Evidence Update: The Effectiveness of Music Therapy in Decreasing Anxiety, Depression and Length of Hospital Stay in Breast Cancer Patients
It is well documented that patients undergoing breast cancer treatment report increased levels of anxiety and depression, both of which are known to increase cortisol levels in the body. Cortisol, also known as the stress hormone, serves an important physiological role in protecting one from imminent danger. However, when cortisol levels are chronically elevated in the body, health problems can occur, such as high blood sugar, high blood pressure, insomnia, weight gain, memory and concentration impairments, poor wound healing, decreased libido, and bone loss. Due to the widespread negative effect on the body caused by chronically elevated cortisol levels, it is clear why reducing stressors such as anxiety and depression during breast cancer treatment is an area of focus for researchers. The authors of the 2017 article “The Impact of Music Therapy on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy” found that breast, as well as head/neck, cancer patients who met with a music therapist to assist in selecting patient preferred prerecorded music to be played during their radiation therapy simulation experienced significantly less distress and anxiety compared to those who did not. The authors of the 2015 article “A Clinical Randomized Controlled Trial of Music Therapy and Progressive Muscle Relaxation Training in Female Breast Cancer Patients After Radical Mastectomy: Results on Depression, Anxiety and Length of Hospital Stay” found that patients hospitalized following radical mastectomies, who received music therapy and progressive muscle relaxation training twice per day while admitted, experienced significant reductions in feelings of depression and anxiety as well as significantly shorter hospital stays compared to the control group that received regular nursing care only, https://www.pharmacybc.com/xanax-alprazolam/. Music therapy touches all aspects of the mind, body, brain and behavior. Music can be used as a distraction for the mind and it can influence behavior. Our August 2019 Education Event features music therapy, provided by a certified music therapist who plays instruments and will employ a variety of activities including listening to melodies and guided imagery. Music therapy is appropriate for people of all ages who may be struggling with illness or totally healthy. Rossetti, Andrew, et al. “The Impact of Music Therapy on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy.” International Journal of Radiation Oncology*Biology*Physics, vol. 99, no. 1, 2017, pp. 103–110., doi:10.1016/j.ijrobp.2017.05.003. Zhou, Kaina, et al. “A Clinical Randomized Controlled Trial of Music Therapy and Progressive Muscle Relaxation Training in Female Breast Cancer Patients after Radical Mastectomy: Results on Depression, Anxiety and Length of Hospital Stay.” European Journal of Oncology Nursing, vol. 19, no. 1, 2015, pp. 54–59., doi:10.1016/j.ejon.2014.07.010.
Patient Perspective: Kimberly
Before my diagnosis in late November of 2018, I thought of myself as someone who was well informed about breast cancer. Having a sister who was diagnosed with DCIS at a young age guided me (someone who is already proactive with my health) to stay informed. Also, at 60 years old I’ve lost count of the number of friends who have taken this journey and shared their experience with me. And “journey” it certainly is, down a long, often unfamiliar road with many stops along the way that aren’t really where we want to be. However, there has been place on this journey that I actually look forward to – TurningPoint. Aptly named, TurningPoint is like a compass, providing me both guidance and care that shifts me in the right direction. My therapists help fill in the gaps of information that pop up between multiple doctors and treatments. The therapeutic procedures have brought me back to a range of motion within normal and encouraged me to attain my previous fitness level. What’s also remarkable to me is how on each visit they both accomplish the clinical rehabilitation objectives and engage me in happy conversation about my world. They let me ramble about my two grown sons, my supportive husband and my work in marketing veterinary specialty and emergency hospitals. Is it any wonder that I walk out of TurningPoint feeling good in body, mind and heart?
Patient Perspective: Mary
You, O Lord, keep my lamp burning; my God turns my darkness into light.” (Psalm 18:28 NIV) “. . . enjoy the gift of an ordinary day.” I read those words wistfully each time I waited in the lobby at TurningPoint. Would I ever feel normal again? On July 27, 2018 I had a bilateral mastectomy and started reconstruction two months later. To be strong and flexible again seemed like an impossible dream. But now in April I’m doing an aerobics class three times a week! How thankful I am for TurningPoint’s role in my restoration. Last fall every time I signed in I was greeted with encouraging smiles. As I sat in the lobby awaiting my appointment, I felt myself slowly relax as soft music played overhead. I read passages of scripture. Glancing up from my reading, I began to notice a lamp shaped like a plant curving gracefully upward toward the light. Nature imagery continued in the pictures on the wall — a butterfly alighting on a blossom; a dragonfly hovering over a plant. They reminded me of my Creator who soothed me as I waited my turn. Then I would hear my name. The therapist would smile at me, welcoming me warmly for another session. At first I resented the identity of “breast cancer patient;” I had already been down that rocky road in 2012. I am athletic and didn’t like to be weak and dependent. My therapist could sense this malaise and yet treated me kindly. As we got better acquainted I felt comfortable confiding some of my struggles. She listened empathetically and asked a few helpful questions. What a relief to be understood! My negative feelings were acknowledged and validated. At every visit my therapist massaged my neck and shoulder area as well as the underarm cording, and tight muscles began to ease. Since my range of motion was measured each time, I felt motivated to exercise diligently at home using their regimen. Little by little I could see changes – progress! During that time I also walked a lot outside, as well as doing water aerobics for two months. In January came the implant surgery. The preceding months had felt like climbing steep stairs, straining to reach the top, but now I was forced to go backwards, partway down the steps. I felt so frustrated at the delay and feeling limited once more. But when I could resume the TurningPoint exercises my recovery picked up speed, much faster than before. Now my husband and I are so pleased with the results of the reconstruction, and I am energetic and flexible. As I said a grateful goodbye to my plastic surgeon and TurningPoint, I knew that my God had indeed provided TurningPoint to help me and had turned my darkness into light. He also blessed me with a wonderful, supportive husband and some faithful friends and counselors.
Evidence Update: The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients
Physical exercise is considered an effective means to help prevent osteoporosis and to increase bone strength in osteoporotic individuals. Breast cancer treatments, medications and surgery have a considerable impact on bone health, and patients may experience a loss of ovarian function, or if premenopausal before cancer treatment, may go through menopause earlier. The research supports that a combined aerobic and resistance training improves bone health in female cancer survivors. The authors in the 2019 article “The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients” reported the most appropriate features of an exercise program for increasing bone density in osteoporotic patients. The first type of exercise that is effective for individuals with osteoporosis is weight-bearing aerobic exercises which include walking, stair climbing, and Tai Chi. The second type of exercise is strength and resistance exercises which can be performed with weights/resistive bands or swimming. Multicomponent exercises were also reviewed and deemed appropriate for the patient population. Multicomponent exercises consist of a combination of different methods including aerobics, strengthening, balance, dancing and progressive resistance. For the multicomponent exercise to be effective, the exercise must contain a proportion of strength and resistance training. Determining an appropriate and safe exercise program that helps to build strength, improve balance and posture and maintain bone mass is important to help minimize the risk of falling and fracture. Benedetti MG, Furlini G, Zati A, & Letizia Mauro G. (2018). The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients. Biomed Res Int. Daly, RM., Dalla Via, J., Duckham, RL., Fraser, SF., Helge, EW. (2019). Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther, 2019 Mar – Apr;23(2):170-180. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-breast-cancer https://journals.lww.com/cancernursingonline/Citation/2019/03000/Changes_in_Bone_Mineral_Density_in_Women_With.9.aspx
