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Breast cancer patients to experiment with imagination

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ANCHORAGE, Alaska -- Mention a clinical trial, and potential wonder drugs often come to mind. But an upcoming Anchorage cancer study will test some different factors in recovery: imagery, art, even storytelling.

Lyn Freeman, who has a doctorate in psychology, is recruiting 45 women -- or men -- who have recently finished treatment for breast cancer. During the next year, she'll offer three eight-week sessions aimed at improving their mental and physical health.

Freeman's study is run through her small Anchorage company, Mind Matters Research, but it's supported by large, nationally recognized cancer organizations. The National Cancer Institute supplied more than $145,000 to fund the study. Freeman will also work with a psychologist from the University of Texas M.D. Anderson Cancer Center in Houston. Anchorage oncologist Mary Stewart will refer interested breast cancer survivors to Freeman's classes.

The National Cancer Institute says complementary therapies like imagery and visualization don't take the place of conventional medicine but add to it by enhancing people's well-being and giving them a sense of control over their health.

Patients spent months fighting breast cancer with chemotherapy, radiation and surgery, Stewart said, after which they are told, "OK, take care of yourselves. Exercise. Eat sensibly."

"I can say 'reduce your stress level' until I'm blue in the face," Stewart said, but she'd rather offer actual tools to help patients do so.

Freeman's study provides those tools. Already dozens of women have contacted her in hope of participating.

Debbie Marquiss of Anchorage is one of them. During the past year, Marquiss went through chemotherapy, then surgery, then back to chemotherapy and radiation to treat her breast cancer.

"When you're diagnosed with cancer, of course you have stress," she said. "And you have stress when you're going through it."

After the fight is over, patients have even more stress as they worry that the cancer will come back.

To help her cope, Marquiss attends a support group for cancer survivors. Freeman recently talked to the group about her study.

Marquiss was immediately interested. She said she believes that the way she thinks affects her physically. She wants to start thinking about wellness, not sickness.

"I'm not sure I'm going to be in the study yet," she said, but "I really want to be."


Freeman's study is called Envision the Rhythms of Life.

Participants will receive a two-month lesson that trains them to use their senses and imagine experiences in hopes of improving their quality of life and physical health, Freeman said.

Eligible participants must have had ductal or lobular breast cancer and be referred by a doctor. They can start the study if they have completed their treatment between six weeks and 12 months before the classes begin. They must be 18 or older and can be of any race.

Participants also must be committed; they must attend all six of the classes taught during the eight-week session.

Freeman will teach participants how to imagine real-life experiences when they felt emotions like appreciation, love and joy. She'll show them how emotions can affect the variability of their heart rate. She'll tell them stories and ask them to create some of their own. They'll also use paint, chalk or even poetry to express themselves artistically.

Work will continue outside of class. Participants will have to practice the imagery techniques for 30 to 60 minutes every day and keep a journal about it.

"The key to all of this is they need to practice it," said Lorenzo Cohen, the M.D. Anderson research psychologist working with Freeman on the study. Cohen has focused on mind-body medicine and cancer for the past decade.

Freeman will use a physical test and a series of questionnaires to measure whether the skills she's teaching improve health.

Participants must complete a saliva test at the beginning, midpoint and end of the eight-week period. Freeman will use this test to examine what she calls the "cortisol rhythm." Levels of the hormone cortisol are typically highest in the morning and drop off throughout the day, Cohen said. Stress, however, can disrupt that rhythm.

Research has shown that increased stress can harm immunity; it's thought to affect healing as well, Cohen said.

Tracking cortisol levels in breast cancer survivors can show whether their hormonal rhythms are becoming healthier while they participate in the imagery study, Freeman said.

Throughout the study, participants will fill out questionnaires to rate their overall physical and emotional health.


Clinical trials occur in phases. Freeman said this study is part of Phase 1. If she gets good results, she plans to move to the next phase and enroll 120 men and women throughout Alaska. She said she'd open the study to participants in remote parts of the state with classes offered through the Internet.

Eventually, Freeman would like to expand the study outside Alaska. Cohen said he hopes to test it at M.D. Anderson, which is ranked one of the nation's leading cancer hospitals.

"We may be the state that develops something unique that can go national, if it all goes well," Freeman said.

c.2005 Anchorage Daily News

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