More on CAM* (Complementary Alternative Medicine)

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1. Published online before print June 28, 2011, doi: 10.1177/1534735411413268 Integr Cancer Ther June 2012 vol. 11 no. 2 101-110

A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients

1. Byeongsang Oh, PhD1
2. Phyllis Butow, PhD1
3. Barbara Mullan, PhD1
4. Amanda Hale1
5. Myeong Soo Lee, PhD2
6. Xinfeng Guo, PhD3
7. Stephen Clarke, MBBS, PhD1

1. ¹University of Sydney, Sydney, New South Wales, Australia
2. ²Korea Institute of Oriental Medicine, Daejeon, South Korea
3. ³Guangzhou University of Chinese Medicine, Guangzhou, China

1. Byeongsang Oh, Sydney Medical School, University of Sydney, Camperdown 2050, New South Wales, Australia Email: byeong.oh@sydney.edu.au

Abstract

Background. Due to the limitations and side effects of conventional cancer treatment, especially in relation to quality of life (QOL), patients are increasingly utilizing complementary and alternative medicine (CAM) to supplement health-related outcomes. However, evidence for the safety and efficacy of such treatments is lacking. The purpose of the current review was to investigate evidence for the role of one CAM, medical Qigong (MQ), in supportive care. Methods. The literature was searched for reported effects of MQ in improving QOL, immune function, and survival in cancer patients. Results. Although many studies possessed methodological limitations and small sample sizes, encouraging evidence was found for the effects of MQ on these health-related outcomes. More robust evidence in the form of randomized controlled trials with larger sample sizes also reflected positive results for the role of MQ in improving QOL, mood and fatigue parameters, and reducing inflammation. Conclusion. Given such encouraging results, further research is recommended in methodologically sound approaches to further delineate the action of MQ. These findings support the utilization of MQ by cancer patients and the place for such programs in comprehensive cancer care.

Out of the Mouths of Babes

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Given the opportunity, children - at whatever age, are truly amazing beings. My kids excel at amazing. Last night, my 19 year old and I are sitting on her bed and I ask so what are we doing...? She lowers her chin, looks me in the eye, and flatly states: You know I am really pissed off at you!

Yeah, I know, why?

Why have you not told me your are sick again!??

...the upshot, SHE reads my blog. Who knew?

I knew I had better talk to my 21 year old. (Yeah! She is home for the weekend.) My baby has come a long way.

I had a fabulous talk with both my girls, and I learned a very important lesson, again. NEVER UNDERESTIMATE YOUR CHILDREN'S ABILITY TO HANDLE LIFE.

I love them so very much.

Perception...

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"You are really brave. A hero"...whhaaat? Why do people feel compelled to flatter a person dealing with cancer with such ridiculous statements of admiration. Why does living with a chronic disease change the perception people have of me?

A "hero" by what measure? "Bravery" measured by what standard? I am not the spokesperson for women with breast cancer, but I think I am on safe ground saying that "bravery" and "heroism" are not the qualities we feel oozing from our emotional or psychological pores.

I am a person with a chronic disease. I chose not to curl up into a fetal position and succumb to the disease. I truly have not encountered many people who have chosen the latter. Does that make me (or them)"brave"? No, it makes us human. The will to live is not being extraordinarily human, brave or heroic. The will to live is a natural instinct. The necessities of life are a responsibility.

How we live as an adult in the present 21st century is defined by our choices and responsibilities.  I  choose to get up every morning, and I must go to work everyday. I choose to have a family and willingly undertake the daily responsibility of caring for them. I choose to continue in my volunteer work. I must pay my mortgage; go grocery shopping; clean my house and do laundry. I even choose to try and through in a little leisure time here and there. I also get pissed off at my kids and husband...and at the check out clerk, and the lawn guy...etc. In short, I am living an ordinary life. This is not heroism. My days are no different than 100 million other women...and we all have minor inconveniences we deal with daily.

Cancer does not make me "special" or elevate me in any way. It makes me human. And, as far as I can gauge, I was human before the diagnosis.

The Purgatory of Cancer

****** Being a survivor is a life sentence. There is no beginning, nor end, per se other than the inevitable we all face.

