San Diego Cancer Research Institute

Contributing Writers

SDCRI will invite people in the Integrative Oncology & Integrative Therapies field to contribute articles for our Education Page. We will have a new informative article for you each month. We are very excited to be able to present these authors to you.

Here are the articles we have to offer today:

Zumba: Gentle Dance Fitness for Cancer Recovery by Alessandra Colfi, posted on April 5th, 2017
Managing Side Effects of Stress, Cancer & Chronic Pain by Kitty Blincoe, posted on March 13th, 2017
The VITA Program by Jennifer Dawes Moore, posted on February 1st, 2017
SDCRI 2016 Yearly Review by Dan Vicario, MD, posted on January 12th, 2017
Hope Made Visible Project Update! by Alessandra Colfi, posted on December 1st, 2016
There is No Magic Pill for Burnout by Jimena Galfaso, MD, posted on November 1st, 2016
What is Yoga Therapy by Monique Lonner, Yoga Therapist, posted on October 2nd, 2016
The Life of a Therapy Dog by Isabella Polley, posted on September 1st, 2016
Fusion of Integrative Methods of Healing by Blanca Noel, posted on August 1st, 2016
Bone Broth by Kim Taylor, DAOM, L.Ac., posted on July 1st, 2016
From Tennis Player to Caregiver by Suzi Martel, posted on June 1st, 2016
Your Complete Guide to Mastering Healthy Eating on a Budget by Chef Jessica Leibovich, posted on April 1st, 2016
Tapas Acupressure Technique by Chris Lewis, PA-C, posted on April 1st, 2016
Cancer Treatment, Cancer Survivors, and Lymphedema: the Truth About Your Risks, by Dana Wylie, posted on March 2nd, 2016
QiGong for Cancer Treatment and Recovery, by Fay McGrew, posted on February 1st, 2016

Contributing Writer’s Archive 2014-2015

Ph.: 858.735.5708

Zumba® is a very popular form of aerobic dance exercise using contemporary music from all over the world with emphasis on Latin, African, Middle-Eastern, Pop, Hip-Hop, and Bollywood. Zumba® is recognized by the American College of Sports Medicine and the Aerobics and Fitness Association of America.

Many beginners and older adults find market-based Zumba® classes intimidating; too fast, too strenuous and too difficult to follow. Specifically, Zumba® dance routines are not suitable for cancer patients and survivors who often experience pain, limited mobility, post-op & recovery issues, fatigue, treatment side effects, self-image issues, weight gain or loss, lack of motivation, and decreased mental and physical energy.

And yet exercise is critical to recovery and prevention: “Based on observational findings physical activity is the lifestyle factor most strongly and consistently associated with both cancer incidence and cancer recurrence.” ~ Robert J. Morgan, MD, FACP – City of Hope, Department of Medical Oncology and Therapeutics Research, Feb 15, 2016.

Since the joy of movement in a group is one of the highlights in Zumba® classes, participants are motivated to exercise playfully. Research shows that movement provides a wide range of benefits: it reduces physical and mental fatigue; increases blood flow and oxygen intake; awakens and enlivens body, mind and spirit; increases range of motion, balance, coordination and focus; facilitates sleep; increases body awareness, and might help individuals affected by depression and isolation – all assisting in lowering risk of recurrence and improving quality of life.

An important consideration goes to our lymphatic system, which needs to be aided through modalities like exercise, dance, massage: “A vital structure to the human body, the lymphatic system is a complex and important part of the immune system that helps maintain fluid balance within our tissues. Acting as a filter, it pushes lymph (fluid that contains white blood cells, oxygen, and other nutrients) throughout the smallest branches of blood vessels and washes the body’s cells. This destroys old or abnormal cells, such as cancer cells, and fights bacteria and infections.” Dana-Farber blog Insight, 2016

Another very important physiological aspect to be considered: studies show that inflammatory response to cancer treatments elevate levels of Cytokines which induce depressive symptoms. The American Cancer Society states that 25% or 1/4 of all cancer patients suffers from depression or distress, which has been found to decrease survival rates. (Candace Pert, PhD)

Studies show that dancing creates new pathways in the brain, improve depression symptoms, elevates mood, and fosters a positive outlook, while lessening the impact of ‘brain fog’ and decreasing risk of developing dementia later in life.
Dancing offers powerful symbolism for coping with the changes that a cancer diagnosis and treatments bring to a person’s life, to family and friends, and impact his or her quality of life – not to mention the beneficial effects of spontaneous laughter shared among your peers!

