Exercises and Information on Breast Cancer

In medical qigong, we learn cancer healing protocols as well as cancer prescription exercises. I think this is a great article by Pamela Ferguson, who had to deal with her own cancer diagnosis and healing. I believe much work needs to be done with all the issues that surround cancer, physically, of course and also the enormous fear that surrounds cancer. Part one was published in the January 2004 edition of Acupuncture Today and part 4 was published in the March 2004. I think the information, exercises and protocols are highly relevant and similar to our medical qigong protocols.

Busting Taboos About Breast Cancer, Part One

As a vigorous 16-year survivor of metastatic breast cancer, I have transformed my experiences into activism and a teaching protocol for my international students of zen shiatsu. I have taken great joy in beating the odds and busting many of the taboos surrounding cancer.

As students over 20 years ago, we were advised by instructors and textbooks to avoid treating cancer patients, but we’ve all moved beyond that into a whole new realm of understanding and specialized procedures.

My workshops cover a number of practical topics. Along with my own personal insights and postmastectomy exercises, I share my professional experiences on the following:

  1. Working with other cancer patients and their families, treating each cancer patient as an individual, and avoiding sweeping generalizations about cancer.
  2. Special qi and zen shiatsu treatment protocols pre -and-postsurgery.
  3. Working creatively with survivors.
  4. Helping patients make informed choices about a combination of mainstream and alternative treatments and adjuvant therapies.
  5. Working creatively with the terminally ill.

In short, students are trained to think – and treat – multidimensionally, and to involve patients and families in teamwork. Sometimes I use shock tactics, like lifting my shirt to show my mastectomy scar, to help some students overcome their own personal fears. “There can be life, and great qi motivation after cancer,” I reassure them. “Cancer doesn’t have to be a death sentence!”

I also share the activism of those of us who feel free to use saunas and changing rooms in gyms as a way of helping others break the taboo of being unibreasted (or no-breasted) and committed to physical fitness. Too many patients have felt pressured into media-hyped reconstructive surgery and implants before giving themselves time to heal or network. Similarly, heads turn in mammography centers when I crack jokes about being entitled to “half-price” mammography – something I have been able to achieve in Zurich, Montreal, and Cape Town, South Africa – but not in the U.S., where I’ve been told that “it’s not in the system.” I remind my students that men also experience breast cancer; in some countries, up to 3% of all breast cancer cases occur in males.

My students and I also discuss new ways of changing the cancer lingo many of us find aggressive and offensive, like “cancer wars,” “bringing out the big guns,” or “battling cancer.” Instead, we opt for terms like “transforming” cancer. My own relationship with cancer changed when I realized that a cancer cell is in fact a confused cell. In my mind I needed to use imagery, such as light, to coax those cells back on track, not smash them! I wouldn’t battle a confused patient, so why battle a confused cell?

Postmastectomy Exercises/”Drawing Circles”

To ease the apprehension some students feel at the beginning of my workshops, I teach a series of “drawing circles” – postmastectomy qi exercises I developed quite spontaneously after my surgery. The circles have helped dozens of postmastectomy patients of all ages. Through one of my students in Germany, the circles have become an integral part of physical therapy training at a teaching hospital in Berlin. The exercises also help prevent the sort of qi stagnation in the breasts and painful breasts many women experience during PMT.

The drawing circles series evolved out of my qi training, and were helpful and joyful, especially when practiced to the gloriously healing sounds of Mozart concerti. The American Cancer Society kindly sent me a booklet of exercises which, while technically sound, I found uninspiring. This prompted me to create the sort of gracefully slow qi movements my body wanted in the weeks post-surgery. The circle evolved as a useful form, a holistic grid for measuring progress each day. I had lost many circles (my right breast, along with some 20 lymph nodes and left breast cysts), so performing qi movements in circle formations felt very restoring.

