FULL LIVES AFTER BREAST CANCER

1. FULL LIVES AFTER BREAST CANCER THE ENVISION THE RHYTHMS OF LIFE (ERL) PROGRAM Lyn Freeman, PhD. Mind Matters Research LLC Anchorage, Alaska

2. Side Effects of Cancer Treatment Quality of Life issues: The IOM Reports Cognitive Functionality (chemobrain) Fatigue Stress/Anxiety/Depression/PTSD Somatization (psychological distress expressed as physical symptoms) Sleep Disturbance Spiritual issues raised by diagnosis and treatment 2

3. SUPPORTIVE FINDINGS New study published in CANCER (12/2008) Breast cancer patients who underwent intensive interventions that reduce stress, improve mood, coping abilities and health behaviors Demonstrated better survival rates 11 yrs later Half (55%) the risk of recurrence compared to controls Cancer-free an average of six months longer (45% reduced risk) for patients who did suffer a recurrence Half the risk (44%) of death from breast cancer and a reduced risk of death from all causes, not just cancer 3

4. PRIMARY PURPOSE OF THIS PROGRAM Trigger a “Phoenix Transformation” Patients use the cancer experience to evoke deep understanding, gain physiological strength, learn new life skills, and short-circuit the potential for post-traumatic stress disorder (PTSD) 4 Art: “Phoenix Transformation” Copyright Mind Matters Research LLC

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6. PROGRAM FEATURES AND DESCRIPTION Mechanisms Down-regulation of HPA axis reduces stress improves immune function, well-being, & QOL Theoretical Foundation Cannon Seyle Pavlov Ader & Cohen Pert Bach-y-Rita, Taub, Merzenich & others 6

7. What is Envision Imagery?Passive, Active, and Targeted 7

8. Class Content Class 1: Brain plasticity, breath entrainment, story, ritual, art, sleep evaluation and sleep audiofile Class 2: Sight, conditioning, passive imagery, PNI, rhythm, memory, temp control, dreaming audiofile Class 3: Odor/taste, effect on brain waves, mood state; malodors; learning with scent; HRV, breath and temperature control; emotional reframing audiofile Class 4: Sound, conditioning and noise pollution effects; circadian, ultradian; neuropeptide animations /audiofile Class 5: Touch, Walking Imagery; lymphadema/pain management audiofiles; long-range imagery planning 8

9. First Study Outcomes 34 patient within-group design, 8-weeks post- treatment, clinically & statistically significant outcomes Anxiety=40% improvement (.005) Somatization=37% improvement (.002) Depression=34% improvement (.028) Global severity index=37% improvement (<.001) Other significant improvements: Breast-cancer specific symptoms, Spiritual, Functional, Emotional, and Social/Family well-being=range of 7-18% improvement (.05 to .008) Cortisol rhythm=8-week trend for improvement Results published in JSIO and ONF, 2008 9

10. Second Clinical Study 165-180 patients (Between and Within Group Design) Four comparison groups Group A. Imagery program with instructor in the room Group B. Imagery program via videoconference Group C. Waitlist control, for comparison to A & B Group D: At six months, controls trained, compared to own extended baseline ( ½ live, ½ videoconference) Study in progress; Completed in October 2010 Clinically standardized assessments will measure: Anxiety, Somatization, Depression, Global Severity Index Breast-cancer specific symptoms, Spiritual, Functional, Emotional, Physical, and Social/Family Well-being HRV (heart rate variability) and Evoked Response Potentials (measure of cognitive speed, concentration, and multi-tasking) 10

11. Delivery Options: Live or Distance 11

12. Original Animations By XVIVO Neuropeptides Brain Mapping HRV Lymphedema 12

13. USER-FRIENDLY WEBSITE Pango Media HIPAA Approved Pass Word Protected Materials Accessible Automatic Reminders/Practice Uploads

14. ARTWORK TO EMBED PRACTICE 14

15. What The Experts Think

16. Candace Pert, PhD, Researcher Discovered Neuropeptide Receptors I have authored a book entitled “Molecules of Emotion” which explains my theory of the importance of neuropeptides and their receptors as the biochemicals of emotion, based on over 200 scientific papers I published as a section chief at the NIH. I have met with Lyn, attended her scientific presentation at an NCI meeting, collaborated on her research, and am extremely excited about being a part of her project and research. Lyn is an extremely well-respected scientist and author of the best selling research-based [Mosby] textbook on Alternative & Complementary Mind-Body Medicine. Her Phase I pilot data suggests that Dr. Freeman is poised to produce a most meticulous, compelling and clinically important study in mind-body medicine. Of course, I am extremely enthusiastic to be able to lend my support for Phase II. 16

17. Lorenzo Cohen, PhD, ResearcherSection Chief/ Director, Integrative Medicine, MD Anderson Cancer Center, Houston TX As an NCI-funded mind-body researcher, I am aware of the important role that psychological factors play in improving cancer patients’ outcomes from a psychological, physiological, biological, and clinical perspective. Relaxation and imagery have gained some acceptance within standard medical practice as a way to reduce treatment and disease-related symptoms and improve quality of life. Dr. Lyn Freeman is a leader in the field and the imagery program she has developed [Envision the Rhythms of Life] is unique in that it engages all the senses and incorporates passive, active, and targeted forms of imagery.  The Envision the Rhythms of Life program will ultimately benefit patients battling any form of cancer.  Data from the phase I trial is very encouraging and the program will be easy to implement nationwide. 17    

18. FUTURE DELIVERY OPTIONSThe Quality Model Training of Trainers Six months of training Required reading lists Written tests and essays Training presentations to the MMR board Co-training in classes lead by master instructors Certified annually Certification maintained by participant outcomes Delivered through contractual agreement with hospitals, out-patient clinics, and non-profit cancer support groups

19. Publications Freeman, L.W., Cohen, L., Stewart, M., White, R., Link, J., Palmer, J.L., & Welton, D.L. (2008). An Imagery Intervention for Recovering Breast Cancer Patients: A Phase I Clinical Trial of Safety and Efficacy Journal of the Society for Integrative Oncology.6 (2), 67-75. Freeman, L.W., Cohen, L., Stewart, M., White, R., Link, J., Palmer, J.L., Welton, D.L., McBride, L., & Hild, C. (2008). Qualitative Analysis of Breast Cancer Survivor Imagery: Themes Leading to Improved Quality of Life. Oncology Nursing Forum, 35, (6), E116-E121. Freeman, L.W. & Dirks L. (2006). Mind-Body Imagery Practice Among Alaska Breast Cancer Patients: A Case Study. Alaska Medicine, 48 (3), 74-84. 19

20. CONTACT INFORMATION Lyn Freeman, Ph.D., CEO Mind Matters Research LLC 7926 Port Orford Drive Anchorage, AK 99507 Phone: (907) 868-7737 Fax: (907) 344-4537 E-mail: lfreeman@mindmattersresearch.com 20

21. END OF PRESENTATION The project described was supported by Award Number R44CA117597 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health 21