 Zumba® Flash Mob ‘Uptown Funk’ at Oceanside Pier to celebrate a special birthday.

Why a special exercise class for cancer patients? Typically, participants in any Zumba® class are not given step-by-step instruction: rather they try to copy the instructor’s moves (which is difficult to do in large, crowded classes) and to follow the dance routines in a sort of “sink-or-swim” scenario. This might lead to injuries or it might be discouraging for someone with any kind of limitation. Zumba Gold® classes for older adults use slower-paced music, which doesn’t provide enough energy, engagement and the playful motivation that popular, high-energy dance tunes do.

A 2015 study conducted at the University of California found that while exercise is perceived by many as “boring, stressful, painful, [and] lonely,” Zumba is described as “fun, stress free, holistic, [and] socially supportive.”

Studies on Dance/Movement Therapy (DMT) effects on cancer recovery are still very limited; one recent study published in the Journal of Pain and Symptom Management states:
DMT showed significant effects on buffering the deterioration in perceived stress, pain severity, and pain interference…The DMT program can counter the anticipated worsening of stress and pain in women with breast cancer during radiotherapy.” (Ho RT, Fong TC, Cheung IK, Yip PS, Luk MY, 2016) “…findings reinforced the benefits of DMT while adding the new perspective that delivering DMT intervention throughout cancer treatment can have different and even additional benefits for patients.” (Ho RT, Lo PH, Luk MY, 2016)

Studies show that healthy weight, regular exercise, and less alcohol could cut incidence by one-third. “Exercise needs to be a lifestyle…” (Dana Farber Beyond Cancer Podcast, 2016)

I’ve been using dance/movement therapy with cancer patients and survivors for 5 years, since Expressive Arts Therapy is an integrated multi-arts approach in which all art modalities – dance/movement, visual art, music, writing, sound, and drama – are woven into the exploration and therapeutic process as appropriate to each individual’s situation. “Dance movement therapy (DMT) is premised on an interconnected body and mind. It has known benefits for cancer patients’ physical and psychological health and quality of life.” (Ho RT, Lo PH, Luk MY, 2016)

I design each Zumba® routine with our patients and survivors in mind and often incorporate their suggestions & preferences; simple dance movements to low, medium to high energy music that are conducive respectively to warm-up at the beginning and cool down at the end, balance, flexibility, muscle toning, and to practice focus and coordination through learning simple dance steps, addressing specific areas of the body and abilities – with the brain benefiting as well from focusing and learning new steps; high-energy music has the effect of stimulating participants to move; free-form dancing according to each individual’s preference, cultural background and style is encouraged as well. Zumba® is suitable for beginners at any age and is adapted to each participant’s ability and limitations, even while sitting on a chair.

Here is a link to some of our dance choreographies:

We all know exercise is good for us, but can it be fun too? My name is Joyce, I am a cancer survivor and volunteer for NCCF. I have two left feet and coordination is not my strong suit. Never, never, never thought I’d find myself in a Zumba class but at the urging of others there I was last week @ Frog’s … in Zumba … right where I didn’t want to be. An hour later with a huge smile on my face, heart pumping, feet tapping, and endorphins at an all time high, I answered my own question, “Yes, most definitely exercise can be fun too!
So, if you are looking to move your body, increase your heart rate and smile for an entire hour, you’ll be at Alessandra’s Zumba class this week! ~ Joyce, Encinitas, CA

You want a fabulous instructor, great cardio, stamina builder, mood enhancer, and laughter? Alessandra’s Zumba class is where you go! ~ D.S., Encinitas, CA

I think the Zumba is so good for so many reasons! Just when I thought I had body awareness, this brings such a new challenge! The incorporation of so much right/brain left/brain movements is so great for the nerve myelination and the movement and shaking of the lymph is so valuable. Thank you for bringing it to us!!
~ Justine Shelton, E-RYT 500
AVI Certified Viniyoga Therapist
Co-Director, Yoga Vista Academy

