November 29, 2008

‘Humor Therapy’ Offers Benefits For Cancer Patients

Laughter intensified at Montefiore Einstein Cancer Center as the off-color anecdotes bounced around the room, with some reciting jokes from memory while others read from journals. 

The participants were cancer patients, some in advanced stages of the disease, taking part in Montefiore Hospital's monthly "Strength Through Laughter" therapy.  

It is one of several types of "humor therapy" being offered by medical facilities throughout the nation for patients diagnosed with cancer and other chronic diseases. The programs feature things such as joke sessions, funny movies and even clown appearances.

Although it is not yet certain whether laughter plays a role in healing, medical experts say it reduces stress, promotes relaxation, lowers blood pressure, improves breathing and increases muscle function.

Shortly before Halloween, many of Montefiore's two dozen cancer patients arrived in costume to "spook cancer."

"The session makes you feel better," Luz Rodriguez, 57, a breast cancer patient now in remission, told the Associated Press.

"I feel healthy when I laugh," said Rodriguez, who came disguised as a security officer.

The laughs generated a noticeable warmth among the group, particularly when Rodriguez changed into an angel costume and began offering a red rose and a hug or kiss to everyone.

The group's facilitator, senior oncology social worker Gloria Nelson, began the therapy five years ago to help cancer patients focus on living, not dying.

"They have such amazing strength, but it's a constant challenge, the fear of it coming back, how to go on living knowing you have cancer," Nelson, dressed as the mother of the bride, told the Associated Press.

"Every time they laugh, it's like kicking cancer out the door. You're taking control, you're saying it's not controlling me."

Norman Cousins' 1979 book, "Anatomy of an Illness" is perhaps the most famous description of laughter's therapeutic effects on the body.  Cousins claimed that a combination of laughter and vitamins cured him of a potentially lethal illness.

"I made the joyous discovery that 10 minutes of genuine belly laughter had an anesthetic effect," he wrote.

Nevertheless, laughter therapy is not for everyone, and some cancer patients are so distraught with their diagnosis that they can't participate. 

Medical experts emphasize that laughter and other complementary therapies such as massage, acupuncture and meditation are not substitutes for traditional therapy, but can be effective in helping relieve the anxiety that often accompanies the disease.

At the Cancer Treatment Centers of America in Zion, Ill., patients experience a different form of laughter therapy.  In this version, participants greet each other with laughter instead of words and engage in games like a pretend snowball fight until laughter overtakes them.

The staff initially tried the new therapy in 2004. At first, they felt "weird and silly" but once they began working with patients the next day, the laughter soon because contagious, according to Katherine Puckett, a mind-body medicine expert.

The therapy has since become a part of the center's culture, and is also offered at facilities in Seattle, Philadelphia and Tulsa.

Psychologist Steve Wilson, who runs the World Laughter Tour, which trains and certifies laughter club leaders, told the AP that over twenty hospitals throughout the nation have asked to be trained in the method during the past few years.

One hospital wanted to try the therapy with its lung transplant patients, since the laughter allows more oxygen to travel through the body.

The Thomas Jefferson University Hospital in Philadelphia is using "Caring Clowns" program, an international initiative with a similar goal but a different approach.  The program uses costumed volunteers to get patients to laugh, smile and open up.

"One of the challenges of being diagnosed with cancer is preserving your dignity ... when we tell you to put on a gown where the back half is missing and everyone's examining you and asking about bodily functions," Dr. Richard Wender, former president of the American Cancer Society and the hospital's chief of family medicine, told the AP.

The clown volunteers create a environment of comfort that helps close the "interpersonal gap" between patients and staff, he said.

Non-Hodgkin's Lymphoma survivor Robbie Robinson, 52, became a certified laughter leader after seeing first hand the "coping mechanism" laughter provided him as a patient at CTCA.

"Some people came in wheelchairs, some were helped by family and friends. You could tell people were down ... then I noticed that through some stimulated laughter, people started smiling. They forgot their troubles. You could see the pressure come off them," he told the AP.

Meanwhile, the nonprofit Rx Laughter is a unique collaboration between the entertainment and medical fields that focuses on pain management and improving mental health through comic entertainment. 

The organization was established in 1998 by Sherry Dunay Hilber, former director of programming for ABC and CBS, and offers a variety of programs for hospitals, nursing homes, cancer support groups and rehabilitation clinics.

Rx Laughter's participation in two large medical studies found that patients who viewed funny videos during certain painful procedures were more relaxed, and actually tolerated the pain longer.  It also discovered that cancer patients experienced less pain and slept better after such entertainment.

"Comic entertainment is at our fingertips 24/7. ... Watching our favorite shows and films can get us through very stressful times - all the more important in light of the cost of psychotherapy that many people cannot afford, and the problematic side effects of too many pain killers," Hilber told the Associated Press.