Yoga for Cancer

Change the way you look at things and the things you look at change ~ Wayne Dyer.

There comes a time in life when we are all called to look at death square in the eye. Although I am no stranger to funerals, this really hit home for me in 2016. In early spring of that year, my stepdad was diagnosed with “some type” of gastric cancer. It would take another month to determine the exact type and stage. The wait was agonizing for him. During the time between not knowing and knowing, I had the great fortune of taking my first trip to India. Since then, I have returned four more times. I took the image above in Varanasi at the Manikarnika Burning Ghat. A ghat is a flight of steps leading down to the river. There are 84 ghats along the banks of the sacred Ganges in Varanasi - most are used for bathing and puja (ceremony), but two are used exclusively as public cremation sites. On average, 80 cremations occur each day. During the pandemic, that number climbed to approximately 200 per day. The Hindu tradition views life and death as impermanent, whereas the soul is viewed as immortal. This means that there is an ongoing cycle of birth, growth, decay, and death (Baba Hari Dass), and then, rebirth. However, if one dies or is cremated in Varanasi, it is believed that the soul will be released from the ongoing cycle of rebirth, and the dead find the “path of the sun,” or nirvana.

While there are many life lessons that I have learned from traveling in the magically complex country that is India, embracing a broader perspective around death is right up there at the top of the list. Wayne Dyer said, “Change the way you look at things and the things you look at change.” Well, being in such close proximity to death on my trips to Varanasi has helped me change the way I look at death. And although I am not completely comfortable with the idea of me dying yet, it has helped me view death as a transformation of energy rather than a finality of life. So, when my dad was diagnosed with cancer in that spring of 2016, I had the privilege to support him through his cancer journey and practice a version of this newfound perspective. In that vein, this post is one part tribute, one part self-reflection, and one part Yoga for Cancer public service announcement.

TRIBUTE:

When someone is diagnosed with cancer, it is like their whole life gets reduced to this one event. To be clear, it is a huge deal, but even so, there remains a whole part of a person’s life that is not cancer. So, I would like to share a little about Ed Campbell’s life before his cancer journey.

I referred to him as the “enlightened redneck,” because of his ability to give the sagest advice in the most blue-collar way. He came from humble beginnings, and legend has it that he was born in a boxcar. Ed played many roles; he was a husband, a brother, a father, a stepdad, a grandfather, a great grandfather, a father-in-law, an uncle, and a friend. He was a millennial parent before it was a thing; telling us four kids from as long as I can remember that we were the smartest, and best at everything we did, and that we could be anything we wanted.

He was a sensitive and compassionate person who would give you the shirt off his back if he could. As a carpenter, he built and renovated more houses than I can remember. As a skilled painter he was able to travel all over the world refurbishing cruise ships. He was generous with his time and his labour, always volunteering to help family and friends with their home renovation projects. Some might have even called him a true Karma Yogi (selfless servant.) He was a creative person who loved to write both fiction and non-fiction and loved to tell stories (both fiction and non-fiction.) He loved to dance, and he loved country music. He and my mother owned a business and worked together every day for over 40 years.

You may be surprised to know that right up until a couple of days before he went into hospice, he was making my mother an egg and tea every morning! He thought it was important to do something for her. It gave him a reason to get out of bed when it would have been easy to stay there. It made him feel alive and useful to continue this morning ritual.

Exactly one day after my return from India, my dad and I made the first of many trips to the hospital. This was the visit where he would do testing to find out what type of cancer he had. It went something like this; my dad was tested, the diagnosis was determined, the Gastroenterologist came out and very matter-of-factly said, “It’s stomach cancer, it’s advanced and it’s in operable.” We all looked at each other in silence for a moment and then the Doctor simply walked away. Stage four stomach cancer – it was shocking news. We were secretly hoping it was colon cancer. We sat in the waiting room and cried and then he said, “maybe this can help you with your Yoga ‘stuff.’”