You are a dynamite instructor, Alessandra.
We are ALL blessed to have you helping us attain physical and mental strengths.
Thank you ever so much. ~ C. M., Encinitas, CA

Thank you for today’s Zumba. It was not only fun but really good for me! ~ J.L., Vista, CA

How can you not smile after a class like that?! Thank you! ~ D.P., Carlsbad, CA

How can you possibly know just how much your dance & exercise class has changed my life?…All I can tell you is that your energy, your dancing joy, your music and your radiance has a been a gift to me. I feel like a different woman. My health is better now that it has been in decades. Thank you so much for opening your heart, sharing your gifts and your passions. You are an angel to me (and to others), and I am forever grateful and charmed by your magic
~ C.A., Encinitas

Our late Deb Snyder, visionary founder of North County Cancer Fitness with our great Zumba® group at Fitness Evolution, Encinitas.

Alessandra Colfi, PhD, ZIN®, Expressive Arts Therapist, Certified Zumba® Instructor, has been leading Dance/Movement Therapy sessions and Zumba® classes for cancer patients, survivors and caregivers through San Diego Cancer Research Institute at Yoga Vista and Fitness Evolution in Encinitas. Since SDCRI ended services to patients as of December 2014, she is offering weekly Zumba® classes through Yoga Branch Vista Village in Vista, North County Cancer Fitness at Fitness Evolution in Encinitas, and UC San Diego Moores Cancer Center.
She attended Master Classes with Dance/Movement Therapist Daria Halprin as well as Certified Zumba® Instructors. JourneyDance, Neuro-Muscular Integration Activity or NIA, 5Rythm and dancing regularly with a Cuban Salsa dance group make her embrace exercise/movement that is fun and encouraging as part of healthy lifestyle and one of the keys to self-care and social connections. Offering a modified version of Zumba® to encourage individuals affected by cancer to enjoy moving and reconnecting with their bodies, and to benefit from exercising in safety and with a group of peers is the highlight of her service.
More about Alessandra

A special note of gratitude to Sherry Zak-Morris owner of Yoga Vista until 2016, and Fitness Evolution Encinitas, for gifting the space to hold free classes for cancer recovery to the community.

Zumba® Classes:
UC San Diego Moores Cancer Center monthly calendar – free Zumba class on Wednesdays:

North County Cancer Fitness: Zumba on Wednesdays. Fill out intake form to register before any class – free.

Yoga Branch Vista Village: drop-in Friday or Sunday Zumba® class $ 5.

Exercise and Cancer. Dana Farber Beyond Cancer Podcast, 2016

A Good Time to Dance? A Mixed-Methods Approach of the Effects of Dance Movement Therapy for Breast Cancer Patients During and After Radiotherapy. US National Library of Medicine @ NIH –

Exercise to prevent depression. Dr. Andrew Weil, Weekly Bulletin.

Exercise Shows Benefits for Metastatic Colorectal Cancer Patients, Dana-Farber blog, Insight, 2017

Study Confirms Dance Fitness Improves Quality of Life. Zumba® Zlife®, 2016

Research shows that women view Zumba workouts as better than exercise. Medical Express, 2015

Can ‘Prehabilitation’ Benefit Cancer Patients? Dana Farber, 2017

Back to the top.


Managing Side Effects of Stress, Cancer & Chronic Pain With the Innovative Mindful Yoga Works Program

By Kitty Blincoe

When diagnosed with cancer life is never the same for the person who is diagnosed, nor for the people around them. Cancer experts agree a cancer diagnosis effects people differently than other disease diagnosis. Post diagnosis, cancer patients must learn to cope with emotional distress, solve cancer-related problems, and gain control over cancer-related life events. Moments of crisis and challenge can include hearing the diagnosis, receiving treatment, completing treatment, hearing that the cancer is in remission, hearing that the cancer has come back, dealing with medical bills, and becoming a cancer survivor. “The National Coalition for Cancer Survivorship (NCCS) pioneered the definition of survivor as being any person diagnosed with cancer, from the time of initial diagnosis until his or her death.” Managing the side effects of stress, cancer and chronic pain is a key mission for the survivor, as well as care givers, in order to find their “new normal” as quickly as possible so they may stay involved in activities and responsibilities that are meaningful and important to them and which affect their overall quality of life. Mindful Yoga Works combines yoga, meditation and group discussion and is an innovative, evidenced-based program developed at Duke University Medical Center for anyone wanting to learn useful tools for coping with stress amidst daily life.

