Healthy Mind, Body & Spirit

Integrative Medicine

By MD Anderson's definition, complementary and alternative medicine (CAM) and complementary and integrative medicine (CIM) are "therapies of proven or unproven efficacy that have been used to promote wellness, to manage symptoms associated with cancer and its treatment or to treat cancer. When properly combined with standard cancer treatments, some complementary therapies can enhance wellness and quality of life, but others may be harmful during or after treatment for cancer."

Image Credit: D. Sharon Pruitt

Complementary and Alternative Medicine (CAM)

Alternative medical systems: Many alternative medical systems are traditional systems of theory and practice that are closely associated with the cultures that developed them. Some examples include:

• Traditional oriental medicine: Emphasizes the proper balance of vital energy, also known as qi (chi), in health. Techniques include herbal medicine, acupuncture, massage, and Qi gong.
• Ayurveda: Meaning "science of life," this is India's traditional medicinal approach that places equal emphasis on body, mind, and spirit. Techniques include diet, exercise, meditation, herbs, massage, sunlight, and breathing.
• Homeopathy: Western system of belief that is based on the principle "like cures like" - the belief that the same substance that produces the symptoms of an illness (in large amounts) can cure it (in small amounts). Homeopathic physicians use small doses of plant extracts and minerals to stimulate the body's defense mechanisms.

Mindy-body interventions: These are mind techniques that are designed to affect the body. Mind-body therapies are practiced by those who believe that emotional, mental, social, and spiritual factors can directly affect physical health. Some studies have backed up this belief: for instance, daily yoga has proven to be helpful to those with chronic insomnia, according to the NIH. Other therapies can include meditation, hypnosis, music, art therapy, prayer, and mental healing, among others.

Meditation encompasses a wide variety of techniques and traditions, many of which originated with Eastern spiritual practices. Meditation, at its most basis, is about focusing attention to become more mindful of thoughts, feelings, and sensations and to observe them in a more nonjudgmental way. The goal is to achieve a state of calm and relaxation. Most types of meditation include the following elements: 1) a quiet location; 2) a specific, comfortable posture; 3) a focus of attention; and 4) an open attitude.

Biologically-based treatments: Therapies in this category include herbal and dietary supplements, as well as biological therapies like shark cartilage and bee pollen. Herbs are seed-producing plants that are valued for the medicinal, savory, or aromatic properties. It is highly recommended that you consult with your medical team before embarking on any biologically-based treatments, as the scientific evidence about these treatments is often unclear and confusing.

Manipulative and body-based methods: Therapies based on body manipulation, commonly practiced by massage therapists and chiropractors. 

Energy therapies: Therapies that focus on energy fields within the body; examples include Qi-gong, Reiki, and Therapeutic Touch.

Complementary and Integrative Medicine (CIM)

The basic principles of integrative medicine, as stated by the University of Arizona Program in Integrative Medicine:

• A partnership between patient and practitioner in the healing process;
• Appropriate use of conventional and alternative methods to facilitate the body's innate healing response;
• Consideration of all factors that influence health, wellness, and disease, including mind, spirit, and community as well as body; 
• A philosophy that neither rejects conventional medicine nor accepts alternative medicine uncritically;
• Recognition that good medicine should be based in good science, inquiry driven, and open to new paradigms;
• Use of natural, less invasive interventions whenever possible;
• The broader concepts of promotion of health and prevention of illness as well as the treatment of disease; and
• Practitioners as models of health and healing, committed to the process of self-exploration and self-development.

Healthy Eating and Nutrition

Tips for Healthy Eating After Cancer (from the American Cancer Society)

• Check with your doctor for any food or diet restrictions.
• Ask your dietitian to help you create a nutritious, balanced eating plan.
• Choose a variety of foods from all the food groups. Try to eat at least 5 to 7 servings of fruits and vegetables, including citrus fruits and dark-green and deep-yellow vegetables.
• Eat plenty of high-fiber foods, like whole-grain breads and cereals.
• Buy a new fruit, vegetable, low-fat food, or whole-grain product each time you shop for groceries. Variety is the spice of life.
• Decrease the amount of unhealthy fats in your meals by baking or broiling foods.
• Choose low-fat milk and dairy products.
• Limit salt-cured, smoked, and pickled foods.
• If you choose to drink alcohol, limit the amount.

Nutrients (Text: American Cancer Society; Image: C.P. Storm)

Protein: One of three major nutrients that supply calories to the body, along with fats and carbs. Protein aids in growth, repairs body tissue, and keeps our immune systems healthy. After cancer treatment, extra protein can help heal tissues and fight infection. Good protein sources include lean meat, fish, poultry, dairy products, nuts, dried beans, peas and lentils, and soy foods.

Fats: Fats and oils serve as an important source of energy for the body and help transport vitamins through the blood. As you know, some fats are better than others. Choose unsaturated fasts over saturated fats and trans-fatty acids. Unsaturated fats include monounsaturated fats (found in vegetable oils like canola and olive oils) and polyunsaturated fats (found in vegetable oils like sunflower, flaxseed, and corn oils and the main fats found in seafood).

Carbohydrates: Carbs are the body's major source of energy, supplying the body with the fuel it needs to be physically active and for the organs to function properly. Good carbs also supply the body with minerals, vitamins, and fiber. The best carb sources are whole grains, fruits, and vegetables.

