Yoga a restorative therapy in cancer

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Yoga a restorative therapy in cancer

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YOGA - A Restorative Therapy In The Management Of Cancer Patients:

YOGA - A Restorative Therapy In The Management Of Cancer Patients Prof. R. K. Dixit Pharmacology and Therapeutics K. G. M. U. Lucknow, India dixitkumarrakesh@gmail.com King George’s Medical University Lucknow Chhatrapati Shahu Ji Maharaj University, Kanpur

Disclaimer:

Disclaimer Present talk is only the scientific presentation of evidences related to use of Yoga in reducing the sufferings of cancer patients. Yoga is a scientific basis of healing and rejuvenation it has nothing to do with any religion or community The yoga practices should always be performed under the able guidance of yoga experts Yoga may not be the replacement of proper modern ways of therapies, however, this plays important role if integrated optimally

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Who is he?:

Who is he?

Slide 9:

Patanjali “ THE FATHER OF YOGA ” Wrote the Yoga sutras to define and standardize classical yoga It comprises of 195 Sutras and an eight fold path

What is the importance of 4th February ?:

What is the importance of 4 th February ?

What is the importance of 21st June?:

What is the importance of 21 st June?

Importance of YOGA:

Importance of YOGA Wednesday , 21 June International Yoga Day 2017

Importance of YOGA:

Importance of YOGA

What is:

What is

HEALTH:

HEALTH WHO – 1948- as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." WHO – 1984 - as "the extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment.".  Thus, health referred to the ability to maintain homeostasis and recover from insults. Physical, Mental, intellectual, emotional, and social health components Health is the level of functional and metabolic efficiency of a living organism. it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment

Health (Expectations):

Health (Expectations)

Basics of Cancer:

Basics of Cancer

Cancer (कैंसर) :

Cancer ( कैंसर ) Latin: Cancer means CRAB Crabs are FAST RESILIENT Having capability to WALK IN MULTIPLE DIRECTIONS   OMNIVORES

:

Series Mutation can Lead to Cancer

Analogy of Cancer cells with Criminals:

Analogy of Cancer cells with Criminals

Cancer the Big C:

Cancer the Big C Profound impact on all levels of life Disease with multi-factor aetiology, inhomogeneous prognosis multi-morbidity Increasing incidence is a major challenge for any health system A multidisciplinary approach is of paramount importance CAM (YOGA) has a valuable place in cancer therapeutics CAM (YOGA) increases the body's ability to Overcome cancer Improve physical and emotional well-being Help with side effects of conventional treatment Feel more ‘in control’

Cancer:

Cancer Influence of stress on natural killer (NK) cells Poorer repair of damaged DNA Modulation of apoptosis Oxidative stress

Burden of Cancer In Globe In India:

Burden of Cancer In Globe In India

Cancer in terms of Statistics:

Cancer in terms of Statistics In 2015, about 90.5 million people had cancer About 14.1 million new cases occur a year It caused about 8.8 million deaths (15.7%) In males   lung cancer, prostate cancer, colorectal cancer and stomach cancer. In females breast cancer, colorectal cancer, lung cancer and cervical cancer.   In children Acute lymphoblastic leukemia and brain tumors  The risk of cancer increases significantly with age The financial costs of cancer trillions of USD 

Burden in India:

Burden in India About 14.5 Lakh people are living with cancer Over 7 lakh new cases being registered every year Over 5 lakh death related to cancer ICMR projects that 17 Lakh new cancer cases in India by 2020 Northeast reported the highest prevalence in India Over 70% death are between age group of 40 to 70 years In men common cancers are Oral Lung Colorectal, Pharynx and Stomach Head & Neck Liver In Women common cancer are Breast Ovary and Cervix Oral and Esophagus

Age is one of the most important non-modifiable Risk Factor:

Age is one of the most important non-modifiable Risk Factor

AGE (IN YEARS) AND CANCER:

AGE (IN YEARS) AND CANCER Age Group % of cancer % of Population 00 -14 4 35 15 – 34 10 39 35 – 64 62 22 65 + 24 3

Bechara Male:

Bechara Male

Being Male is an Important unavoidable Risk Factor for Cancer:

Being Male is an Important unavoidable Risk Factor for Cancer

INITIATIVES BY :

INITIATIVES BY

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Integration of Yoga

Cancer: CAUTION:

Cancer: CAUTION C hange in color (of any thing), Continuous fever, Continuous pain A ltered bowel habit (Acute), appetite, weight, exercise tolerance U nusual bleeding or discharge T hickening or lump I ndigestion or difficulty in swallowing or evacuation O bvious changes in skin (in wart or mole or pigmentation) N agging cough, hoarseness, headache, Non healing ulcers,

Modalities of Treatment for Cancer:

Modalities of Treatment for Cancer Surgery Radiotherapy Chemotherapy Immunotherapy Hormone therapy Gene therapy Cancer specific immune system cells to treat cancer Complementary medicines CAM including Yoga

What is Yoga?:

What is Yoga?