Performing the Drawing Circle

  1. Initially, a day after surgery, heavily stitched and trussed up, I rolled my hands wrist-over-wrist to enhance deep breathing. “Wrist rolling” in Chinese medicine also helps stimulate the movement of lymph.
  2. My hands then formed a rolling qi ball in front of me, which grew in proportion day-by-day.
  3. These prompted fun “polishing the mirror” circles, similar to those “wax on/wax off” movements practiced in the movie “The Karate Kid.”
  4. Then came the horizontal circles, with the hands moving from waist level to full lateral extension in slow, full circular movements (great for the San Jiao and Pericardium meridians).
  5. Creating vertical circles proved to be the most ambitious, prompted first by swinging the arms, modestly of course, while I still had stitches. After the stitches were removed, I increased the swing each day until I could point my fingers to the ceiling and complete the circle, like a swimmer’s backstroke, in slow motion! (This was great for the Stomach and Spleen meridians.)
  6. I then concentrated on “scar circles” – small, circular movements along my scars to help reduce scar tissue, increase local flexibility, and move stagnant qi out of the meridians cut by the scalpel. Other useful exercises involved pressing two fingertips into ren 17 (the front shu point for the Pericardium), then slowly extending my arms laterally and perpendicular to my body (equally good for opening the entire Pericardium meridian and enhancing qi flow through the breasts).

These exercises are simple, but quite healing, on many levels. As a result I had full arm extension and range of motion within three weeks of my surgery, and a strong sense of restored symmetry. A few months later, I began teaching these exercises to my students, and resumed my twice-weekly swimming regimen. I swear my exercises also prevented the form of lymphedema that confounds a number of postmastectomy patients who endure a thickened arm and reduced mobility. Indeed, these exercises have also been useful for reducing long-term lymphodema experienced by many patients. I’m saddened to encounter patients who were never taught how to move creatively after breast surgery, or who were given “don’t do this, don’t do that” lists that caused inhibited movements, fear, frozen shoulders, a tight neck, and a tendency to hold an arm over the area as though protecting a frightened bird.

By contrast, how wonderful it was to discover that a group of breast cancer survivors in Vancouver, Canada, created a special dragon boat canoeing team to celebrate their survival and build upper body strength through competitive rowing movements! I wrote about the team in my book Take Five, and happened to meet them recently (and quite by accident) in a Philadelphia hotel lobby.

Here’s some additional advice for shiatsu therapists who plan to work with breast cancer patients.

  • Minimize your techniques. Practice the art of less is more. Maximize your own personal qi prepping. Avoid deep pressure. Practice off-the-body qi work around any area of recent surgery.
  • Treating the Stomach meridian can be vital, not just because of location and function. The Stomach meridian plays a strong role in the “qi scaffolding” of the breast. I helped Peggy J., a double mastectomy patient, overcome so-called “phantom pain” by talking to her about the role of the Stomach meridian, and asking her to cup her hands around the twin spaces above her scars where she felt pain and where she had lost her physical breasts. I worked down the Stomach meridian and performed a slow-motion “ski-jump” over her hands, following the meridian line. Not only did Peggy feel the qi line, but a day later she told me the pain had gone. She was able to drive her car again and couldn’t wait to get back to the golf course!
  • Similarly, the Spleen and Pericardium meridians run through the upper outer quadrant of the breasts where most tumors occur. Your diagnostic techniques will help you select the most appropriate meridians and acupoints to treat, of course, but some simple off-the-body work following the line of the affected meridians through the area of surgery will help repair meridian qi unsettled by tumors and scalpels.
  • It’s always useful to ask your patients to demonstrate their range of motion so you can avoid any inappropriate movement or treatment position during simple stretching. Whether you work on a table or a floor mat, always ask your patients to arrange themselves in their most comfortable position. One of my patients, Lisa N., could hardly extend her arm in the supine position without a cushion for support.
  • Placing a light, colorful cloth over the area of surgery can help remind you of its exact location.
  • I often ask patients to draw their scars on body outlines, so I know the exact location. As an alternative, I suggest they line colorful Five Element stick-on dots over their clothing to track scars. I can then pinpoint the exact meridians and points affected locally and distally by the surgery. This is good for kids of all ages, especially when you show them in a mirror how stretching helps the scar “smile.”
  • If a patient is undergoing chemotherapy, the Pericardium is great for minimizing nausea, especially P6 and P8. Minimize movement to avoid vertigo, especially when working neck and shoulder points.
  • Remember that chemotherapy hits jing (affecting bone marrow, causing hair loss, and in some cases, premature onset of menopause). There’s a subtle art in using shiatsu to minimize pain and nausea during the actual chemotherapy process, as has been discovered by a sensitive shiatsu therapist and AOBTA board member, Wayne Mylin, in the sessions he gives in a Philadelphia cancer clinic.
  • Rebuilding jing and the immune system after chemotherapy is one part of survival. Humor, life goals, a strong support system, a selection of mainstream and alternative therapies, and economic security, can all make the difference between life and death. I’ll expand on that in part two in my next column.

