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Healing the Mind, Healing the Body: Coping with Ovarian Cancer

Learn how to cope with the physical and emotional challenges of ovarian cancer survivorship. Reduce distress, improve quality of life, and enhance emotional well-being. Explore effective stress management and coping techniques.

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Healing the Mind, Healing the Body: Coping with Ovarian Cancer

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  1. Healing the Mind, Healing the Body:Coping with Ovarian Cancer Bonnie A. McGregor, Ph.D. Executive Director and Founder Orion Center for Integrative Medicine http://www.orionskywellness.org/

  2. Betty’s Story

  3. Survivorship comes at a price • Changes in physical appearance and functioning • Fatigue • Cognitive difficulties • Foreshortened future/ fear of recurrence • Pain • Changes in sexual functioning • Altered financial status • Change in social relationships

  4. HR= 0.87 ( CI, 0.77-0.98), p=0.018 Lutgendorf et al., 2012

  5. Most ovarian cancer survivors report high levels of distress. • Late diagnosis • Rigorous medical treatment • High rates of recurrence • Poor prognosis • High levels of anxiety and depressive sx • Sleep disturbance • Treatment side effects • Poor quality of life

  6. Psychological distress occurs across the cancer continuum • Before diagnosis among those at increased risk due to family history • Diagnosis and Treatment • Immediately post treatment • Survivorship

  7. Effects of chronic stress • Increased vulnerability to common cold • Slower wound healing • General decrements in immune function • High blood pressure and high cholesterol • Heart disease • Weight gain (central fat storage) • Poor control of blood sugar among diabetics • Poor health behaviors (e.g., diet, smoking, no exercise) • Shortened telomeres and telomerase activity • DNA damage and poor repair • Increased VEGF production and vascularization of tumor cells • Increased rates of tumor cell metastases • Resistance to chemotherapy

  8. Effects of chronic stress Before work After work

  9. Bio Behavioral cancer risk factors • Increased vulnerability to common cold • Slower wound healing • General decrements in immune function • High blood pressure and high cholesterol • Heart disease • Weight gain (central fat storage) • Poor control of blood sugar among diabetics • Poor health behaviors (e.g., diet, smoking, no exercise) • Shortened telomeres and telomerase activity • DNA damage and poor repair • Increased VEGF production and vascularization of tumor cells • Increased rates of tumor cell metastases • Resistance to chemotherapy

  10. Take a deep breath…

  11. Psychological Interventions • Reduce distress, anxiety, depressed mood • Improve social support • Enhance quality of life • Enhance emotional growth • Improve immune function • May improve survival – In breast cancer survivors

  12. Two RCT’s with breast cancer survivors The Stress and Immunity Breast Cancer Project Cognitive Behavioral Stress Management (CBSM) • Stress management, coping ect. • Health behavior change • Relaxation training • Education to adherence to tx • Met weekly for 4 months then monthly for 8 months • 227 Stage 1-3 breast cancer • Stress management, coping ect. • Social support • Relaxation training • Met weekly for 10 weeks • 240 Stage 0-3b breast cancer Anderson et al., 2002 J Consult Clin Psychol Antoni et al., 2001 Health Psychology

  13. CBSM associated w changes in gene expression Control Control Control CBSM CBSM CBSM 273 upregulated 336 downregulated Baseline Month 6 Month 12 Good genes turned on IFN Imm Activ GCS Sensitiv Unhelpful genes turned off CREB/PKA NFkB Inflammation MMP9 Antoni, Lutgendorf, Blomberg et al (2012) Biological Psychiatry

  14. Reduced Risk of Death – Breast cancer 56% reduced risk of death 79% reduced risk of death HR = .44, P = .016 HR = .21 P = .04 Andersen et. al, Cancer, 2008 Stagl et. al, (2015)Br Ca Res and Trtmnt

  15. Can we build on that success and create an intervention for Ovarian cancer survivors?

  16. WebEnhancedLessonsforLivingfor Ovarian Cancer Survivors

  17. Groups delivered via video conference

  18. Kinner et al. 2018

  19. Kinner et al. 2018

  20. Does anyone want to learn a few stress management and coping techniques?

  21. How stressed are you right now? 0 10

  22. Take a deep breath…

  23. How stressed are you right now? 0 10

  24. What is stress?

  25. What is stress? The physical, mental, or emotional tension experienced in reaction to an event.

  26. What is stress? • Typically experienced when we perceive demands exceeding our resources Demands Resources

  27. What is stress? • Typically experienced when we perceive demands exceeding our resources Resources Demands

  28. How can we manage stress? • Decrease perceived demands • Increase perceived resources Demands Resources

  29. How can we manage stress?

  30. step 1. Increase Awareness: How do you know when you are stressed?

  31. Symptoms of stress

  32. Symptoms of stress Stressful situation cognitive social behavioral physical emotional

  33. Thoughts determine feelings

  34. Imagine a lemon

  35. Symptoms of stress Stressful situation Automatic thoughts cognitive social behavioral physical emotional

  36. Symptoms of stress Stressful situation Challenge Automatic thoughts cognitive social behavioral physical emotional

  37. Step 3: Coping with stress • Problem focused coping • Ask for help • Get more information • Emotion focused coping • Talk to a friend • Relaxation practice

  38. Coping with stress • Exercise • Yoga • Social support • Meditation 

  39. Mindfulness and Stress • Staying present in the moment reduces stress • Living in the past or future brings the past and future demands into the present – adding to your perception of stress in this moment • Planning is good, but when you plan, just plan, then execute your plan moment by moment. • Multi-tasking is less efficient than doing one thing at a time

  40. Guided Imagery can help https://www.healthjourneys.com

  41. Betty…The rest of the story

  42. Where can I get support? Living WELL https://psychology.uiowa.edu/lutgendorf-lab/lab-research/living-well https://stepsthrough.org/ www.orionskywellness.org 206-525-0414

  43. What participants have said: • “I didn’t know I needed this work shop… but I did!” • “Living Well has been a game changer for me!” • I had never met another OC survivor before this group. I don’t feel alone anymore. • “I think every ovarian cancer patient should go through this course.”

  44. A national support system for women, families and caregivers living with ovarian cancer In depth, professional telehealth counseling and education resources for patients, family, & caregivers.

  45. Counselors that care

  46. www.orionskywellness.org Bonnie A. McGregor, Ph.D. Anna Charbonneau, Ph.D. Mary Malkiel BSN, MSAc, LAc. EAMP Jessica Randall, MS, EAMP Jennifer Cerulli, LMP Gretchen Gruenden, MS, RDN, CSO • We can help you cope! • CBSM groups • Psychotherapy • Acupuncture • Nutrition • Oncology massage

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