It is a matter of waiting...waiting...waiting. These are prophetic words articulated by so many of the blogs that I follow off the Being Cancer blog-os-phere network. What all these individuals dealing with caner seem to have in common is that they all opted in for the cut/slash/ and or burn protocol after being told those karma-changing words... "it's cancer.". Even my anti - pink fellow marauder, Anne, opened up her veins to the "juice." I am not making any judgment here. This is purely observation and the musings that arise therefrom.

I don't think of myself as a survivor. It seems that moniker more aptly belongs to those who have come through the horrific battleground of adjuvant treatment. Does this make me a coward? A deserter? Did I burn my draft card with my post-operative bra? Since I am not a survivor, then what I am? I experience the same immutable waiting game...waiting...waiting...for the what next. I have the same objective ... out live the odds. I crave to go back to "normalcy," i.e. pre-cancer existence where tomorrows had a boundless meaning; when day to day life did not feel internally controlled by the tolling of a time bomb; when I felt that I could outrun my own mortality by wearing my seat belt, avoiding semis on the interstate, and keeping the speedometer under 110 mph. Instead, I am neither survivor nor casualty. I am in cancer purgatory. Dante could not have conceived of a more stifling environ. Which would be fine, if I wasn't Jewish.

"At some point you have to accept defeat..."

****** A dear friend from life-times past made the comment : "At some point you have to accept defeat...." These words were said a couple of months ago; and certainly not in the context of my life with breast cancer. These words, however, have gnawed at me. I find that I bristle at the implications. I find, that I cannot help but think of the myriad of situations where someone might say them to me. And this thinking started me to wonder about the concept of "defeat" and "acceptance" in all facets of my life.

Definition of DEFEAT (n.)

1: frustration by nullification or by prevention of success
2: obsolete : destruction
3 a : an overthrow in battle / b : the loss of a contest

I just can't imagine accepting nullification, obsolescence, destruction or even loss. 

To ACCEPT would require me to:

... to take or receive with approval or favor; or

... to agree or consent to; accede to; or

... to accommodate or reconcile oneself to; or

... to regard as true or sound; believe; or

... to regard as normal, suitable, or usual.

I cannot bend to the concept of combining accept with defeat. Not in any situation. It is not that I am unreasonably obstinate, intolerant, inflexible, or pig-headed (at least the majority of the time). (I acknowledge that I can be opinionated - but the Libra in me desperately tries find balance.) Rather, I attribute my disposition to the fact that in all arenas I have a tendency to bring my whole self with me. (Many times, to my detriment.) Whether the situation involves my children, my relationships, my profession, my avocations or my beliefs.  My whole self is brought to bear even in my approach to living with a chronic disease. In all of these I am present. With such a self - investment and the high stakes that attach when you are personally vested, I admit that accepting defeat is not in my genetic make up.

That is not to say that I am incapable of graciously embracing contrary situations, and the concomitant lessons that unpleasant circumstances offer. I am also not generally naive. I consider myself cynically optimistic. An an optimistic cynic I embrace such adages as: "evil can only triumph if good people do nothing:" [Edmund Burke] And dare to expand that ideal to encompass my further belief that people can do as much harm, if not more, by their overt negligence and inaction. For me, this view finds its way into all aspects of my life. To passively accept defeat and be a bystander is, in my little universe, tantamount to overt negligence. And, personally abhorrent to me.

Anyone who truly knows me would most likely agree that I am not one to accept defeat. Analyze it, scrutinize it, dissect it, challenge it, do everything to rise above it -- yes. But to meet defeat with approval or favor, agreement or consent, or to accede a bad or destructive situation as true or sound. No, I don't think I am capable of that.

Marking the Day

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A birthday. A milestone of time? Yeah, but what else? Hash marks on calendars? Crow’s feet on the face? A skirmish with the forces of gravity? In its sum, what does celebrating “a birthday” mean?

A compelled moment to take stock? Hmm…new year celebrations and anniversaries allow (if not insist) for that.

A reminder to be appreciative for last year and look forward to the next? Too Hallmark-ish.

A time for tolerated narcissism? A time to be personally recognized for our basic essence…that is, being US…ME? Maybe.