The first question my dad had for the Oncologist was “how long do I have?” Nobody really wants to hear the answer to that question. So, when he heard the Dr. say, “about 3 months, if you do nothing, and around 10 months if you do treatment.” He made a quick decision to do palliative chemo; 8 rounds of IV chemo in combination with oral chemo and a plethora of other medications – 2 weeks on and 1 week off. Even at a reduced dosage, it was tough going. It literally felt like a death clock started ticking.

According to Yoga philosophy there are five main obstacles, or Kleshas, that we humans experience throughout our life. They are Avidya (ignorance), Asmita (egoism), Raga (attachment), Dvesha (aversion) and Abhinivesha (love of life and fear of death). Arguably, my dad now faced the biggest obstacle of his life. In his commentary on the Kleshas and Abhinivesha specifically, Baba Hari Dass said “this love of life appears in all beings equally, no matter whether they are a worm or a human being, or whether the human being is foolish or wise. In spite of all the evidence to the contrary, one thinks, ‘Perhaps death will not happen to me.’” 

The survival instinct is strong in each of us, and still it seems that some other intuition takes over when one is faced with their own mortality. Perhaps this is a remembering of the contract we make when we come into existence. I witnessed my dad digest the events of his life very quickly. He started to ask the big questions, and on one of our what he used to call “chemo dates” he said, “I wonder how you let go of life?” To which I shared that I had once heard that Baba Hari Dass said “you simply leave the body like you’re taking off an old worn overcoat.” To which he replied, “well kid, I’m not ready to take off my coat yet.” But not more than two weeks later, having already said goodbye to the bird that lived in a tree close by the house, he shared that he was no longer afraid to die.

Without going in to all the gory details, I will say that Oncologists are surprisingly accurate at predicting how much time someone has left to live. After 10 months from the original prognosis, on January 22, 2017 (my mother’s birthday) he left his body peacefully, with a smile on his face, Elvis Presley softly playing in the background and me by his side silently chanting the Mrityunjaya mantra to help him on his journey.

SELF REFLECTION

The relationship with my stepdad was sometimes complicated. We did not always see eye to eye. In fact, we had been known to have some good ‘debates.’  However, through it all, I grew to love and respect him. He was always, and I mean always, there for me in my moments of need (and there were a few).

When he was diagnosed with cancer, I came to realize each family member has their own way of coping in a crisis. It can look like denial, avoidance, the use of humour or sarcasm, or sinking into addiction. My coping mechanism is to spring into action: trying to determine what is needed and then getting it done. Since I am a Yoga Therapist specializing in Yoga for Cancer, I put on my imaginary cape and got to work.

It is important to note here that supporting a loved one who had cancer gave me a whole new appreciation for my chosen field. Never having been through it myself, I understand now more than ever, I never fully grasped all the complexities that accompany a cancer diagnosis. It is one thing to theorize about it, and work with clients and students, but I did not know what I did not know. For instance, in addition to understanding medications’ side effects, having someone be an extra set of eyes and ears, and having someone to ask questions and translate the scientific jargon is a necessity. It is helpful, and sometimes even essential to have someone attend doctor appointments, keep a journal or take notes with important contact numbers and personal information (i.e., birth date, medical health # etc.) It was key to track progress or decline in appetite, weight gain and loss, and the effects of chemo and other medications from visit to visit. All this information proved to be valuable when my dad was admitted to hospice. The nurses were surprised and impressed at the amount of data I had collected. Of course, they could not have known I was afraid that I would miss something important, so I captured literally everything.

To express what it means to support someone who is on a cancer journey is difficult. I cannot envision the challenges for those who must go it alone. What I came to learn first-hand is that when someone is told they have terminal cancer, the shock can be profound. The stress from receiving the news affects everything, and the body goes straight into fight or flight mode. And it is not just the cancer patient, but the whole family that is affected. The body’s response to the physical, mental, and emotional pressure is to release stress hormones. This, in turn, increases blood pressure, speeds heart rate, and raises blood sugar levels. As you may know, these physiological changes help a person act with greater muscular strength and speed to escape a perceived threat, but of course the type of strength that is required for a cancer journey is quite unique and different from outrunning a puma. This is a different type of battle, and the perceived threat never really leaves the mind. While you definitely need internal strength and fortitude, there is no amount of speed that will help you outrun the diagnosis.

