at.ti.tude /ˈadəˌt(y)o͞od/ “A settled way of thinking or feeling about someone or something” or “individuality and self-confidence as manifested by behavior”
Beyond the doctor-patient relationship
Hello! Jenna Bailey, ND, FABNO, here as a guest blogger. I feel so honored to have been asked by Michele to contribute. Reading through her prior posts has been so enlightening. What an amazing way to get to know her past the doctor-patient relationship.
Naturopathic medicine and naturopathic oncology
You may not all be familiar with naturopathic medicine, let alone naturopathic oncology, so let me briefly explain myself. Naturopaths in Washington State are considered primary care providers, though myself and my colleagues have chosen to specialize in oncology care. Our role is supportive in helping individuals through chemotherapy, surgery, and radiation with a little bit more grace and when (and if) treatment is completed, working towards recovery and prevention. All of this lies on what I consider to be the foundations – nutrition, stress management, sleep, hydration, and exercise.
Seattle Integrative Oncology offers safe and effective
expert naturopathic cancer care integrated with conventional oncology and telemedicine
Michele’s amazing response
As you all know, Michele had what some would say is an amazing response to just three cycles of chemotherapy and during our last visit I was noting that I felt that was, in large part, due to her attitude throughout this experience. Upon mentioning that, Kwami encouraged me to be a guest blogger to speak to this point. So here I am.
Of course, this is pure observation but, in my experience, an individual who maintains a positive (though realistic) attitude tends to do better regarding quality of life. The question is how that might translate into cancer outcomes. Now this is not to say that an individual needs to be positive just to be positive. There are naturally going to be ups and downs with cancer diagnoses and it would be completely unrealistic to not
have sadness, anger and frustration mixed in with the feelings of joy and hopefulness.
To see if there was more to this than just an observation, I did a little bit of digging and as it turns out there is some evidence to support a positive attitude in the face of a cancer diagnosis. To summarize –
Laughter reduces anxiety
Laughter, after just a single event, reduced anxiety, depression, and stress. Laughter is used to communicate joy and can help to create a sense of well-being. It can normalize blood pressure, boost immune function (has been shown to improve the function of our Natural Killer Cells!) and improve circulation. Laughter also activates endorphins and pain-relieving hormones. Humor is a great way to remember that there are and will continue to be good times despite the bad times. So, for your enjoyment – “What do you call a
pile of kittens?” – “a MEOWtain”
Laughter can normalize blood pressure and boost immune function
Bright outlook reduces likelihood of hospitalization
Research at The Ohio State University (no affiliation other than my husband is a die-hard Buckeye fan) found that cancer patients with a bright outlook were less likely to be re-hospitalized whereas individuals with psychosocial issues like anxiety, depression, or lack of social support (a biggie) were at high risk for hospital readmission and stayed longer when readmitted.
The mechanism is not fully understood, though it may have to do with our cortisol (the stress hormone) and the influence that anxiety and depression have on raising cortisol which can leave us in an immunocompromised state.
Interpersonal positive events were more predictive of lower inflammatory markers
Another interesting study of almost 1,000 adults showed that the frequency of daily positive events was associated with lower IL-6 and CRP (inflammatory markers that can help to support tumor cells and decrease the immune system’s response) Interpersonal positive events were more predictive of lower inflammatory markers. So, if it were not for COVID-19, I would say go out there and get some hugs!
Worry increases inflammatory markers
One more note is that worry has also been shown to increase these inflammatory markers.
Of course, there are things that we cannot control and many individuals are diagnosed with cancer having preexisting anxiety, but it speaks to an untapped area of focus that could potentially improve outcomes and quality of life.
An individual is more than their cancer diagnosis
We often focus on the big bad cancer but forget that an individual is not just their cancer diagnosis, but they are so much more than that. I often make it a point to ask individuals if they feel like they can live outside of their diagnosis and continue to be themselves.
I think that, especially as it is highlighted in this collection of blog posts, is where Michele has found her edge. She has continued to be herself despite this diagnosis.
However, I will say I would never want her or anyone with a cancer diagnosis to feel down on themselves for not being positive all of the time or feel like any negativity they felt had a detrimental impact on the course of their diagnosis.
I am extremely fortunate to have met Michele and be part of her care team. As is the case with most of my patients I end up learning way more from them than they learn from me.