Thursday, February 20, 2014

The Relaxation Response, Stress, Meditation, Smoldering Myeloma

As I have written about previously, I am currently in a clinical trial at the Benson-Henry Institute for Mind Body Medicine at the Massachusetts General Hospital in Boston. The study is measuring the genomic and psychosocial affects of their mind/body program on patients with MGUS and SMM. I receive daily emails from Dr. Mercola (who I have mixed feelings about ;)), and today there was an article written by Dr. Kelly Brogan explaining the science of meditation: how meditation affects your mind, and how meditation alters genetic expression.

Here is the link to the article, which also includes a very interesting Ted Talk: "How Meditation Can Reshape Our Brains". I copied the two sections from this article, "The Science of Meditation" and "Meditation Alters Your Genetic Expression" below the link:

How Meditation Affects Your Health and Wellbeing

The Science of Meditation

Since we have come to appreciate the power of genetic expression as more than simply the 20,000 genes you're born with, we can now harness tools that optimize the "good" and suppress the "bad."
It turns out that our in-born DNA interfaces with an "exposome" or elements in our environment, and our conscious behavior, dictating exactly how the book of you will actually be written. With one fell swoop, things like spices, exercise, and relaxation can accomplish what pharmaceuticals could only fantasize about.
Some diligent researchers out of the Benson-Henry Institute for Mind Body Medicine1 in Massachusetts have begun to illuminate the mechanisms of meditation's effects, specifically the relaxation response which can be achieved through various forms of meditation, repetitive prayer, yoga, tai chi, breathing exercises, progressive muscle relaxation, biofeedback, guided imagery, and Qi Gong.
According to Dr. Benson, the relaxation response is, "a physical state of deep rest that changes the physical and emotional responses to stress (e.g., decreases in heart rate, blood pressure, rate of breathing, and muscle tension)" and is characterized by:
  • Metabolism decreases
  • Heart beats slow and muscles relax
  • Breathing slows
  • Blood pressure decreases
  • Levels of nitric oxide increase

Meditation Alters Your Genetic Expression

Forty years of research support these claims. Only recently have the tools to assess gene-based changes been available. Far from summoning their inner monks, subjects in the Institute's studies simply pop in some ear buds and listen to a 20-minute guided meditation, passively. The Benson-Henry Institute has sought to quantify the benefits of the relaxation response by assessing gene expression before, after 20 minutes, after eight weeks of practice, and after long-term meditation routines.
In a series of papers, they walk us through the anti-inflammatory effects of this intervention. Genetic study2 of eight-week and long-term meditators demonstrated evidence of changes to gene expression – specifically antioxidant production, telomerase activity, and oxidative stress – as a result of the relaxation response.
They theorize that NF-kappa B gene sets may be the messenger between psychological and physical stress wherein the body translates worry into inflammation. It appears that the relationship between gene expression optimization and relaxation response is dose-related, so that increasing amounts confer increasing benefit. Even after one session, changes were noted, characterized by:3
"Upregulating ATP synthase —with its central role in mitochondrial energy mechanics, oxidative phosphorylation and cell aging — RR may act to buffer against cellular overactivation with overexpenditure of mitochondrial energy that results in excess reactive oxygen species production. We thus postulate that upregulation of the ATP synthase pathway may play an important role in translating the beneficial effects of the RR."
These changes represent an orchestra of base and high notes that synergize into a body-balancing harmony. The experience of the relaxation response also appears to change brain plasticity or cellular connections in areas of the brain associated with stress response.
These changes occur based on internal recalibration of the nervous system – with no manipulation of circumstantial conditions, meaning stressors remain the same. According to neuroscientist, Dr. Lazar,4 long-term meditation practice appears to be associated with preferential cortical thickening:
"…brain regions associated with attention, interoception and sensory processing were thicker in meditation participants than matched controls, including the prefrontal cortex and right anterior insula" and that these findings were further validated by an eight-week intervention trial.5
Clinically, mindfulness-based meditation practice has been demonstrated in randomized trials6 to improve depressive symptoms in fibromyalgia and to have lasting anti-anxiety effects after only eight weeks of group practice.7

There was also a recent article on meditation and managing stress from the ASCO Post:

Stress and Tumor Biology: Insights Into Managing Stress to Help Improve Cancer Care

This part of the article really stood out to me:

"The health-damaging effects of chronic stress are well documented in the medical literature, and research indicates that chronic stress affects almost every biologic system. With regard to cancer, there is little convincing evidence that chronic stress affects cancer initiation. However, there is extensive evidence that chronic stress can promote cancer growth and progression."

When I was first reclassified as smoldering myeloma, after being diagnosed with MGUS about 3 years prior, Dr. R stressed to me the importance of reducing stress. He told me that he had "seen" in other patients what stress can do as far as causing progression from the precursor states to full blown myeloma. He encouraged me to do yoga twice a day, go to mass every WHATEVER I had to do to reduce and manage stress. Well, I'm proud to say I'm working on that as we speak!

Tuesday, February 4, 2014

High Fives at the Farber & Aspirin

Last week I was at Dana-Farber for my first round of testing for 2014. Fairly uneventful visit. And, it was actually by far the shortest wait time I've ever had since being a patient there! We reviewed my labs and 24 hour urine from the week before. My m-spike is up slightly, free light chain ratio down slightly, and everything else is fairly "stable" as Dr. R likes to say. In the appointment he actually said, "Rock solid!" and gave me a high-five. Ha. ;)

Last spring Dr. R had recommended I start taking aspirin. He was hoping that daily aspirin would help settle down my fevers. He also mentioned that there had been studies that have shown that daily use of aspirin helps fight/prevent cancer. I wrote about that visit in this post last year: Hospital evacuation, 2 specialists down, and aspirin. He told me that they were in the process of planning clinical trials for MGUS and SMM patients using aspirin.

Well, hopefully the aspirin that I have been taking is making a difference because check this out:

Long-term aspirin use decreased risk for multiple myeloma

Regular aspirin use and risk of multiple myeloma: a prospective analysis in the Health Professionals Follow-up Study and Nurses' Health Study

Dr. Durie wrote about it in his blog as well:

Dr.Durie: Can an Aspirin a Day Keep the MYELOMA away?

I will return to Dana-Farber in April for labs andddd NO 24 HOUR URINE (I convinced him to let me skip since I've had 10/11 24 hour urine collections that were normal and could really use a break from the orange jug. I'm sure I'll repeat the test for the July visit. I have a repeat DEXA scan scheduled in April to see how my bone density is doing. We will review those results and decide next steps as far as repeating more imaging, bone marrow biopsy, and if I am going to begin zometa infusions. This will all depend on my results, in particular if I will have to repeat the bone marrow biopsy. Dr. R said that he doesn't want to "poke me" if the results will essentially be the same as they were in July and December 2012. He was very excited that I am participating in the Mind/Body trial for SMM at Mass General. He actually said that I seemed, "much more relaxed than usual."

Hmm, what's that supposed to mean? ;)