You can never know in advance the path your life will take, or how or when you will be called into service. I could have never known in advance that service would look like making countless trips to the oncologist’s office, to chemo appointments, CT scans and x-rays, and ensuring that blood transfusions were made available when necessary. It was important that my dad had a strong advocate to ensure that when his faith in a big medical system was challenged, he was getting exactly what he needed when he needed it. Not to mention all the deep conversations we had about questioning life and how one lets it all go. The most challenging conversation, though, was giving news we assume a daughter should never have to give. When he could no longer attend doctor’s visits, I was asked to tell him how much longer he might have left to live; it was a matter of weeks. We cried.

What I understand now more than ever, is that grieving is not something that happens at the ‘end,’ when someone leaves their body. It happens all along the way - when you find out your loved one has a terminal disease, when you find out that the treatment will no longer work, and at every difficult stage in between.

YOGA FOR CANCER

If you were wondering whether there is really a need for Yoga for Cancer, according to the Canadian Cancer Society, there were an estimated 225,800 new cancer cases in 2020. That is an average of 617 Canadians being diagnosed with some form of cancer each day. The numbers are staggering, to say the least.

I concluded early on in my yoga teaching journey, that yoga is not ‘one-size-fits-all.’ Which is to say that each person’s practice is entirely unique to them. This could not be truer for people who have cancer. Back in 2003, as a new teacher, I remember leading a class where four people, each with different types of cancer, came to practice in one class. It was a challenge to feel as if I was teaching four different classes in one, but it prompted me to become a Yoga Therapist with a specialization in cancer.

Since then, I have gone on to develop and lead Yoga for Cancer workshops for Yoga teachers who want to understand more about cancer and how they can use Yoga to support their students.

In order to teach Yoga to people who have cancer safely, you need to have knowledge and information. Compassion will take you a long way, but it is not enough. There are more than 100 types of cancer and many different types of treatments, such as:

• Surgery
• Over 100 different chemotherapy treatments
• Radiation Therapy
• Targeted Therapy
• Immunotherapy
• Stem Cell or Bone Marrow Transplant
• Hormone Therapy  

Each of these treatments has side effects that can be debilitating, and which remain long after the initial treatment. For example: chemotherapy, a drug that can identify fast-growing cells, can result in hair loss, nausea, ‘chemo brain’ (confusion) and bone loss as chemo breaks down the bone building process. Chemo can cause hormonal imbalances; premature menopause (and all the symptoms that go along with that); and neuropathy, a neurological sensation in the feet (and fingers) that makes it difficult to feel the feet or hands on the floor. Surgery, on the other hand, can cause mobility issues, discomfort, fatigue, extended recovery time, scar tissue, depression, loss of range of motion, pain, digestion issues, constipation, and risk of infection. Additionally, it often causes lymph-edema - a buildup of lymph fluid in the body that cannot find its way out due to lymph node removal; and while it is manageable, it is not reversible.

But there is hope! Since we Westerners need empirical proof, science continues to verify what Yogis have known since time immemorial. Research on Yoga for cancer has been taking place for several years, showing improvements in fatigue, mood, anxiety, cancer-related pain and stress, cancer-related symptoms and medication side effects, and overall quality of life.

I am often asked what type of practice should be adopted by students who have cancer. Generally, without doing a full intake to determine the type and stage of cancer, treatments regimes, medications, ensuring folks are cleared to attend classes by their medical professional, it would be irresponsible to recommend a practice. It is important to remember that having cancer does not supersede other medical conditions that may need to be taken into consideration.