Yoga (Terminology):

Yoga (Terminology) Word “yoga” Sanskrit “ Yuj ”, means to yoke or TO JOIN Asanas means: Poses Pranayama means: Pra : First Na: Energy Yama : Control (Breath Control)

Yoga:

Yoga Originated in India approximately 4,500 years ago Several styles of yoga continue to be practiced in the world Ashtanga yoga- involves meditation, and divided into eight phases Hatha yoga,- emphasizes notion of life energy ( prana ), and  teaches physical postures Ashtanga and Iyengar yoga are subtypes of Hatha yoga Power yoga that combines Ashtanga and Iyengar styles Laughter yoga that combines laughter exercises with yogic breathing Restorative yoga- for persons who are less active Bikram Yoga- Prepare to sweat: in a room heated atmosphere Yin Yoga- The opposite of a faster moving practice like Ashtanga ,  Yin yoga poses are held for several minutes at a time

Types of Yoga:

Types of Yoga Ashtanga yoga- Discipline of mind Hatha yoga- Discipline of body and prana Bhakti yoga- Discipline of emotions Karma yoga- Discipline of actions Gyan yoga- Discipline of intellectual Mantra yoga Kundalini yoga Swara yoga Nada yoga Laya yoga

Yoga postures (Asanas):

Yoga postures ( Asanas ) Asanas are the heart of Hatha Yoga Stretching that maintains and enhances flexibility

Aasna (Poses):

Aasna (Poses)

Philosophical Aspects of Yoga:

Philosophical Aspects of Yoga

Philosophy of 3+5=8:

Philosophy of 3+5=8 3- Sharira ( शरीर ) Gross body – Sthool Sharira Subtle body – Sookshma Sharira Causal Body- Karana Sharira 5- Kosha ( कोष ) Annamaya Pranamaya Manomaya Vijinamaya Anandmaya 8- Limbs ( अवयव )- of Yoga ( Ashtang , अष्टांग  )

Analogy of Five Kosha of Sharira to the House:

Analogy of Five Kosha of Sharira to the House

Slide 69:

SHARIRA AND KOSHA

SHARIRA AND KOSHA:

SHARIRA AND KOSHA

Eight Limbs of Classical Yoga:

Eight Limbs of Classical Yoga Samadhi - Ecstasy Dhyana - Meditation Dharna - Concentration Pratyaha r - Sense of withdrawal preparation for meditation Pranayam - Breath control or regulation Asana- Physical exercises Nimyama - Personal observance of purity, tolerance and study Yama - Social restraints or ethical values

Pranayama Sadhana:

Pranayama Sadhana Inhalation – Purak Pause – Kumbhak Exhalation – Rechak Practice should be done properly under experts guidance

MIND-BODY MEDICINE:

MIND-BODY MEDICINE One of the guiding principles of mind-body medicine is the interconnection of all things, including the mind, the body, and the environment From this holistic perspective , health isn’t merely the absence of disease or symptoms Health is a state of optimal wellbeing, vitality, and wholeness

The Mind-Body Connection :

The Mind-Body Connection Since the body and mind are connected, every time we have a thought, we set off a cascade of cellular reactions in our nervous system that influence all the molecules in our body. Our cells are constantly observing our thoughts and being changed by them. The relationship between the mind and body is complex We have amazing potential to heal and transform ourselves through our thoughts, perceptions, and choices Establishing a healthy dialogue between our thoughts and our molecules helps us shift from imbalance to balance Yoga brings us home to the peace of present moment awareness and gives us an experience of profound relaxation that dissolves fatigue and longstanding stresses

ABCDE of YOGA:

ABCDE of YOGA A- Asana (Posture or Poses) B- Breathing ( Pranayama ) C- Concentration ( Dhyana ) D- Deep Dhyana E- Ecstasy (to be or stand outside oneself)

Battle and Victory:

Battle and Victory

Battling Cancer:

Battling Cancer Battling with possible cancer-related fatigue, standard therapy ( e.g chemotherapy) side-effects, sleep problems, and anxiety and/or depression etc. Need for an integrative support in form of Yoga techniques, like mindfulness, meditation and poses to control cancer-related symptoms. There are about 100 different forms of yoga from which to choose, varying in intensity and pace (Expert Advice)

HIGHLIGHTS FROM THE SCIENTIFIC RESEARCH ARTICLES FAVOURING YOGA AS RESTORATIVE THERAPY IN CANCER:

