Bob Underwood, M.D. (Host): Once regarded as a mysterious practice, meditation has gained widespread acceptance and scientific validation. We now know that meditation can be a valuable complementary therapy for cancer patients, providing multiple benefits. Hi, I'm Dr. Bob Underwood and welcome to the Cancerwise Podcast from The University of Texas MD Anderson Cancer Center. I'm really excited about this episode. Our guest today is Senior Mind-Body Intervention Specialist at The University of Texas MD Anderson Cancer Center's Integrative Medicine Center, Smitha Mallaiah. Smitha, thank you for being here with us today and discussing meditation.

Smitha Mallaiah: Thank you, Dr. Underwood. It's my pleasure to be here.

Host: Sure. So, let's start with the basics. What is meditation?

Smitha Mallaiah: Meditation is a practice that involves focusing the mind's attention on a small object, thereby inducing rest or a parasympathetic response at the body level, which in turn creates relaxation and increased awareness of the present moment. It can come in many different forms, and there are different types of meditations that people can try, and sometimes would be mindfulness meditation, breath awareness, mantra or a repetition of a word that people can use and other forms.

Host: So, how does it work?

Smitha Mallaiah: Meditation works by bringing the mind's awareness to a point of focus that the person is focusing on. And when there is this increased attention or focus at the mind level, this can actually create a parasympathetic rest, relaxation response, thereby enhancing the health benefits at the body level.

Host: And so, as we talk about meditation, of course, this being the podcast from MD Anderson Cancer Center, how does meditation help cancer patients specifically?

Smitha Mallaiah: Cancer patients go through a variety of physical and psychological symptoms as they navigate the journey of cancer. And these could be the side effects at the physical level that they're experiencing from the treatment, like radiation, chemotherapy, which can actually bring in anxiety, depression to face the disease, or other symptoms like nausea, pain. And when patients engage in meditative, awareness-based practices, there is evidence to inform that it supports them both psychologically as well as physiologically. And when patients experience enhanced physical mental benefits of the meditation, it improves their overall quality of life, helping them to navigate the disease, face the disease, and also enhanced awareness of the present moment. So, meditation brings in, essentially, benefits at all different levels for patients that may be faced with cancer.

Host: Sure. And so, if a patient is interested, how would they prepare for meditation?

Smitha Mallaiah: Preparing for meditation, there is no one perfect way to do that. Depending on individual's ability, background, exposure, there can be a variety of different meditative practices that one can actually approach. If people have specific background to already having some meditation experience, going through that is great. But some simple tips that can be helpful for patients is start always with short time. So many patients may have this idea of you have to meditate for a certain long amount of duration to actually reap the benefits. I would say however long it takes you to calm your mind, that would be an appropriate dose of meditation they need to start with. In my experience, I've seen even when patients dedicate two, three, five minutes, as little as that, to simply calm, bring the awareness to the present moment, or start focusing on breath, all these are simple ways that they can get started to explore the benefits of meditation in their own journey.

Host: Yeah, absolutely. You know, it's really how long does it take to calm your mind, and it's not that long, often. So, it's wonderful. You know, as a physician, what I want to know, and I think what a lot of people want to know, is what does the research show about the health benefits of meditation?

Smitha Mallaiah: There is, fortunately, some really wonderful research that is put out on the benefits of meditation, specifically for people with cancer, but also for everybody out there who would like to try meditation.NCCN, National Comprehensive Cancer Care Network, releases guidelines periodically to recommend such practices for patients. And NCCN recommends meditation for a variety of managing cancer symptoms like pain, anxiety, nausea, distress and so many other symptoms that are there. But it is also studied to see if meditation can actually benefit patients with cognitive dysfunction as a result of their cancer treatment side effects. So, these are all few areas that meditation can benefit cancer patients. But most importantly, many times we say this when we look at mind-body research, there are so many benefits that can be that we cannot necessarily quantify to say, “This is where it is benefiting.” So, beyond the symptoms of cancer treatment, meditation helps improve quality of life, building resiliency for the cancer patients.

Host: Yeah. So, it's really an added tool in the cancer patient's toolbox. I think it really is just a benefit.

Smitha Mallaiah: Absolutely. And there are so many tools that patients can develop. And most patients who use meditation come back to say they feel empowered because they have something with them to use any moment that they need it.

