescence, the reality is that it involves a very busy and chaotic schedule of appointments, which Morris balanced on top of working half time. With chemotherapy and work occupying most of her time, Morris found it challenging to make time for personal appointments which were not offered at the hospital. This issue is addressed by integrative oncology, which aims to make alternative healing resources available in the same location as typical cancer treatment and offered by the same doctors, making it much more accessible to patients who may not otherwise have the time and ability to attend. The stigma surrounding a cancer diagnosis is another source of difficulty for many people going through cancer. Bartley presented an anecdotal view of the two “dialogues” surrounding cancer in Mindfulness-Based Cognitive Therapy for Cancer. One of these hypothetical scenarios illustrates the perception that cancer is the “plague of the century,” causing destruction completely out of control. The other story is of the brave survivor battling cancer heroically. Bartley concludes, “It becomes very hard to be just an ordinary person going through cancer” (323). These pressures to either be helpless in the face of an increasingly preventable disease or to stand up courageously to battle the illness overwhelm patients in either direction and dramatize the experience to only represent a state of martyrdom or helplessness, making patients feel inadequate. Loved ones of cancer patients are for the most part quick to lend help to the patient. However, the help offered to cancer patients from loved ones comes with their own complex feelings and expectations relating

Previous page: Garden at the Anada Meditation Community

to the illness. This is where mindfulness can assist caregivers and family members of cancer patients in dealing with stress and becoming stronger sources of support. This practice would help caregivers to care for and look within themselves to accept how the patient’s illness has affected them. Although mindfulness would assist with becoming a helpful support system for someone going through cancer, strong support for cancer patients is already commonplace due to our societal impression of the illness. Morris was grateful for the help she received during her experience. She explained: “culturally there’s a lot of... basically, compassion for people with cancer diagnoses. It’s recognized, it’s understood, people are concerned and kind, and I had a beautiful team of support and... it was wonderful”. The recognition and media surrounding the cancer has its drawbacks, but one benefit is that it has led to a general empathy towards people going through the illness. It is highly important that people struggling with the incredibly difficult experience of cancer have a community of people willing to lend support without expecting something in return, and mindfulness can help caregivers achieve the calm headspace necessary to lend themselves in this way. Palo Alto Medical Foundation, the hospital where Morris received the majority of her treatment, did not offer integrative oncology specifically. However, Morris experienced a more subtle version of integrative healing. This came in the form of an accidental emotional moment when Morris was being examined with an ultrasound by a

doctor who’s hip made physical contact with Morris’ lower back. She recalled the impact of this moment for me in our interview: “All I needed to do was lie there, but just having that close proximity of someone who’s neutral or well-intentioned. And I realized like, wow, I haven’t had this. This hasn’t happened. And all these careful planning and doings, just this beingness– and it’s so clear to me now, with my perspective from my work, that that’s the space where the actual integration happens. And the word is integrative. Oncology. So it’s this actual space where all that has happened, all that is happening can actually digest, and find its place, and come home and settle, where it can be accepted and integrated into the being” (Morris). Morris’s experience of connection, embodiment, and acceptance of the present which was brought on by silent contact during her illness illustrates the depth and significance of mindfulness and body-centric healing practices which are aspects of integrative oncology. This experience is also representative of the benefits of group mindfulness courses. By engaging in mindfulness practices with individuals experiencing the same challenges, doubts, and pain, patients can gain a feeling of intimate community and understanding of themselves and others.

Larger Application

indfulness practice is not limited to individuals going through or recovering from a chronic illness. In the comprehensive definition of integrative oncology, includes a statement of its purpose: “To empower people to prevent cancer and become active participants before, during, and beyond cancer treatment” (Witt). These treatments are recommended “beyond” cancer care because they can help any person increase their health, even an already-healthy person. Holistic healing can be applied to small feats of well-being, like taking a moment to breathe between activities or nourishing your body with nonprocessed food. By equipping yourself with tools for inner resilience, challenges are easier to face and improve. As well as using mindfulness and non-pharmaceutical healing after cancer, these practices may be used to help avoid a diagnosis altogether by addressing mentality. Morris introduced me to the ACE (Adverse Childhood Experiences) test, a questionnaire which is used in her practice to establish a basis when evaluating the history of trauma in clients. She told me, “Developmental trauma can leave this sort of impaired resiliency to optimal health, and then that sort of system is more fertile ground for these chronic conditions like heart disease, and cancer, diabetes” (Morris). Following trauma, there is a heightened proclivity towards developing these conditions, a phenomenon that is easily quantifiable and may even be avoidable. The most apparent cause for the occurrence of chronic illnesses in people who have gone through adverse childhood experiences (which may include