Why do we want, no need, to have the anniversary of our birth actually mean something? Is it because we are a narcissistic species who like to believe ourselves capable of appreciation, reflection, optimism and therefore recognition? Probably getting closer to the truth.

From where I sit, I think it may simply mean that, today on the marking of my birth, I have the scoring advantage. . . .

“Visitor (Reaper) -0- / Home (Me) -49-“ 

For today, that’s enough.

Happy Anniversary Baby!

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Truckin' like the doodah man
Once told me "Gotta play your hand
Sometimes the cards ain't worth a dime
If you don't lay them down"

Sometimes the lights all shining on me
Other times I can barely see
Lately it occurs to me
What a long strange trip it's been

One year ago today I was diagnosed with Invasive Lobular Carcinoma - Stage III (in truth the staging came in August after the mastectomy). One year of "survivorship" under my belt...only four to nine more years to surpass the prognosis! (How's that for a point spread!)

What a wild ride it has been these last 12 months. It is with utter amazement that I reflect back on the day my mortality was handed to me, with a soundtrack courtesy of YES reverberating through me. That day was a lifetime ago.

Today, if I am lucky, the wild ride will continue. The landscape may change, however.

What in the world ever became of sweet Jane?
She lost her sparkle you know she isn't the same
Living on reds and vitamin C and cocaine
All her friends can say is ain't it a shame

One of the realities that I discovered along this road is, that when facing your mortality it is not about "battling" a foe or trying to regain what was "normal" before. Rather, the ride is about developing a "new reality" that allows me to live with a chronic disease.

I cannot say that I have succeeded in my new reality. I don't know how "success" should be defined. What I can say is, that I have embraced the road I am on. It is a road beset with rabbit holes. It is also a road that is shrouded with many uncertainties. Yet, there can be clarity even in the darkness. At all times on the road I am cognizant of my long term objective -- the legacy, if you will. This knowledge is what helps keep me from getting too distracted by the "tea parties"* of Vitamin C & D and Calcium Glucarate.

So today, I take a breath. I embrace that I've been on the road for a year. And I note that I have more than earned the status of "survivor."



* No political connotation intended what-so-ever!

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I revisited the Dodge Theatre last night. It was for an incredible night of music. Fusion as defined by Merriam Webster. The Phoenix Symphony performing the music of Queen and Led Zeppelin. Not as bizarre as it sounds. They had vocals, base and lead guitar, electric violin, and the most incredible set drummer! All supported by the richness of the symphony. I must say it was the first time I had ever seen a symphony conductor leap and jump into the air!

What was even more significant, for me personally, was that I could enjoy myself. You see, I have had a negative association with the Dodge Theatre. I had received my diagnosis of breast cancer (ILC - later to find out its Stage III) just hours before I attended a YES concert there back in July, 2009. At the time, my husband kept asking: Are you sure you want to do this? We can find someone to take the tickets! I was adamant. I wanted normalcy. I had been looking forward to this concert for months. Besides, I am singly most happy when I am at live concerts. (Which, hopefully, explains my 4 Stones concerts during their Big Bang tour that I attended in two different states. I know, the word groupie comes to mind...but that is the stuff of another TMZ moment!)

So I went.

So, it was an emotional disaster.

First mistake. The 3 double Cosmopolitans I drank in fairly short order.

Second mistake. Underestimating the emotional effect that music can have.

Look around - Got no place to stay.
God I hate this town, depending on the day.
You look me up, you look me down - Alright, OK.
While I got no life, I got no hope;
I'm falling in love.
Help me through the fight;
Help me win tonight - I'm calling.
What to do I find it hard to know;
The road I walk is not the one I chose
Lift me up and turn me over;
Lead me on into the dawn.
Take me to the highest mountain;
Tie me up, love in a storm.
Have you decided on my fortune?
Facing the future in your eyes,
With your imperial behaviour
We fight amidst the battle cries.
Open doors - They may be closed to me;
The fire's still burning in my heart...
What to do I find it hard to know;
I want to turn my life around...

