Eucalyptus Magazine / July-August 2011 / Fighting Cancer on All Fronts

Fighting Cancer on All Fronts

A broader approach to cancer care

In a back corner of the Palo Alto Medical Foundation’s Radiation Oncology offices, nurse Jeanette Fedasz has created an oasis of tranquility. Opening a heavy wooden door and stepping around an Asian paper screen, she reveals a space that looks more like a meditation studio than a treatment room.

A massage table lined with cream-colored sheets dominates the scene. Soothing music mingles with the murmur of a small fountain, and soft lighting illuminates framed nature photographs on the walls. Embroidered throw pillows, nestled against the arms of two cushioned chairs, a tiny bamboo plant, and a colorful glass vase complete the picture.

“I tried to make it as non-clinical as possible,” says Fedasz, who set up this room in 2009, when she began offering an energy therapy known as Healing Touch as a service to the Foundation’s cancer patients. In Healing Touch therapy, practitioners use their hands for light or near-body touch to balance the energy of their patients. This extremely gentle “massage” helps patients to cope with their experiences in the other rooms of this building, which might include a frightening diagnosis, an invasive surgery, and the fatigue brought on by corrosive chemotherapy drugs. Fedasz has believed in the power of energy work since her first Healing Touch training session. “It’s been really wonderful and rewarding,” she says. “It’s a profound exchange that I have with patients.”

Fedasz is one of a growing number of Bay Area medical professionals who are responding to patient demand for a new approach to treating cancer. Emerging scientific research suggests that patients who supplement traditional treatment with alternative practices, including energy therapy, massage, exercise, and social and psychological support, may experience better treatment outcomes and lower rates of cancer recurrence.

Fedasz and her colleagues say that the benefits go beyond treating the disease. Alternative therapies also enhance self-esteem and connect patients to support networks, helping them to maintain a positive outlook and a high quality of life through diagnosis, treatment, and survivorship.

Dr. Lawrence Kushi, Associate Director of Research for Kaiser Permanente’s Northern California division, says there is growing evidence that exercise and nutrition can affect cancer survival rates. In 2004, Kushi and his colleagues launched a long-term study to evaluate the impact of diet, exercise, and alternative therapies on breast cancer patients. Although the study’s final results are still pending, the researchers have garnered enough evidence to support one important conclusion: cancer patients are enthusiastic about alternative medicine. A preliminary paper published by Kushi and his collaborators in 2009 reported that over 86 percent of the study participants had used some type of non-traditional treatment, such as herbal supplements or mind-body healing, in the months following their diagnosis.

With patients showing this degree of interest, mainstream health care providers have begun to acknowledge alternative medicine as a powerful complement to traditional practice. Dr. Gordon Ray, Department Chair of Radiation Therapy at the Palo Alto Medical Foundation, encouraged Fedasz to pursue Healing Touch training after he learned about the therapy from a patient. When she began her training in 2007, Fedasz recalls, the Foundation “wasn’t quite ready for it.” But since Fedasz began practicing Healing Touch in the oncology department two years ago, her colleagues have grown more enthusiastic.

“Jeanette was a leader in this, but now it’s become much more a part of the program,” Ray says. “It surprised me the degree to which it’s really been embraced.” The Foundation now offers several alternative treatment options free of charge to cancer patients, ranging from Healing Touch to art classes, exercise programs, nutrition guidance, and group counseling.

For Ray and others, the strongest argument for embracing alternative treatments is one of patient quality of life. Ray says that group classes, personalized therapy, and activities that facilitate mental and physical relaxation can all help counter the feelings of isolation and victimization that frequently accompany a cancer diagnosis. Holistic alternative care puts patients in control, he says.

Dr. David Spiegel, Director of Stanford’s Center for Integrated Medicine, agrees. “It’s a part of health care where the patient is more in the driver’s seat,” says Spiegel, a Harvard-educated psychiatrist who leads a staff that uses meditation, hypnosis, massage, and acupuncture to help patients manage pain and anxiety.

Physical exercise can also foster a sense of control and self-confidence. Physical activity is increasingly regarded as an effective tool in cancer treatment and recovery and may even have a measurable effect on cure rates. Doctors who once advocated bed rest for cancer patients now encourage them to participate in yoga and exercise classes designed to address cancer-related problems. Spiegel says, “There’s more and more evidence that exercise during cancer treatment, as well as after it, is a very helpful component.”

Joyce Hanna, Director of Stanford’s Living Strong, Living Well exercise program for cancer patients, says that she has seen a discernible shift in the medical consensus regarding exercise over the past decade. “When we started our program, we had support, but everyone wasn’t really convinced at that point,” she recalls. Now, however, doctors often encourage patients to enroll in Living Strong, Living Well classes.

According to Hanna, exercise helps patients to maintain both physical and mental strength during cancer treatment and recovery. The 12-week Living Strong, Living Well program, which is offered three times each year at 10 Bay Area YMCAs, focuses on rebuilding muscle mass and sustaining balance in patients undergoing chemotherapy. But Hanna, like Ray, emphasizes the program’s valuable impact on confidence and quality of life.

“A lot of people talk about how it gives them a sense of control after feeling totally out of control,” Hanna says. Her favorite testimonial came from a patient who, upon entering the YMCA, said that he felt “normal again” for the first time since his diagnosis. “He just felt like he was going back into the community,” she says. “[That’s] a first step in becoming healthy.”

Through Living Strong, Living Well, patients also often form an impromptu support group. Hanna says this appeals to individuals who might not attend traditional group counseling. “We don’t sit around and talk, because we’re exercising,” Hanna says, “but it obviously can be a supportive group.”

That opportunity to share experiences with other patients may have very tangible benefits. According to Spiegel, some studies show that cancer patients randomized into group therapy live longer than control patients, and similar research has also demonstrated the effectiveness of group therapy in reducing cancer patients’ anxiety and controlling their pain.

Michelle Duguay, a certified yoga practitioner who teaches classes for cancer patients through the Stanford Cancer Supportive Care Program, also feels that group interaction is a key benefit of her program. “There’s definitely a camaraderie, a community, a support system,” she says. “That’s what really is drawing people there.”

Like Hanna, Duguay tailors her approach to help cancer patients manage the physical and emotional effects of treatment. Focusing on breathing, guided imagery, and mental relaxation, she says, gives patients a toolbox of coping techniques that they can draw on when they go in for a round of chemotherapy or an invasive surgery. Because of the skills they’ve learned, “they know how to deal with their stress,” Duguay says. “They know how to deal with their pain.”

Duguay says that the supportive community and the skills she teaches inspire many of her patients to continue attending yoga classes long after their cancer enters remission. “This class is what they do to take time for themselves and relax,” she says.

Fedasz, who faced a breast cancer diagnosis herself last fall, has personal experience with the ways that the disease can reshape habits and priorities. “It’s really a time for you to reevaluate how you’re living your life,” she says. “And how you should change your life.”

Fedasz agrees that alternative therapy not only provides invaluable support during diagnosis and treatment, but can also help patients live better lives after cancer. She recalls a young woman who enrolled in one of the Palo Alto Medical Foundation’s painting classes for cancer patients.

“She kept saying, ‘I haven’t painted in years, I haven’t painted since high school,’ ” Fedasz says. “[By having] these options during this time of reevaluation, people can really tap into what they need to do to lead a more positive life... I think it’s really wonderful.”