abuse, loss of a parent, or other distressing experiences) is that this trauma leads to unhealthy coping mechanisms such as excessive smoking, drinking or eating disorders, some of which are carcinogens on top of having other adverse effects on the body. Dangerous coping mechanisms are sometimes adopted by cancer survivors as well, following the trauma of going through the devastating illness. This could make the disease more likely to reappear, turning fear of recurrence into a self-fulfilling prophecy. These habits are hard to break when they have become a way to deal with intense emotions. Western medicinal treatment often falls short in addressing mental illness and correlated addiction, and there is a tendency to over-prescribe pills to patients that they then become addicted to, compounding the issues they are facing. Chronic pain is a common symptom found in people with a history of trauma. To address chronic pain that does not have a clear source, pain medications tend to be casually dispensed to patients even when this pain is a result of mental illness. This raises the risk that the drugs become another coping mechanism that patients depend to meet their emotional needs. In getting away from Western medicine, mindfulness meditation and related practices such as the massage/counseling that Morris provides may assist victims of childhood trauma in fostering the resiliency that is necessary in overcoming addictions, chronic pain, and chronic distress. By addressing the issue at this stage in its development, a large portion of cancer diagnoses for what are considered preventable forms of cancer may be

avoided. In “The most important thing I didn’t learn about in medical school: Adverse childhood experiences,” Dr. Nancy Hardt writes, “Resilience can overcome the effects of toxic stress. As adults, we can’t undo the early childhood trauma we experienced. But, our ability to develop resilience starts in early childhood and never goes away” (Hardt). Physicians and scientists have only recently begun examining the correlation between childhood experience and adult health. It is becoming increasingly apparent that this may be a large factor of disease development, as diseases caused by poor health and lifestyle choices are one of the leading causes of death in the United States today. In a study from Kaiser, they found, “a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults” (Felitti). Other than the inferable risk of trauma survivors developing cancer-causing coping mechanisms, more and more evidence is pointing to trauma being a correlated factor in development of autoimmune and neurological disorders which previously did not exhibit a clear source. Mental health has never been justly focused on in the medical community, and as a result the societal response to mental illness is often apathetic. After receiving support during her cancer treatment, Morris recalled a disconnect between how her mental and physical illnesses had been addressed by loved ones throughout her life. She hesitantly explained to me: “...I have a history of depression (mental illness, if you will, if you use that hefty word), so I’ve had really tough times in my life, but I haven’t really felt like I

can lead with saying, ‘Y’know, my depression’s really bad, could you make me dinner and deliver it?’. Like you’re not gonna do that. But yet, with cancer– I’ve had surgery, I could use help, and help came. So it was actually very light filled, and really a good time for me to have so much support in a challenging time where I have this history of having had years of challenging times, but because I felt it being more taboo or not so accepted, that I endured that alone and didn’t reach out ‘cause I couldn’t be transparent about it” (Morris). The positive impacts of loving compassion that Morris experienced during her cancer treatment were fundamental to the healing process, and it was possible for her to get this help because she was comfortable asking for it. If mental health were a greater focus in clinical health care, it is likely that the societal response to mental illness would gravitate towards understanding and empathy. People going through mental illness or hoping to reach out to someone suffering from mental illness can all practice non-intrusive alternative healing practices to reduce symptoms of stress and depression before relying on potentially addictive pharmaceutical drugs. It is necessary that mental health be an integral aspect of caring for people who need help. By integrating mentality-oriented practices into hospitals around the world, a culture of acceptance can be fostered and patients can build tools for increased resilience toward both mental and physical illness. All of this goes to show that mind-body health must and will become a larger focus in the healthcare community when helping patients prevent, treat, and recover from the chronic illnesses which take so many lives.