Host: Yeah, absolutely. I agree. And so, when you're first starting to meditate, would you recommend listening to a guided meditation? I mean, how would someone get started?

Smitha Mallaiah: When people are starting to meditate, guided meditation can be a great way to help focus your awareness and attention. Especially if you're new to the practice, you want some kind of guidance, what to be doing, because if you don't have any instruction, your mind may begin to ruminate. And these guided meditations, again, can be short. But as eventually you develop meditative practices and you have a habit of meditation, you can definitely do an independent silent meditation where you are able to guide your mind to a state of meditation, creating that calm, rest, relaxation response on your own. Many patients do benefit from this guided meditations to begin with.

Host: So, with that, would you be so kind as to guide us on a 5- to 7-minute meditation?

Smitha Mallaiah: Absolutely. I invite all of you to come to a comfortable position. Make sure that the space that you are in is safe, comfortable. And I'm going to be assuming that you are sitting for this meditation practice, but you also could be standing or you could be maybe even lying down if you're doing this meditation. So, come to a comfortable position that allows you to rest coming to this present moment. If you're sitting on a chair, try to bring your feet down to the floor and gently press your feet as you develop your awareness to your knees and your thighs. Lengthen your back and neck. Aligning your spine in an open, comfortable posture. Maybe resting your hands on your lap. Relax your shoulders. Relax your face. Relax your jaw. Maybe gently bringing a gentle smile. And if it feels OK, you can close your eyes, bringing your awareness internally. If you prefer to keep them open, look down with a non-focused gaze and relax into the posture. Bring your awareness to your body here and now, noticing any sensations that you may find. You don't have to change them. Simply acknowledge whatever this moment brings up. Gently guide your awareness to your breath. Noticing the inhalation and exhalation. Again, you can simply observe without having to change anything right now. As you continue to arrive to this moment, notice any thoughts, emotions, any feelings on your mind. Completely arriving to this moment at your mind-body breath level. Gently guide your awareness back to the breath. During the practice, if your mind gets distracted with thoughts, sounds, without any judgment, simply bring it back to the practice, to the instruction of my voice and to the breath. Let breath become your anchor. On your next breath, feel the air entering your nostrils. On the next out breath, feel the air exiting gently. If your mind is active, begin to gently engage your mind in the details of your breath. As you inhale, you may notice the air slightly cooler. As you begin to exhale, notice the air may be slightly warmer. Even simply noticing any difference as the air enters and exits. Continue to inhale and exhale. On your next inhalation, follow your breath deep down, beyond your nostrils, feeling the breath in your chest, maybe even in your belly. After a full inhalation, you may notice your breath pause just for a gentle moment and feel the breath return. Your abdomen and chest gently sinking as you exhale out completely. You may continue to notice this gentle rhythmic movement of breath happening on its own. To help you focus further, you can bring nurturing qualities with every inhalation, that in breath bringing more ease, rest, joy. And as you exhale, feel free to let go anything that doesn't help you to be in the present moment. Inhaling as you welcome more strength, more rest. Exhaling, letting go pain, tightness, discomfort. Let this practice be your own. As you inhale, nurture yourself, being in the present moment. As you exhale, let go, creating the sense of lightness and ease within you. As you release things that don't serve you, notice your presence deepening into the moment. You may notice your body achieving a state of deep rest. And take a moment to notice, acknowledge this rest you have created with your own awareness. As you continue the practice, you may notice your mind more settled, more at ease, maybe even more focused. And the rhythmic breath continues on its own, soothing, calming, and grounding you into the present moment. As you have arrived at this state of beautiful, restful awareness, consider staying here a moment without having to change anything, just the way it is, restful. And when you are ready to complete your practice for today, awaken your body with gentle movement. Maybe moving your toes, fingers, still connecting to that rest that you have created. And if it feels comfortable, maybe even gently stretch your arms, move your back, move your toes, and when ready, begin to slowly open your eyes with a few blinks. Thank you for your kind attention. Hope you have a beautiful rest of the day.

Host: Smitha, thanks for being with us today. If you'd like more information, go to MDAnderson.org/Cancerwise to read survivor stories and more insights from our experts.We've reached the end of this episode of the Cancerwise Podcast from The University of Texas MD Anderson Cancer Center. May you carry this sense of peace and calm with you.