What I do offer is this, considering that there is an imbalance of the immune system and all the side effects noted above, it is recommended that the Yoga Therapy approach should begin with a Langhana practice (restorative and detoxing), and then move onto a Brahmana (more heating) practice as the student becomes stronger. The same goes for any breathing practices. Usually, sticking to cooling and balancing breaths such as alternate nostril breathing or three-part breath, while focusing on long slow exhalations, will be beneficial. At first, the moral of the story is to relax the nervous system.

Here is a short accessible cooling practice:

• Sukhasna/Easy Pose: Sit cross legged (or with straight legs) on a block (or folded blanket) and take several breaths, inhaling and exhaling through the nose, lengthening the exhalation comfortably. Support knees with blocks if necessary or sit in a chair.
• Matsyendrasana/Seated twist: Keeping legs crossed (or sit in a chair), inhale through the nose. On the exhale, slowly twist your body to look over your right shoulder, placing your left hand on your right knee and your right hand behind your body. Breathe deeply and hold the stretch for as long as you are comfortable. Repeat other side.
• Viparita Karani/Legs up the wall: Come close to a wall sitting with your right side at the wall. Turn toward the right, coming onto your back and bring your legs up the wall. Scooch your buttocks closer to the wall and lay with hands on belly for several breaths.
• Supta Baddha Konasana/Reclining Bound Angle pose at wall: From legs up the wall, bend knees so the soles of the feet are on the wall, then bring the soles of the feet together and let the legs open. Continue to focus on the breath.
• Savasana/Corpse pose or Constructive Resting: Lie on your back with legs long and apart about the width of a Yoga mat and arms resting beside your body or, have the soles of the feet on the floor as wide as your mat, with the knees collapsed towards each other. Give yourself a big hug. Stay for several breaths.
• Sukhasna/Easy Pose: Sit cross legged (or with straight legs) on a block (or folded blanket) and take several breaths inhaling and exhaling through the nose, lengthening the exhalation comfortably. Support knees with blocks if necessary. Anchor the mind on the coming and going of the breath. Stay for several breaths or as long as comfortable.

Even with all the treatments and Yoga for Cancer, some people will succumb to this disease. I have a firm belief in the intelligence of creation, and that just as we know how to be birthed into this world, we know how to leave it. Both ends of the spectrum are unknown; what lies beyond the entry and the exit is a mystery. Sometimes it is painful and sometimes it is graceful. In my dad’s case I am thankful it was peaceful and, dare I say, elegant.

In the years since he left his body, I remain curious about his transition, and I am left with many questions. What was he smiling at when he departed? What did he see? Who was there to greet him? Where did he go? Because one thing is for sure, one moment it was clear he was in his body, and next, he was gone.

To be sure, our relationship was not always perfect, but he was a good and loving teacher. I believe he taught me what mattered most in this life and even in death I continue to reflect on what I have learned from him.

He taught me to shoot for the stars and reminded me that it is important to think outside the box, to be creative, and to improvise and unapologetically enjoy this one life we have.

He taught me that it is important to stay curious, and fight for what you believe in.  

He taught me it is really important to be kind to people, especially those less fortunate.  

He taught me that family always comes first, we are allowed to make mistakes, let each other off the hook and the real kicker, that love does not always look like you expect it to look.

In retrospect, it seems strange to call bearing witness to my dad’s death a gift. He allowed me to be present for one of the most intimate and possibly frightening and mysterious moments on the human continuum. He showed me it can be done with grace. The sheer fact that he seemed fully surrendered and accepting and not at all fearful and was an important lesson for me. It shifted something in me and for that I have nothing but gratitude. His death invited me to look at my fear around my own mortality head on, something we all must do at some point. I feel his energetic presence and even hear his voice in my head sometimes when I feel the need of support and I am reminded “goodbyes are only for those who love with their eyes. Because for those who love with heart and soul, there is no such thing as separation ~ Rumi.”