Stress affects most people who are diagnosed with colorectal cancer (CRC), and it's important for patients to learn stress-reduction techniques. Learning to manage chronic stress can be extremely helpful in coping with a cancer diagnosis and maintaining a positive outlook.

Living with CRC and going through treatment is not just hard; it’s mentally, physically, and emotionally grueling. Life is stressful and uncertain. How do you cope? Join us as we explore ways to calm and relax your minds and bodies, and share strategies and tips to help you “stay in the moment!” 

In this enlightening webinar, Andrea Lee, RN, discusses stress reduction strategies and awareness techniques to manage stress at all points along the cancer continuum. Patients, survivors, caregivers, and loved ones can all benefit from recommendations and suggestions given during this webinar. 

Read the NEW Q&A with Andrea

Q: What’s new and exciting in the world of mindfulness training and experience?

Q: What virtual resources currently exist for practicing mindfulness at home?

PODCASTS:

Conversations in Supportive Care is a series of discussions with Stanford Health Care experts whose disciplines complement a patient’s cancer treatment.

Going through cancer treatment is full of things outside our control. When attention is focused on things outside our control we often struggle. It can be useful for patients going through this journey to focus on what they can control – their thoughts, actions, attitude, and effort. Resources, such as this podcast, can be helpful tools to anchor a person’s mindset toward thriving in the face of illness.

The Stanford Podcast for Supportive Care is a series that covers all things oncology and wellness.

MINDFULNESS CLASSES:

The Cancer Supportive Care Program is an integral part of the Stanford Cancer Center. This program provides you with emotional, physical, and spiritual support through all stages of cancer survivorship: Living With, Through, and Beyond Cancer. We're here to help you strengthen your body, nurture hope and courage, and enrich your spirit. Our free support groups, classes, workshops, personal one-on-one consultations, and services are open to all cancer patients in the community regardless of where you receive care. Choose the offerings that best meet your needs.

FREE APP FOR MINDFULNESS MEDITATIONS:

I also recommend the UCLA Mindful app, which contains both basic and wellness meditations. Each week, mindfulness teacher Diana Winston leads a mindfulness meditation at the Mindful Awareness Research Center (MARC). Their weekly meditations podcasts are posted free on the app. Due to the pandemic, the MARC’s weekly meditation is also free for people to join virtually. I highly recommend both the app and the weekly podcast meditations. They are a great way to start a personal mindfulness practice.

BOOKS:

Q: How do you recommend people begin a mindfulness routine and stick with it?

One key to sticking with a mindfulness practice is to adopt the attitude of beginning again. It’s impossible to stay in the present moment all of the time. We are made to remember the past and plan for the future. But the moment you realize you are not present, suddenly you are. In that moment of awareness, there is choice; there is agency over the focus of attention. The moment we realize that we are not present, we can choose to begin again; we can choose to be present for the experience we are having in that moment, as it is. We can choose to get curious about what we are experiencing, rather than judging it. ‘Oh, isn’t that interesting?’ ‘I am thinking fearful thoughts and my chest is feeling tight.’…Simply noticing what is happening in the moment is sometimes enough to shift us out of a stress state. Sometimes we need more.

Here are two tips for starting a practice:

Couple habits with mindfulness practice

What is the difference between a ritual and a habit? A ritual is something we intentionally pay attention to – an action infused with intention, with mindfulness. A habit is something we do automatically, without thinking; it’s a mindless action (or a mental habit). In essence, you can make a ritual out of anything simply by intentionally infusing the quality of your attention with principles like openness, curiosity, acceptance, and nonjudgment – simply by being with the experience that you are having, while you are having it, as it is in this moment. And then setting an intention for the quality of your attention.

This could look like:

• Before a meeting or doctor’s appointment. I place my hands on the chair, feel my feet on the floor, and take three deep breaths. On the first breath, I notice what feelings and sensations are present in my body. On the second breath, I become aware of the thoughts or stories present in my mind. On the third breath, I set an intention for how I want to pay attention in that moment (i.e., with compassion, gratitude, curiosity, etc.). Our intention guides our attention. An integrated practice like this can create some space to become aware of what we are carrying around and intentionally choose to shift the focus of attention toward something we truly value and want to create more of.

• Every time I walk into a patient's room I have to first put my hand on the doorknob to open the door. My hand on the doorknob is my cue to pay attention. I take a breath and check in  – ‘How am I feeling?’ ‘What is the quality of my mind (open and receptive, or busy planning and organizing)?’  I take another deep breath, feel my feet on the floor, and set an intention for how I want to focus my attention in that moment (i.e., to be fully present for the individual’s experience I am about to walk into). When I am in the room, I pay close attention to the individual’s experience in front of me, as well as to the feelings and sensations arising in my own field of experience. This all helps me to bring my full presence to my patients and better meet their needs.

•  During transitions we often lose our sense of presence. Getting into a car is a great cue and time to practice mindfulness. Can we turn off the radio, put down the phone, and just breathe? Be in the moment. Be in the body. Notice what is present without judging. Sense the body moving through space as it travels down the road in the car. Just watch the focus of attention as it drifts from one thing to the next with an attitude of curiosity instead of judgment. Be interested in the experience you are having as it unfolds. 

Those are integrated practices that we can do any time throughout our day. Awareness grows stronger each time we notice where the mind has wandered and bring it back to the present moment. A formal seated mindfulness meditation practice is like going to the gym. You go and lift weights, and then it’s easier to notice where the mind drifts to when it wanders. These two types of practices, integrated and formal practice, go together well.

 Start with a short formal practice.

• Set aside a time and space. When we practice in the same place each time, our brain starts to get primed for meditation before we even sit down to practice. Sort of like when you start to salivate at the sight of a hamburger (or veggie burger) – your brain and body know that what is about to happen will be delicious. When we sit in the same place (particularly a calm one, maybe with essential oils or a candle) and practice, our brain starts to recognize and respond to what is about to happen and starts to prime the pump for calm.

• Start with a short guided meditation, like the ones you can find UCLA’s Mindful Awareness Research Center and on the UCLA Mindful Awareness App.

Q: How can a patient's care team support the goals the patient is trying to achieve through mindfulness?

I am working on getting a mindfulness program started on my floor to help providers with stress resiliency and ultimately improve patient care. I feel exposing providers to mindfulness training will make them more likely to refer patients to mindfulness programs and obviously help coach and counsel patients along their journey. Overall people are becoming more sensitive to the impact of mental health on our experience and outcomes. The Stanford Cancer Center recognizes this truth and provides free resources to help patients with this aspect of their journey. I only wish more institutions provided these types of resources.

Q: Are there other self-care strategies you recommend?

• Allow space to feel your feelings, without getting stuck in them. What you can feel you can heal. And ultimately, you can let go of or find a way to move through.
• Breath in nature: trees or beaches. Whatever you can find that helps you feel grounded in this moment is what you should use.
• Embrace the elements: water, a salt bath,fire. Feel the glow of a soft candle in a peaceful space. Feel the calmness in open spaces. Feel the air on your face: Remember that in this moment there is more right with you than wrong with you (otherwise you wouldn’t be here).
• Inhale the oil from an essential oil diffuser. Breathe in the comforting scents of essential oils.
• Enjoy your food.  Nutrition sustains our bodies and souls. Choose your foods carefully and chew your foods slowly and thoughtfully.