Finally, here are some …

Useful Tips Surrounding the Treatment of Cancer Patients

  1. Encourage patients to spend time empowering themselves by networking and seeking solid information before they rush into decisions about surgery and adjuvant therapies (either mainstream or alternative). Patients often go into a tailspin when they are told they have cancer. Be reassuring and supportive. It’s not helpful to throw “New Age” theories at them about why they got cancer.
  2. Encourage patients’ families and friends to create a support network so practical needs can be spread around the group, such as setting up phone trees, group rides, picking up kids from school, shopping, etc. This helps free time and precious qi for the patient to deal with immediate concerns.
  3. Treat your patients with ABT and meridian stretching, or ABT and needling, as often as you can before surgery. You can help enhance qi by encouraging them to do some relevant form of exercises the day before surgery. I went rowing on the lake in New York’s Central Park with my loved ones before my mastectomy, to enhance my upper body qi.
  4. Encourage your patients to keep repeating positive imagery of those exercises, and your treatments, in their minds when they are wheeled into the operating room and when they awake from anesthesia. Not only does this reduce pain, but it encourages a good qi flow to help recovery.
  5. Discourage female patients from scheduling surgery during ovulation, when the immune system is low. An epidemiologist at New York’s Memorial Sloan-Kettering Hospital discovered a strong connection between cycles and recovery rates.
  6. Try to arrange to work on your patient a day or so after surgery. Even modest pressure-point work on the hands and feet, or simple, gentle palming down either side of the UB meridian, will help stimulate qi and peristalsis!
  7. Remember that cancer is caused by a variety of factors, including environmental and industrial pollution, pesticides, stress, family genes, smoking, etc,. Survival is equally dependent on a variety of factors, along with great teamwork. Famous cyclist Lance Armstrong had youth and a driving ambition on his side to help him survive and soar through his multiple, record-breaking Tour de France victories.

Busting Taboos About Breast Cancer, Part Two

While planning part two of this series, I heard a clip on ABC-TV about a new study claiming that people who exercise are 35 percent less likely to develop cancer. Those who exercised a lot as teenagers are at an even lower risk of developing breast cancer.

Well, I’m an exception to this “comforting” news! I have always been athletic. As a teenager, I played field hockey for my school and university. I was a fitness “nut” when my cancer was diagnosed. Being fit and a vegetarian may not have prevented my cancer, but they certainly helped my survival!

Somehow, the universe had unusual ways of prepping me for this experience. As a zen shiatsu practitioner, I treated several cancer patients before my own cancer diagnosis. I learned about the valuable role played by the Stomach and Pericardium meridians in the “scaffolding” of the breast, and in helping ease pain postmastectomy. I learned the value of treating and stretching the lower extremities to help ease the discomfort of patients who couldn’t be touched around the torso or arms in the days immediately following surgery. I learned the value of teaching slow qi movements to patients to help stimulate circulation and qi flow postanaesthesia, and to prevent lymphedema. I learned the value of treating the hara and back shu points to stimulate peristalsis. Moreover, I gained great respect for the effectiveness of simple qigong techniques to help harmonize qi fragmented by surgery or organ removal.

