The Benefits of Humor When Confronted with Cancer

August 2018 Vol 9, No 8
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Editor-in-Chief, JONS; Program Director, AONN+; University Distinguished Service Professor of Breast Cancer, Administrative Director, The Johns Hopkins Breast Center; Director, John Hopkins Cancer Survivorship Programs; Professor of Surgery and Oncology, JHU School of Medicine; Co-Creator, Work Stride-Managing Cancer at Work

Some days it's hard to laugh and easy to cry, especially when confronted with the harsh reality of cancer. But according to Lillie D. Shockney, RN, BS, MAS, ONN-CG, Director of Cancer Survivorship Programs at Johns Hopkins, finding humor in the day-to-day can actually boost the immune system and improve the overall health of patients with cancer.

At the AONN+ Midyear Conference, Ms Shockney told inspiring stories of her own patients who were able to harness the power of laughter and shared how she learned to laugh at something every day after her own cancer diagnoses. She told attendees how to engage their own patients in the use of humor as complementary medicine, and how they can take advantage of the benefits of a genuine "belly laugh."

Research has shown that a robust laugh exercises the muscles of the face, shoulders, diaphragm, abdomen, and sometimes even the arms and legs. Heart rate and blood pressure temporarily rise, breathing becomes deeper, muscles relax, and oxygen surges throughout the bloodstream.

Laughter serves as a distraction while producing endorphins that act as natural painkillers in the body. In a study of 35 patients at a rehabilitation hospital, 74% agreed with the statement that laughing sometimes works as well as a pain pill. The patients surveyed had a range of serious neurological and skeletal muscle disorders, including traumatic brain injury, limb amputations, spinal cord injury, and severe arthritis.

It has long been recognized that stress weakens the immune system, leaving the body more vulnerable to illness. When under stress, the body undergoes a series of hormonal changes that make up the fight-or-flight response. Although there is no actual threat, the body reacts as if there were. But if under that kind of stress day after day, this preparation for a rigorous physical response creates an environment of chronic stress and actually begins to pose a threat to one's health. Some studies have even demonstrated that chronic stress may be a contributor to an eventual diagnosis of cancer. But laughter reduces those stress hormones; 1 minute of anger weakens the immune system for 4 to 5 hours, whereas 1 minute of laughter boosts the immune system for more than 24 hours.

Several studies have shown that watching as little as 30 to 60 minutes of a comedy video is enough to increase saliva and blood levels of immunoglobulin A, the body's first line of defense against upper respiratory infections. Watching 1 hour of a humorous video also increases the number of T cells in the body—the natural killer cells that play a significant role in destroying cancer cells.

"But for many people, the mere fact that you feel better after a good laugh is enough to have affirmation that laughter is good for our health," Ms Shockney said.

Take in regular doses of comedy, she advised. Browse through the humor section of a bookstore or library or make a point of looking at the cartoons in the newspaper (or on an app). Laugh at other people's jokes and get into the habit of listening for unintentional amusing remarks (and write them down).

"Finally, listen for the wonderfully funny things children say. As we grow up, we're taught to be more serious, but children look at the world in a very different way, and we can learn some lessons from them," said Ms Shockney. "And become aware of the sitcom in your own life. Even during moments that we think are anything but funny, there will always be something that we can laugh about."

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The Value of Palliative Care Early in the Treatment Process
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Best Practices in Breast Cancer – October 2018 Vol 9
Palliative care has a serious identity problem. Seventy percent of Americans describe themselves as “not at all knowledgeable” about palliative care, and most healthcare professionals believe it is synonymous with end-of-life care.1 This perception is not far from current medical practice, because specialty palliative care—administered by clinicians with expertise in palliative medicine—is predominantly offered through hospice care or inpatient consultation only after life-prolonging treatment has failed. This means that the majority of patients who could benefit from palliative care are not receiving it until they are very close to death. To ensure that patients with metastatic breast cancer receive the best cancer care throughout their disease trajectory, palliative care should be initiated alongside standard oncology care, and it should be implemented early.
Last modified: October 19, 2018

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