As reported on CNN, USA Today and Business Week, the Mindful Yoga Works (formerly “Yoga of Awareness”) course has been through five clinical trials to date and participants in the program experienced a decrease in pain, improved sleep, vigor and relaxation. These five research studies have demonstrated important benefits of Mindful Yoga in medical populations in the form of an 8-week course “Yoga of Awareness”. The first two studies involved breast cancer patients at Duke University Medical Center, and three more recent trials focused on fibromyalgia patients at Oregon Health & Science University.

Mindful Yoga Works is a pioneering program focused on the journey of how we live with stress – from noticing how it physiologically impacts our body, our mind and even those around us, to learning to skillfully work through it. This course conveys essential elements of the ancient tradition of yoga – including meditation, breath work, postures, self-study and group sharing – in a context that is informed by modern, evidence-based medicine. The result is a powerful and transformative healing experience for an individual that reflects both the heart of yoga and the understanding of integrative medicine. Mindful Yoga Works has been shown in research studies at Duke Medical Center to help cancer patients at early stages as well as advanced stages of the cancer experience.

Clinical trials of this program demonstrated in the participant:
• significant decreases in pain, fatigue, insomnia, negative mood and hot flashes
• as well as increases in vigor, acceptance and relaxation
Important topics such as mind/body stress reactivity, and the value of awareness and skillful action in the midst of one’s daily life are covered. During the course participants are encouraged to practice yoga at home guided by audio and video recordings and illustrated handouts. Mindful Yoga Works is appropriate for anyone who is mobile and who wants to learn tools for coping with stress amidst daily life – whether managing chronic pain, “Type A personality”, sleep apnea, insomnia, illness such as cancer or fibromyalgia, or any other possible life challenge that may be difficult to accept and embrace.

Mindful Yoga Works combines yoga, meditation and group discussion; no prior yoga or meditation experience necessary. The founders of Mindful Yoga Works write,

“Yoga, which means “union” (“yoked”) – the union of mind and body in awareness – has been practiced for its mental and physical benefits for thousands of years. Far more than a mere exercise program, true yoga teaches the art of living skillfully, of finding our balance and keeping our poise amidst the tumult of life’s ever-changing challenges.
Living skillfully in this way depends on mindful awareness. Mindfulness is the key to doing anything well in life, whether it be working, playing, talking, or eating.
In Mindful Yoga we learn to connect more fully with our inner resources – our deep down goodness and wholeness – as well as our daily life circumstances, so that we can experience greater well being and less suffering.
As a complement to ongoing medical treatments, Mindful Yoga may help with a variety of symptoms by promoting a sense of soothing bodily relaxation, refreshed vitality, and a greater ability to tolerate symptoms. For people who are feeling well physically but otherwise facing challenges, Mindful Yoga can assist in relieving general stress, and for dealing with issues such as how to maintain healthy relationships
This course incorporates experience gained by teachers with extensive training in traditional schools of yoga. Each class includes instruction and practice of:

▪ gentle physical stretching exercises
▪ meditation techniques
▪ breathing exercises
Teachers adapt the yoga exercises and instructions during the course to individual needs and limitations.