Vitamins and minerals: Vitamins (like A, C, and E) and minerals (like iron and calcium) are key nutrients that the body needs to grow, function properly, and stay strong. A person with a well-balanced diet usually gets enough vitamins and minerals but you can also discuss supplement pills with your doctor or nutritionist.

Antioxidants: Antioxidants work by attaching to free radicals, preventing them from attacking and damaging normal cells. Free radicals are created by by-products of the body's normal processes and can damage important cell proteins and enzymes. To take in more antioxidants, experts recommend consuming a variety of fruits and veggies.

Family and Peer Relationships

"Don't Worry, Be Happy?"

A new study, published in the NY Times in March 2010 suggests that people who spend more time engaging in deep, meaningful conversations are happier than those who focus on small talk.

The study's author suggested that the reason substantive conversation makes people happier is because humans are social creatures that need to connect with others and are driven to create meaning in their lives. As a cancer survivor, you may have discovered that your personal need to find and create meaning in life is even greater now than before your diagnosis. For this reason, it's a good idea to periodically evaluate your relationships with those who are closest to you. Are you comfortably independent while still understanding your family's natural desire to be protective? Have you maintained an open dialogue with your siblings about their feelings surrounding your cancer experience and survivorship? Have you been open and honest about your cancer experience with your peer group?

Family Relationships:*

*Much of the information in this section comes from Beyond the Cure's "The Mountain You Have Climbed" resource guide, which you can order for free here.

A cancer diagnosis often causes roles and responsibilities to change with in the family. Your increased emotional and physical needs during treatment may make you temporarily more dependent on your parents. Once treatment ends, you may expect your parents to resume their old roles while you return to a more independent lifestyle.

Your parents, on the other hand, may have ongoing worries that make them uncomfortable with your need for independence. This is normal. Talk openly with your parents about their concerns and the impact on you. Some of their fears may seem irrational, but remember that your illness has affected them as well. Your self-esteem, confidence, and good decisions may ease their worries.

Cancer may have a completely different meaning to you than to your parents. At the end of treatment, you may both feel some anxiety in separating from your medical team, but it may be even more difficult for your parents than for you. You may need to remind them that although cancer is still a part of your life, it is important for you to return to, or develop, your own support system outside of the cancer community. This does not mean you are breaking all ties, but rather that you are choosing the role cancer will play in your future.

Here are some ideas to help you and your parents understand each other's feelings: 

• Discuss your memories of both diagnosis and treatment and how it will affect your future.
• Talk with your social worker to see how others are dealing with establishing independence.

Because a cancer diagnosis affects all members of the family, you may want to have some of these same discussions with your siblings. Siblings are likely to experience a wide range of conflicting emotions involving your diagnosis and treatment - some of which may persist for many years after your treatment has ended. They may feel empathy, increased closeness, and protectiveness - as well as jealousy, guilt, fear, anger, and neglect. Showing openness and concern will help them resolve these feelings. In fact, cancer can make sibling relationships stronger than ever.

Peer Relationships:

Changes in Friendships: Survivors of childhood cancer often note feeling isolated from their peers by their cancer experience. Although it is normal to feel some amount of social isolation, hopefully you have also noticed that some of your peers respect and admire you for your courage and survivorship.

It is important for you to understand that your friends had to continue living their normal lives while you were undergoing treatment. When your friends catch you up on what you missed in your social circle while you were being treated, be sure you also catch them up on what they missed on your end - educate them about your disease, your treatment, and your overall experience.

In addition, talk to them about the enhanced importance to your own well-being of maintaining a healthy lifestyle. You may, in fact, find that you motivate some of your peers to improve their own lifestyles by being more aware of their healthy around you; for example, if one of your friends has been wanting to quit smoking, you may serve as a catalyst to them, or perhaps someone who has been wanting to exercise more often will offer to go to the gym with you.

Revealing Your Cancer Experience to Others:

No one but you can decide if and when to share your cancer experience with the new people you'll meet in life. You may want to wait until you know and trust someone well before disclosing your cancer history. Or you may want to let someone know right away so you can gauge whether or not he or she would be the type of person you'd want to be friends with or date.

Talking with old friends, cancer survivors, siblings, and parents may help you if you are in a situation where you're not sure of what to do. But in the end, do what feels right and is most comfortable.

Exercise

Exercise is an important component of maintaining a healthy mind, body, and spirit. For childhood cancer survivors, it is especially important because survivors are at a greater risk for obesity, diabetes, and heart disease compared to the general population. It's important to talk with your follow-up team to determine exactly what kind of exercise regimen is best for you, which will vary depending on how far out from treatment you are and what kind of physical late effects you might be experiencing. But, in general, at least 30 minutes of exercise five times a day is a good goal for all of us to follow. 

It's always ideal if you can find a form of exercise that is something you love to do, like swimming, dancing, or kicking a soccer ball. It's also helpful to find a work-out buddy - you'll keep each other motivated! To stay on track, you'll need to schedule your exercise time into your day - and be realistic about it! 

For more on exercise, check out this PowerPoint presentation that was given by Lauro Munoz at our April 2010 Rise To Action conference at MD Anderson, entitled "Exercise 101." Click the image below for an easy-to-browse PDF of the presentation.

Resources and News Articles

"Study Shows Childhood Cancer Survivors Exercise Less" (St. Jude - 5/1/09)