I also learned the value of working subtle points on the hands and feet of a terminally ill breast cancer patient hooked up to assorted machines in the hospice at Cabrini Hospital in New York City. I learned the value of talking her through her interpretation of death to help ease her passage according to her belief system. During those last few days, we were able to connect on levels she had been unable to achieve with close family members. I was the outsider, the one without baggage. In the hours when she drifted in and out of consciousness, I placed a single red rose in a vase opposite her bed in direct view, to give beauty to those brief moments when she opened her eyes. I also connected with an amazing hospice nun, Sister Loretta, who used to dress up as a clown at night and drift between the beds to chat to patients with insomnia.

Some five years later, I’d had my mastectomy in that same hospital. During that same week, a close friend of mine died of metastatic breast cancer in another part of the city. During the previous year, I learned the value of giving her subtle shiatsu and qi focus to ease pain in her legs by minimizing touch after the cancer metastasized to her bones.

Roll the clock back even further to my years as an investigative journalist on Fleet Street in London, England, when I campaigned against the tobacco companies during the days when they denied any link between smoking and lung cancer. My research prompted me to write Dominion, a fictional but realistic view of the cynical ways the industry developed marketing and advertising strategies to beat or flaunt smoking-related diseases or death. My research helped prepare me for the dramatic lung cancer deathbed scene of my uncle, which I described in Dominion. The book also described a court case in which a widow sues the tobacco conglomerate following the smoking-related death of her husband. Before the work was published in the U.S. and Canada several publishers rejected it on the grounds that it was “unbelievable.” Such court cases have become commonplace in the last five years, prompting me to republish the book through iUniverse.

My resulting knowledge of smoking-related diseases helped me develop special shiatsu techniques for a dear friend, “Geo,” who died recently from lung cancer in England. To ease her coughing spasms, I encouraged Geo to sit up while I focused qi on front mu points for the Lung (L 1) when she couldn’t be touched. When Geo welcomed touch, it was helpful to support back shu points UB 13 (Lung) and UB 14 (Pericardium) and front mu for Pericardium (Ren 17) simultaneously. P6 and P 8 helped treat nausea, and helped calm her during coughing fits or anxiety spells. Geo required a minimum of movement, techniques and points. Another patient with a similar prognosis may react very differently. As always, adaptability is the key. Laughter helped her move congestion, except for a moment when she spluttered into her oxygen mask: “Ferguson, forget about cancer. Your jokes are going to kill me!” When side-effects from morphine included constipation, it was helpful to apply subtle shiatsu to Geo’s back, feet and hands (especially LI 4).

Just before I left England, I talked to her palliative physician about acupuncture, to ensure the continuity of my treatments. His minimal needling helped her a great deal. Many palliative physicians in England are trained to integrate specific acupuncture techniques (among other procedures, like compassionate counseling and working within family structures) for the specific purpose of easing pain, discomfort and distress in terminally ill patients, especially those who cannot handle morphine.

I share these assorted experiences with my students as a way of encouraging a holistic, compassionate and practical approach, tuning into the needs of each patient as an individual. I tell them to avoid preconceptions, and certainly to avoid any “recipe” approach. What worked for patient X may be inappropriate for patient Y, even though the prognosis is similar. I (and a number of fellow cancer survivors) find it offensive when we are “lumped” together in sweeping generalities about “treatment procedures for such-and-such cancer patients.” I certainly know that after my experience, I was extremely fussy about who worked on me (whether the care delivered was shiatsu, needling or chiropractic). I avoided any practitioner who spouted assumptions and preconceived ideas about cancer causes or treatments.