In order to be a certified Mindful Yoga Works teacher, one must attend the training which is intermittently offered at Duke Integrative Medicine Center and Oregon Health & Science University. The Mindful Yoga Works teacher training explores:
Evidence-based modules for cancer-related symptoms
• Tailoring asana and pranayama to specific symptoms
• Principles of Mindful Yoga
• Contexting yogic principles for people from various faith traditions
• Effective and clear ways of presenting models of stress
• Appropriate guidance for working with the mind
• Partnering with the medical community
• Group facilitation skills
Additionally, the founders write “For this course to have meaning and vitality, the leaders delivering it must do their best to embody the practice of Mindful Yoga in their daily lives. This will allow for them to lead from their personal experience and wisdom, rather than in a cookbook fashion. A person may be certified as a Mindful Yoga teacher if she or he: (a) has an established meditation practice, as defined by Criterion 1 – Meditation Practicum; (b) has demonstrable group facilitation skills and experience, including (but not limited to) completion of Criterion 2 – Presentation Skills Practicum; (c) is a registered hatha yoga teacher with ample experience working with special populations, as defined by Criteria 3-4 – Registered Yoga Teacher who has experience teaching yoga postures including specialized populations; and (d) Mindful Yoga Teacher Training Level 1 (formerly Yoga of Awareness Teacher Training Level I) course, and in most cases a Mindful Yoga Teacher Training Level 2 course; and (e) after fulfilling all the above requirements, has offered an initial Mindful Yoga course free-of-charge to a group of individuals, and recordings of the course sessions have been reviewed by Jim and/or Kimberly Carson. The Mindful Yoga course must be based on the 8-session Yoga of Awareness Program.”

The 8-week mind/body program was developed by Jim Carson, PhD and Kimberly Carson, MPH, ERYT at Duke University Medical Center. Here in San Diego, the Mindful Yoga Works course is led by Kitty Blincoe. Kitty Blincoe is currently the only certified Mindful Yoga Works teacher in Southern California, one of eight certified Mindful Yoga Works teachers nationwide and is the founder of Sanctuary Z – a recently opened private and semi private sleep, stretch and stress management treatment space near Carlsbad Village.

About Kitty

Back to the top.


The VITA Program

By Jennifer Dawes Moore

It is tax time, not a favorite thing for most people, except those geeks that love to prepare them. I am defiantly one of those geeks. Last year I had the enjoyable experience of working with the Encinitas Community Resource Center (CRC) to prepare taxes for free. Why would they do that? Well the CRC is one of thousands of sites across the country that do this every year. This IRS sponsored program called VITA (Volunteer Income Tax Assistance) prepared more than 3.7 million returns at nearly 12,000 sites last year, and all free of charge.

This program is set up to assist low to moderate-income families and individuals. All Volunteers receive training and pass an IRS certification test. Some volunteers are accounting students or retired tax preparer and some are just people looking for another way to help their communities. Most volunteer return year after year, like me!

Who is eligible to get tax assistance? Anyone with low to moderate income who did not have rental income from properties you own, did not file for bankruptcy last year, and did not have self-employment expenses above $10,000.

Where can you find a VITA site? The Community Resources Center has appointments at its main office 650 Second St, Encinitas on Wednesday from 1-6 and Saturday from 9-5. They also offer preparation at sites in Oceanside, Vista and San Marcos though out the week. Appointments can be made by calling the CRC at 760-753-8300, calling 211 or online at

What to bring with you to the appointment.
• Photo ID for you and your spouse
• Social security card or ITIN for you and any dependents
• Income documents (W2 or 1099)
• Bank Account information for direct deposit (voided check)
• School tuition or student loan interest statements
• Mortgage interest statements
• Dependent care

And what if you are a tax geek like me, and would like to help out. I would love to hear from you. You can serve in a variety of roles, greeters, translators and tax preparers. No experience is needed, you will receive free training and materials.
For more information or question about filing or volunteering email

Back to the top.


SDCRI Review 2016

By Dan Vicario, M.D.


As a medical oncologist, I’ve had the privilege of working with a large number of cancer patients since 1987. I’ve been on an inspirational journey where I’ve learned so much from my patients and their loved ones that I feel the need to share some of that knowledge from now on. Having been medical director of two cancer centers for almost two decades and being part of a community that created an integrative oncology program back in 1995, I am now able to take some time off to reflect on the many things I’ve learned. This learning came from many teachers: cancer patients and their caregivers, nurses, colleagues, cancer center staff and practitioners of the many different healing arts.