“It’s so clear to me now, with my perspective from my work, that that’s the space where the actual integration happens. And the word is integrative. Oncology. So it’s this actual space where all that has happened, all that is happening can actually digest, and find its place, and come home and settle, where it can be accepted and integrated into the being”

~Noelle Morris

The Zen Center main room

Conclusion

athering from many different perspectives and experiences, I assert that Mindfulness Based Cognitive Therapy and other alternative therapies, when integrated with traditional cancer treatment, are decisively effective in increasing the health, happiness, quality of life, and comfort of cancer patients, their caregivers, and their loved ones. Beyond cancer treatment and coping with a chronic illness, mindfulness can be utilized by any person. It is best to start the practice during a time of stability and strength, and by using mindfulness you can develop a habit of appreciation and awareness for even the mundane and trivial everyday tasks we are faced with as people. If a threatening situation arises, mindfulness has the power to clarify and strengthen your cognition. If youâ&#x20AC;&#x2122;re looking for the next step in your treatment or general health, look within.

Works Cited Atreya, Chloe. Biographical Sketch. Nov. 2016, https://drive.google.com/file/d/0B3jn1EfRcOJHSmdFQllZZ2NL dVluaUptZEV3MW54VDQ1WUIw/view?usp=sharing Atreya, Chloe. Personal Interview. 22 Feb. 2018. Baade, Peter D., et al. “Non-Cancer Mortality among People Diagnosed with Cancer (Australia).” Cancer Causes & Control, vol. 17, no. 3, 2006, pp. 287–297. JSTOR, JSTOR, www.jstor.org/stable/29736461. Bartley, Trish. Mindfulness-Based Cognitive Therapy for Cancer, John Wiley & Sons, Incorporated, 2011. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/losaltos-ebooks/detail. action?docID=822581.Created from losaltos-ebooks on 2018-03-14 13:44:39. Brown, Kirk Warren, et al. “Addressing Fundamental Questions about Mindfulness.” Psychological Inquiry, vol. 18, no. 4, 2007, pp. 272– 281. JSTOR, JSTOR, www.jstor.org/stable/20447397. “Cancer Facts & Figures 2017.” American Cancer Society, 2017, www.cancer.org/research/cancer-facts-statistics/all-cancer-factsfigures/cancer-facts-figures-2017.html. Carlson, Linda E. “Distress Management Through Mind-Body Therapies in Oncology.” Oxford, J National Cancer Institution, 2017, file:///Users/chloe/Downloads/CarlsonMonograph.pdf. “Donald I. Abrams, MD.” UCSF Osher Center for Integrative Medicine, UCSF, www.osher.ucsf.edu/patient-care/our-practitioners/donaldi-abrams-md/. Felitti, Vincent J. “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults.” American Journal of Preventative Medicine, May 1998, www.ajpmonline.org/article/S0749-3797(98)00017-8/fulltext. Harding, Anne. “In pain? Try meditation.” CNN, Cable News Network,

5 Apr. 2011, www.cnn.com/2011/HEALTH/04/05/meditation. reduce.pain/index.html. Hardt, Nancy. “The Most Important Thing I Didn’t Learn about in Medical School: Adverse Childhood Experiences.” ACEs Too High, 14 Feb. 2017, acestoohigh.com/2017/01/23/the-most-important-thing-i-didnt-learn-in-medical-school-adverse-childhoodexperiences/#more-6525. Morris, Noelle. Personal Interview. 17 Apr. 2018. “Preface to ‘Does Alternative Medicine Work?’.” Alternative Medicine, edited by Lynn M. Zott, Greenhaven Press, 2012. Opposing Viewpoints. Opposing Viewpoints in Context, http://link.galegroup.com/apps/doc/EJ3010501127/ OVIC?u=los42754&xid=4806f2e1. Accessed 18 Feb. 2018. Van, N T, et al. “Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation.” Perspectives on Psychological Science : a Journal of the Association for Psychological Science., U.S. National Library of Medicine, Jan. 2018,www.ncbi.nlm.nih.gov/pubmed/29016274. Witt, Claudia M. “A Comprehensive Definition for Integrative Oncology.” Oxford, 14 Aug. 2017

Garden at the Ananda Meditation Community

About the Author

Chloe Christiansen is a 17 year old high school student living in Mountain View and San Francisco, California. She is a junior at Freestyle Academy of Communication Arts & Technology part time time and spends the rest of her time in school at Los Altos High School. In her free time Chloe enjoys drawing and petting her chubby dog, Bear.

Integrative Oncology: Synergistic Healing

Chloe Christiansen The QR code above can be opened with an iPhone to view Integrative Oncology Documentary Website and video.