Similarly, Wayne Mylin, Dipl. ABT (NCCAOM), CP (AOBTA), a gifted, sensitive shiatsu colleague and fellow AOBTA board member, shared his amazing experiences of working on patients undergoing chemotherapy at Pennsylvania Hospital’s Joan Karnell Outpatient Cancer Center in Philadelphia. The center’s administrators welcomed Wayne into an evolving CAM program, as they knew that the majority of cancer patients sought CAM therapies nationwide. They also knew Wayne based on his 17 years of experience as a psychiatric technician in the psychiatric unit. “I was hired for a three-hour block of time every Wednesday,” Wayne told me. This involved great adaptability, during which time he had to give 35-minute chair shiatsu sessions to five different patients before, during and after chemotherapy. “The challenge was that after completing an assessment (pulse, tongue, clinical intake, etc.), I had to figure out how to give the session within the limitations of the chair.” The most common symptoms he treated included fatigue, body aches, nausea, insomnia, depression, anxiety, flu-like symptoms, anger, frustration and fear. Ever modest about his shiatsu talents, Wayne said, “I have worked with patients where all I could do was lay my hands on their backs with minimal pressure, or work only on their hands, only to find that what I did made a notable – sometimes a dramatic – difference.” His background in psychology has proved invaluable. “During treatments, many patients will start talking, sharing, unloading and expressing,” he said, adding that he is often the only member of the treatment team able to give the patients 35 minutes of undivided attention.

With his group of patients, Wayne found the following techniques and points to be very helpful:

  • back shu points (generally useful for a variety of problems)
  • nausea and vomiting: P 6, H 7, St 36, and general footwork
  • anxiety: P 6, H 7, shen ear point, Du 20 & 24 and sacrum, basically any supportive touch, and footwork
  • depression: support (verbally and physically), back shu point balancing and tonifying
  • vertigo: LI 4 & footwork
  • yin deficiency: St 36
  • rising heat: Liv 2

Wayne added, “It’s necessary for any shiatsu therapists working in this (hospital) setting to be supportive of the Western medical treatment that the patients are receiving. If you are not supportive of chemo or radiation, don’t even think of working in this setting. It is not fair to the patient.”

Wayne’s involvement in a pilot study on the effects of shiatsu on sleep disturbance in chemotherapy patients was discussed at a palliative care conference in Phoenix, Arizona earlier this year. He found the following points effective: all back shu points, St 36, GB 12 & 20, Du 20 & 24, H 7, P 6, and LI 4.

Gabrielle Mathieu, one of my graduates from the Academy of Oriental Medicine in Austin, came to some similar conclusions while writing her mammoth research thesis on shiatsu treatments on cancer patients undergoing chemotherapy (The Benefits of Zen Shiatsu for Cancer Patients, May 2000). Gabrielle wrote: “Shiatsu seems to be effective in reducing fatigue, helping insomnia and achieving relaxation. In selected cases shiatsu helped neuropathy, and abdominal distress.” In her thesis, Gabrielle concluded, “As a generalization-I noted the Liver and Kidney meridians were often involved. Five of my six clients were postmenopausal women. The Kidney energy declines during menopause. I can only speculate that cancer and conventional treatments further weakened it. The Liver is associated with the smooth flow of emotions: Certainly the experience of having cancer would distress even the most calm individual. In Western medicine, of course, the liver and kidney have the burden of clearing the drug metabolites from the body.” Gabrielle’s thesis included her invaluable experiences of working as a cancer information specialist for the American Cancer Society, and her prior background working in hospitals and clinics as a medical technologist.

I include the aforementioned examples from the fresh experiences of Wayne (an accomplished, board-certified shiatsu practitioner) and Gabrielle (now a licensed acupuncturist and certified zen shiatsu practitioner), as both of them had the additional benefit of years of hospital experience. Both believe in integrative medicine. Certainly, I owe my own survival to a skillful blend of Western and Asian medicine, two remarkable Swiss physicians, shiatsu, yoga, cycling, swimming, qigong, acupuncture, a vegetarian diet, humor, five years of mistletoe injections (Iscador), six months of the mildest form of chemotherapy possible (Alkaran), a marvelous partner and support group, and my global teaching practice. All of this was achieved without health insurance! Even when my cancer metastasized, I told God to help me survive, in order to teach my students through this experience to help hundreds of other cancer patients – and to write articles like this.

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