HIGHLIGHTS FROM THE SCIENTIFIC RESEARCH ARTICLES FAVOURING YOGA AS RESTORATIVE THERAPY IN CANCER

Ways by which cancer patients can be benefitted from yoga:

Ways by which cancer patients can be benefitted from yoga Yoga helps to manage depression, fear and anxiety (Breathing exercises regulate nerves that deeply calm beyond mind) Release of serotonin and other happy neurotransmitters Improves circulation, relaxes muscle tension and remove toxic chemicals Provides support Provides HARMONY between Body and mind Emotions and intelligence Self an society Purpose of life and method of living

General Benefits of Yoga:

General Benefits of Yoga Flexibility and balance Enhanced immune system Increased energy Increased Cardiovascular and respiratory efficiency Weight control Relief of stress and anxiety Increases self awareness Controls emotions and thoughts Improves memory and concentration Sleep duration and quality improvement Reduce pain Reduces the damage of organs

Effects of Yoga:

Effects of Yoga Physiological Effects Decreases Reduce Pulse, Respiratory rate Activity of amygdala (fear reduces) Reduce BP Reduce EMG Reduces pain Increases cardiovascular efficiency Stable ANS with predominance of Parasympathetic Musculoskeletal flexibility Joint range Gastrointestinal and endocrine function Immunity Energy level and Endurance Neuro -endocrine coordination

Effects of Yoga:

Effects of Yoga Psychological Effects Decreases Anxiety Stress Depression Hostility Worthlessness Increases Social adjustment Somatic and kinaesthetic awareness Subjective and wellbeing Self acceptance and self actualization Positive emotions

Effects of Yoga:

Effects of Yoga Biochemical Effects Decreases Glucose Sodium Total Cholesterol Triglyceride LDL and VLDS Catecholamine and other stress neurotransmitters Oxygen intake Free radicals in blood Reduced oxidation process Increases Haemoglobin Lymphocyte HDL Serum proteins Seroton in (Mood elevation), GABA (Relaxing neurotransmitter) Dopamine

Most Common Poses Advised to Cancer Patients:

Most Common Poses Advised to Cancer Patients Corpuse Pose Legs up against the wall Pose Half sun Salutation Pose Recycling Butterfly Pose Four Legged Pose Child Pose

Most common Pranayam Techniques used in patients of cancer:

Most common Pranayam Techniques used in patients of cancer

YOGA AND IMMUNE FUNCTIONS :

YOGA AND IMMUNE FUNCTIONS Defensin antimicrobial peptides exert their effects by destroying the hydrophobic core of the lipid bilayers belonging to microbes. Human β- defensin 2 (HBD-2) is expressed in the epithelial cells of the oral cavity and respiratory tract Yogic stretching for 90 min increased salivary HBD-2 concentrations and HBD-2 expression rate HBD-2 expression is known to be responsive to emotional stress and yogic stretching decreases stress, in turn increasing salivary HBD-2 expression. Yogic breathing increases NK cells in cancer patients NK cells and T cells are the predominant cell types that secrete IFN-γ IFN-γ exerts its function by activating endothelial cells, macrophages, and T cells, and by promoting the differentiation of T helper 1 (Th1) cells. Therefore, a decrease in serum IFN-γ levels indicates a decline in cellular immunity Yoga could increase in cellular immunity Yoga reduces stress and inflammation makers The mean level of cortisol decreased and β-endorphins increased from baseline

Analogy of Modern Medicine with Yoga for managing Cancer patients:

Analogy of Modern Medicine with Yoga for managing Cancer patients Modern western oncology is focused on destroying the weed , Complementary healthcare concentrates on the soil the weed grows in and on making the soil as inhospitable as possible to the growth and spread of the weed. Yoga integration in the management of cancer leads to HOLISTIC APPROACH of care to embrace the psychological, emotional and spiritual needs. Additional advice on lifestyle, diet and self-help also incorporated

English Names of some of the Yoga Kriya and difficulty Levels:

English Names of some of the Yoga Kriya and difficulty Levels Sanskrit Name English Name Difficulty Surya Namaskar Sun Salutation 3 Dhanur asana Shooting bow posture 6 Ardha Chandra Asana Half moon posture 2 Ardha Matsyendra Asana Half Spinal Twist Posture 4 Bala Asana Child Posture 1 Chakra Asana Wheel Posture 8 Shava asana Corpse Posture 1 Tada Asana Mountain Posture 1 Trikone Asana Triangle Pose 2 Vrischika Asana Scorpion Pose 9 Sirsha Asana Headstand Postrue 7 Pawan Mukta Asana Wind releasing pose 1

There is good scientific evidence that YOGA :

There is good scientific evidence that YOGA Increases muscle and bone strength Increases lean muscle and decreases body fat Helps control weight Enhances psychological well-being, reduces depression Reduces symptoms of anxiety and improves general mood

Yoga therapy for Cancer Patients:

Yoga therapy for Cancer Patients To relieve side effects of cancer treatment or symptoms of cancer Yoga treatments relieve side effects of conventional treatments: reduction of nausea, vomiting, skin reactions, pain and analgesic medicines but also a reduction in the number of hospitalizations for serious side effects. Yoga to reduce the spread of the disease and prolong life While improving quality of life is the major rationale Cochrane reviews that have been published of the evidence that yoga therapies may have benefits on measures of Quality Of Life, psychological wellbeing , adverse effects of cancer treatments, or even impact on survival.

