Health Administrator Vol: XVII, Number 1: 151-157,pg.

CANCER TREATMENT:
ROLE OF YOGA, NATUROPATHY AND PRAYER
Manju Sengar, Manisha Bhutani,
Dhiraj Aggarwal and Vinod Kochupillai*

INTRODUCTION cells, which would otherwise induce carcinogenesis;

stress, however, impairs this process(6).
Behavioral or psychological factors such as
chronic stress may influence occurrence or progression Oxidative stress: aggravated by psychosocial stress
of cancer through several mechanisms:
Though oxygen is the most critical nutrient of
1. Influence of stress on natural killer (NK) cells. life, it is also the source of free radicals or reactive
2. Poorer repair of damaged DNA. oxygen species (ROS). ROS are generated either during
3. Modulation of apoptosis. the normal metabolic processes of the body or due to
4. Oxidative stress: aggravated by external agents such as radiation, ultraviolet light,
psychological stress cigarette smoke, and environmental pollutants such
as asbestos, pesticides etc(7,8). ROS provide a state
Stress and natural killer cells called as oxidative stress, which is aggravated by
psychosocial stress (9), and leads to many diseases
NK cells are the surveillance cells of immune including atherosclerosis, coronary heart disease
system, capable of destroying tumor cells and infected (CHD), rheumatoid arthritis, and cancer.
cells. Stressors have been demonstrated to decrease
lymphocyte proliferation and reduce NK cell An antioxidant is a substance that scavenges
cytotoxicity(1). Also, the cytokines- interferon ? and ROS. The body is equipped with antioxidant defense
interleukin -2 (IL-2) which otherwise enhance NK cells in the form of glutathione and antioxidant enzymes
and lymphocyte activated killer (LAK) cell activity get such as superoxide dismutase (SOD), catalase and
suppressed due to stress(2). Smoking may play a glutathione peroxidase. Balance between the levels of
synergistic role (in conjunction with psychological ROS and antioxidant defense in the body would
factors) and may further reduce NK cell cytotoxicity. determine as to whether a person remains healthy or
Suppression of NK cells and its functions may lead to suffers from one of the chronic diseases including
onset and/or progression of cancer. cancer, as mentioned above.

Stress and DNA repair From the foregoing, it is apparent that

psychologic stress could induce cancer and/or may
Carcinogens induce tumors by damaging cellular cause its progression through a variety of mechanisms
DNA(3). Body’s defense processes repair this damage including suppression of immune system, faulty repair
so as to prevent the occurrence of cancer. Ability to of DNA, modulation of apoptosis and through
repair damaged DNA, however is impaired in those aggravation of oxidative stress.
with depression(4). Some of the animal studies have
also suggested that stress may alter the DNA repair
processes(5). Thus, inability to repair DNA damage may Behavioral interventions
lead to cancer.
Behavioral interventions in the form of
Stress modulates apoptosis relaxation techniques have been studied to see if these
could improve immune functions and/or antioxidant
Apoptosis is a genetically programmed process, defense and may have positive effects on patients
which leads to alteration in cell structure and eventual suffering from cancer. NK cell activity has been
suicide. This process helps elimination of damaged demonstrated to increase by many researchers(10, 11)

* Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences,New
Delhi 110029

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with the help of relaxation techniques. Those patients relaxation and has been demonstrated during the
with malignant melanoma (skin cancer) who practice of transcendental meditation (TM) in the
underwent relaxation program for six weeks had earlier studies (14). Police trainees in the age group
significant increase in the percentage of NK cells, as ranging between 21- 27 years were included in two
well as increase in NK cell cytotoxicity as also lower groups in a study conducted at our center.
rates of recurrence and deaths related to their cancer Experimental group underwent AOL workshop and
compared to those, who did not undertake this practiced Sudarshan Kriya (SK) and Pranayam (P) for
program(11). Weekly supportive group therapy with self- a period of 5 months. Control group with similar age
hypnosis led to longer survival(12) and/or better quality range, living in similar conditions and undergoing
of life(13). similar physical exercises, was not exposed to SK and
P. Blood lactate was measured in both the groups at
Sudarshan Kriya, Pranayam, and Yoga the end of 5 months. Four-fold lower level (t = - 2.265,
P =3.118e - 10) of blood lactate was observed in
Yoga, meditation and pranayam are centuries practitioners of SK and P (Fig. 1). There was further
old, time tested processes; these are known to relax fall in blood lactate level during SK and P at 45 minutes
mind and energize the body. Recently, Sudarshan (t = 3.072, P = 0.013) and at 65 minutes (t = 4.123, P
Kriya has been introduced by Sri Sri Ravi Shankar ji. = 0.0006); there was negligible change in the blood
The process is introduced to participants through a lactate levels in the case of controls (15).
22-24 hour structured program called as Art of Living
(AOL) workshop, spread over 6 days. Sudarshan Kriya Effect of Sudarshan Kriya and Pranayam on
- rhythmic cyclical breathing of slow, medium and fast Antioxidant Status
cycles is preceded by Ujjayi Pranayam - slow breathing
3 cycles per minute; it is a forced inspiration and In the two groups of police trainees studied for
expiration against airway resistance, Bhastrika blood lactate levels as described above, glutathione and
Pranayam - rapid exhalation at 20 -30 cycles per antioxidant enzymes, superoxide dismutase (SOD) and
minute and brief ‘Om’ chanting. These processes are catalase were measured at the end of 5 months of
practiced while sitting with eyes closed and awareness practice of SK and P (15). Glutathione levels were
focused on breath. Process ends with a ten minutes significantly higher in practitioners of SK and P Vs
rest in a tranquil supine position. This can be followed non - practitioners (t = 6.968, p = 2.038 e - 06), shown
by a 20-minute meditation. in Fig. 2. The basal value of catalase was also higher
in practitioners, compared to non-practitioners (p =
Effect of Sudarshan Kriya and Pranayam on Blood 0.0016). Similarly, significantly higher values of SOD
Lactate Levels were obtained in practitioners of SK and P compared
to non-practitioners (t = 4.727, p = 0.0001415). These
Blood lactate levels increase during tension and results have been graphically represented in Fig. 3
anxiety; lowering of blood lactate indicates a state of and 4.

Figure 1: Bar diagram showing the comparison of lactate levels (mean ( S.E.) in controls and in
practitioners of SK&P at various time points during Kriya.

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Figure 2: Bar diagram showing the comparison of glutathione levels (mean ( S.E.) in controls and in
practitioners of SK&P at various time points during Kriya.

Figure 3: Bar diagram showing the comparison of catalase activity (mean ( S.E.) in controls and in
practitioners of SK&P at various time points during Kriya.

Figure 4: Bar diagram showing the comparison of SOD activity (mean ( S.E.) in controls and in
practitioners of SK&P at various time points during Kriya.

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 TM program has been shown to decrease compared to normal controls and cancer patients,
psychosocial stress (16). Epidemiological data (14,16) and please refer to Fig.5. No significant difference was
controlled clinical trials (17) have suggested that lower seen in NK cell population between normal subjects
rates of CHD morbidity and mortality are associated and cancer patients in remission (18).
with long-term practice of TM in older subjects. In
addition, rate of cancer and aging have also been Subsequently, 21 cancer patients, who had
reported to be lower in TM practitioners (14). Though already been treated and were either in remission or
such studies are not available for SK and P, better having stable response, underwent AOL workshop and
antioxidant status achieved through regular practice, practiced SK and P for 6 months. Six cancer patients,
as highlighted above, would be consistent with the similarly treated, under follow up but not exposed to
possibility that regular practice of SK and P might SK & P were taken as controls. Blood samples for T
reduce the incidence of CHD and cancer and other age cell subsets (CD 3 +, CD 4+ and CD 8+ cells) and NK
related chronic diseases. cells were taken from both groups at day 0, day 8, week
12 and week 24. There was no significant difference
Effect of Sudarshan Kriya and Pranayam on T cell between the population of T cell subsets among control
Subsets and Natural Killer Cells group and experimental group; neither was there any
difference in the experimental group from day 0 to week
T cell subsets and NK cells, recognized as 24. However, NK cell population of experimental group
important cellular components of immune system, showed a statistically significant increase (p<0.05) at
were studied in 17 AOL teachers (had been practicing 12 and 24 weeks compared to baseline. Increase in
SK and P for at least 2 years), 17 cancer patients NK cells at 24 weeks in the experimental group was
(already treated, under remission) and 63 normal also significantly higher (p <0.05) compared to control
subjects of either sex; age range 18 - 65 yrs (18). Major group (unpublished data).
lymphocyte subsets were estimated quantitatively in
the peripheral blood using two-color flowcytometry In summary SK and P, as highlighted above,
technique. induces relaxation, increases antioxidant defense and
NK cells in the body. These observations would have
Total T-cell and its T helper subset were important implications for cancer: as they would
significantly higher in AOL teachers and normal suggest that (i) SK and P may have a preventive role
controls compared to cancer patients. However, there against cancer (ii) SK and P may be effective as a
was no significant difference in these cells between secondary preventive measure, after curative
AOL teachers and normal controls. A significant treatment of cancer and (iii) in metastatic cancer, SK
difference was found in NK cells, which were and P may delay progression of cancer, improve
significantly higher (p <0.001) in AOL teachers survival and/or quality of life.