Those lyrics, plus having a bladder the size of walnut, sent me into the ladies room where I had a complete emotional breakdown. The brunt of this breakdown borne by a dear friend whom I woke up two time zones away. Damn cell phones!

I have not wanted to remember this moment of vulnerability, because it was just that...a moment of vulnerability. (I do not do well flaunting my vulnerabilities.)

It was a moment of base, raw emotion -- fear / anger / hostility / desperation / despair all rolled into a maelstrom of unplugged emotion (forgive the concert pun). I did not want to remember how much I scared my poor husband, disappearing on him like that; or the horrific car ride home I had inflicted upon him.

It was all so primal that I was not ready to claim it until last night.

Interestingly, or trite...depending on your personal level of cynicism, it was a set of back-to-back songs that allowed me to make peace with myself regarding my prior indulgence. And both belonged to Queen.

There's no time for us
There's no place for us
What is this thing that builds our dreams
Yet slips away from us
Who wants to live forever?
Who wants to live forever.....?
There's no chance for us
It's all decided for us
This world has only one sweet moment
Set aside for us
Who wants to live forever?
Who wants to live forever.....?
Who dares to love forever
When love must die?
But touch my tears with your lips
Touch my world with your fingertips
And we can have forever
And we can love forever
Forever is our today
Who wants to live forever?
Who wants to live forever?
Forever is our today
Who waits forever anyway?

Is this the real life?
Is this just fantasy?
Caught in a landslide,
No escape from reality
Open your eyes, Look up to the skies and see,
I'm just a poor boy, I need no sympathy,
Because I'm easy come, easy go, Little high, little low,
Any way the wind blows doesn't really matter to me, to me

What can I say? I am a child of the '70s who has always taken refuge and found self-forgiveness in prose, lyrics and rock 'n roll.

This time when I left the Dodge Theatre I did so without needing to be supported. But enjoying the long-haired crowd, humming Stairway to Heaven (no kidding, it was the final song!) and enjoying the full moon illuminating the 65 degree night-time in the desert.

Birthday Interlude

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Happy Birthday! I have made it to 48 years old! If, at 20 years of age, I thought I would be around this long...blah...blah...blah. And, what a strange and wild ride it has been! I am such a different person at 48 than I was at 20, and glad for that fact. In retrospect, I did not much like who I was at 20.

That person was insecure; and hence cared deeply about how others perceived her. She was deeply passionate; but did not know how to channel it - at least in a way that would not inflict self-harm. That person was independent; but did not know how to stand up for herself. That person cared deeply for the general "health" of the community at-large; but had not developed any skills to contribute toward that "health." That person was driven and dictated by her emotions; often times too willing to sacrifice who she might be to make someone else happy. Twenty-year old me was unsure of the potential and power that she held within - the power of defining herself.

In knowing all that, I find curious the realization I had this morning: I am ready to be done with feeling responsible for the feelings of others.

When I started on this journey back in July, I posed the question, in an August 19 post: what would be the "bigger challenge" for me now that I had been slapped with a cancer diagnosis? At that time I thought it was "allowing others to care for me." So far, I was wrong. It has not been that all. Don't get me wrong, THAT part has not been easy! But, it has not been the greatest challenge. The greatest challenge has been: not being overwhelmed by the strange responsibility for how people handle my diagnosis!

Some, but by no means all, seem to need me to reassure them that I am okay -- and quite often!? They need me to be "normal" while at the same time, change my daily patterns and be more accessible (so that I can assure them that I am okay???) For some reason I believe some have forgotten that having cancer has not given me a "get out jail free card" from the daily tasks and responsibilities of life (work, kids, work, husband, work, home, work, philanthropy, work...) And when I can't (i.e. change my schedule and accessibility) some are actually put out with me.

Is it inconsiderate of me not to be accessible to rehash my state of health and reassure them that I am o.k.? Today I do not think so.

I am very sure that it is not a conscious endeavor on some's part. But it is curious to me.

Since my diagnosis the greater challenge has been to divest myself from feeling responsible for making others feel comfortable with my having cancer. It is a big enough job doing that for myself!

And, today, I realized that I think I can do just that. Why? Because I am not 20 years old anymore! Yippeeeeeee!

Happy Birthday to middle-aged me!