Yoga therapy for Cancer Patients:

Yoga therapy for Cancer Patients Clinical Practice Guidelines In 2014, the Society for Integrative Oncology (Deng et al, 2014) issued evidence-based clinical practice guidelines for doctors to consider when incorporating yoga therapies (and other complementary) in the care of cancer patients Yoga therapies should never be used as a replacement for conventional cancer care or as a reason to postpone seeing a doctor about any problem. Before using any yoga therapy, people who have been diagnosed with cancer should talk with the doctors who treat their condition—to make sure that all aspects of their cancer care work together Cancer patients need to make informed decisions about using YOGA Supportive treatment for anxiety, fear, depression and for primary tumour In addition Yoga has the potential for the primary and secondary prevention of cancer through counselling on healthy lifestyle, nutrition and supporting the human power In the past two decades scientific research has emerged to provide support for a complementary form of treatment that addresses all aspects of the patients healing process. As an addition to conventional treatment, yoga aids in holistic healing of a patient, providing both physical and psychological benefits Results from research studies indicate that programs involving variations of “gentle” poses , stretching, breathing , and meditation based stress reduction techniques are highly effective interventions for a wide range of cancer patients and survivors ( Chaoul , 2010, p.152). For patients undergoing radiotherapy treatments, DNA damage to “peripheral blood lymphocytes” (PBLs) is common. M.D Anderson Cancer Centers’ 2014 . Most recently, yoga has been investigated as a viable complementary treatment option for various cancer populations, specifically breast cancer patients.

The Science behind Yoga and Stress :

The Science behind Yoga and Stress YOGA boosts brain chemicals that promote a sense of wellbeing. it increases the levels of the brain chemicals like GABA, Serotonin, Dopamine , Acetylcholine the happy chemicals responsible for feelings of relaxation and contentment. These neurotransmitters are targeted by the drugs for medicating mood, such as anti-depressants and anti-anxiety drugs. Yet yoga has long been shown to successfully reduce and heal anxiety and depression. Yoga boosts the PARASYMPATHETIC activity of ANS

Yoga is different from the Conventional Exercises:

Yoga is different from the Conventional Exercises

Something about Chemobrain:

Something about Chemobrain

Effect of Yoga on Chemobrain:

Effect of Yoga on Chemobrain Chemobrain is a common term used to describe the cognitive problems that cancer survivors often face during and after chemotherapy, radiotherapy, hormone therapy or any treatment of cancer

What cognitive skills are most affected In Chemobrain? :

What cognitive skills are most affected In Chemobrain? Difficulty finding words- unable to finish a sentence Difficulty remembering things Greater need for reminders Slower thinking Memory lapses -forgetting things Trouble concentrating Trouble remembering details - like names, dates, and events Trouble multi-tasking - answering the phone while checking email Taking longer to finish things - disorganized, slower thinking and processing Leaving tasks incomplete

Contributing Factors :

Contributing Factors Chemotherapy Other medications Menopause, hormonal changes Depression/anxiety Pain Fatigue Sleep problems Other medical problems Alcohol, sedatives Normal aging

Managing Chemobrain by Yoga:

Managing Chemobrain by Yoga Exercise Biofeedback and cognitive behavioural Yoga Therapy Increases blood flow Reduces inflammation Reduces oxidative stress Mindfulness-based stress reduction (MBSR) A new study published in the  Journal of Cancer Survivorship  has found that cancer patients who participate in a mindfulness-based stress reduction program, practicing activities such as yoga and meditation, can improve cognitive impairment that occurs as a result of cancer treatment. 

Key Messages:

Key Messages Yoga is one of the most powerful drugless and harmless system Yoga has its own concept of wellness proved scientifically Yoga combines moderate-intensity exercises, breathing and meditation Yoga can be performed comfortably and easily but under experts Yoga has beneficial effects CANCER and many other chronic diseases Yoga creates a balance between the body and mind Yoga helps in self-enlightenment and stability of mind and body Yoga is associated with a healthy and lively lifestyle Yoga is based on the aspects of science, philosophy and art

Slide 122:

Thanks Comments/Suggestions at dixitkumarrakesh@gmail.com

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