Figure 5: Bar diagram showing percentage of NK cells in peripheral blood, as obtained by flowcytometry,
in normal subjects, AOL teachers and cancer patients

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Meditation and maintain health. It is premised that the therapies
used to support and stimulate this healing power of
Meditation is art of doing nothing with eyes nature must be in “the gentlest, least invasive, most
closed. One gets into the awareness of nothingness efficient manner possible”. Naturopaths do not simply
(emptiness) or infinite space. Several techniques are treat the manifestation of the disease but rather search
available to make one reach a meditative state. for the cause and treat it.
Meditation can play a useful role for cancer patients.
It can relieve the stress and the physical and emotional To accomplish these goals, naturopathic
pain. Meditation can be helpful to some people in medicine incorporates many therapeutic modalities:
dealing with side effects of treatment and in herbal medicine, homeopathy, nutrition, hydrotherapy,
overcoming the sense of loss of control and to gain food, exercise therapy, physical therapy, manipulation
mastery over their lives. It may be most useful when of the bony and soft tissues, and lifestyle and
treatments have ended and the person is attempting counseling.
to return to normal activities as a survivor. It can also
help the people to change lifestyle to promote health There is no scientific evidence that naturopathic
and reduce the risk of recurrence (19). medicine can cure cancer or any other disease. Specific
methods within naturopathic medicine vary in terms
Meditation has been used to great advantage in of effectiveness. Some methods may be of little value,
caring for terminally ill and dying patients in hospice while others may prevent and/or control symptoms.
settings and at home. This involves the use of Examples include the importance of diet in lowering
meditation to relieve physical and emotional pain and the risk of severe illnesses such as heart disease and
suffering due to the disease. It is used to best cancer, and the usefulness of acupuncture to reduce
advantage when integrated into a comprehensive pain.
palliative care approach, which includes, if desired
discussing death and dying and feeling of loss within Many herbal remedies have shown to have
the context of mindfulness practice and the states and anticancer effects. Essiac, Iscador, and pau d’ arco tea
thoughts that arise during meditation and other times. are the few herbal drugs popular in USA. Several
Many dying patients also find that calmness and mushroom derived compounds are approved for use as
silence of meditation bring profound feeling of cancer treatment in Japan. There are suggestions that
acceptance, well being and inner peace (20). Healthy a Chinese formula containing herbs may be weekly
persons at higher genetic risk of cancer also may be estrogenic and may be of use in the treatment of
drawn to meditation to reduce environmental and life prostate cancer (21). Another Chinese herb was found
style risk factors and to control anxiety and stress. to have inhibitory properties against breast cancer
cells(22). Garlic (diallyl- disulfide) inhibited the growth
All these techniques can be helpful to patients and induced apoptosis in human colon cancer cell
with cancer. Their practice enhances the coping ability lines(23). Polyphenolic compound (Resveratrol) found
of patients. These measures change the hopeless and in plant species and food products (grapes, peanuts
helpless attitude to the active fighting spirit. They and herbs) had similar effect (24). Major component in
reduce the stress associated with the diagnosis as well green tea, enhanced the growth inhibitory effects of 5
as treatment of cancer. By reducing the stress they flourouracil (chemotherapeutic agent) (25).
may alter the treatment outcome. On account of the
positive effect of meditation on NK cell cytotoxicity and Research carried out at AIIMS has shown that
consequent up regulation of immune system, antioxidants and ginger (Zingiber officinale) (26) had
meditation can lead to prevention as well as useful antiemetic effect in animals (cats and dogs)
progression of cancer. undergoing cisplatin chemotherapy; human trials are
awaited. Ocinum Sanctum (27) had antiproliferative
Naturopathy and chemo preventive effects; thus it has the potential
Naturopathy is a system of medicine that uses as an anti-cancer agent. Maha Amrit Kalash enhanced
natural substances to treat the patient and recognition immune status of cancer patients undergoing
that the patient’s mental, emotional, and physical treatment. A study done by our group at cancer center
states must all be treated for a lasting effect. The showed that high doses of multiple antioxidant
foundation of Naturopathic medicine is laid on vitamins along with chemotherapy (Carboplatin and
philosophy of the “healing power of nature.” This means Paclitaxel) enhanced apoptosis of non-small cell cancer
that within every human organism there is a healing cells H520 (28). Clinical study also demonstrated that
energy, which includes our immune system, which is combination of chemotherapy and antioxidant vitamins
responsible for our wellness and our ability to heal yielded better response rate and longer survival.

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Prayer 6. Tomei LD, Kiecolt-Glaser JK, Kennedy S, Glaser
R. Psychological stress and phorbol ester
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213
CONCLUSIONS
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