Our San Diego Cancer Research Institute (SDCRI) is a nonprofit organization created in the year 2000 with two divisions: Genomic Oncology, directed by my business partner and dear friend Dr. Mark J. Adler, and Integrative Oncology which will be discussed here.
The integrative program started offering free complementary services in 1995 at the San Diego Cancer Center thanks to the generosity of several successful practitioners of the different healing arts who offered their time and skills as volunteers servicing the community of cancer patients. This program started at the San Diego Cancer Center in Vista and Encinitas with the intention of offering cancer patients the option of experiencing complementary healing modalities that were proven to improve their quality of life. It was open to all cancer patients in the San Diego community. This program was extremely successful, offering services to over 150 cancer patients every month with an average of 100 visits per week. At one point there were 50 active volunteers enrolled in the program. During its last ten years, the program’s coordinator was Mary Hollander, RN. Without Mary’s support and guidance we could not have reached everything the program was able to accomplish. Unfortunately, for the several reasons mentioned in previous news articles on this web site, the SDCRI’s free integrative services facility in Encinitas had to close in December 2014.

The good news is that the San Diego Cancer Research Institute remains active in its mission of education, collaboration and research. Since the closing of the free integrative services facility in Encinitas, SDCRI has continued its education and research collaborative efforts with several other institutions and has remained an active web-based resource. The Integrative program team will continue to update the webpage with news, Integrative and Genomic Research updates, Nutrition and Oncology updates, Dr. Paul Brenner’s videos, the latest info on the Hope Made Visible Project directed by Dr. Alessandra Colfi, educational programs and more. Mary Hollander and Juli Shelton continue to help with SDCRI’s Integrative program and update the website on a regular basis. SDCRI will continue to expand in 2017, continuing its online nutrition program: Reality Based Nutrition by Mary Hollander RN, Dr. Paul Brenner’s Blog, SDCRI’s integrative oncology projects, collaborative research and educational videos.

SDCRI’s Integrative Oncology program continues to collaborate in various broad based Integrative Research projects. We are working to continue to expand research on the importance of embracing proven integrative healing modalities to support cancer patients. Research projects include the fields of nutrition, exercise, yoga, mind body practices, massage, psychoneuroimmunology, acupuncture, bio-field therapies, art therapy, aromatherapy, and others.

We also have the pleasure of collaborating with practitioners, professionals and researchers in naturopathic medicine, homeopathic medicine, and ancient healing traditions like Ayurveda, Chinese medicine, and Indigenous medicine.

Current SDCRI’s collaborations include:

-U.C. San Diego Cancer Services Encinitas and Vista
-UCSD Center for Integrative Medicine (CIM):
-UCSD Center of Excellence for Research and Training in Integrative Health (CERTIH)
-Chopra Center and Chopra Foundation:
-Consciousness and Healing Initiative (CHI):
-Guarneri Integrative Health:
-Miraglo Foundation:
-Scripps Center for Integrative Medicine
-University of California, Los Angeles (UCLA)
-University of California, San Francisco (UCSF)
-Institute Of Noetic Sciences (IONS):
-Resolution Care: Dr. Michael Fratkin and Team:
-Dr. Bob Uslander:

  • At a recent SDCRI board meeting, the following updates were discussed:
    Research protocol collaboration between SDCRI, UCSD, Chopra Foundation, UCSF: “I-CAN”: Initiative for Cancer Survivorship Approached Naturally. For this research project, patients who are breast cancer survivors will attend the “Perfect Health” healing program at the Chopra Center, La Costa resort. Several markers of healing and quality of life will be measured before and after the 6 day retreat. This research protocol has been approved by the UCSD Investigational Review Board (IRB).
  • The San Diego Cancer Research Institute, Dr. Dan Vicario and SDCRI’s Integrative Program have partnered with the “Consciousness and Healing Initiative (CHI)” to support its purpose, projects, research and service. CHI is an international collaborative accelerator of scientists, health practitioners, innovators, educators, researchers, professionals, artists, individuals and nonprofit institutions who share CHI’s vision. For details on the “Consciousness and Healing Initiative (CHI)” please go to this link:
    At this time, SDCRI offers CHI administrative support and is also its fiscal sponsor until CHI becomes its own separate nonprofit entity.
  • SDCRI continues collaborating with UCSD Center of Excellence for Research and Training in Integrative Health (CERTIH) and Center for Integrative Medicine.
  • Paul Brenner, M.D., Ph.D. continues with his educational videos and working on research in Epigenetics and his “Family Triangles” method.
  • Mary Hollander R.N. continues with her outstanding online nutrition program: “Reality Based Nutrition”, filled with inspiration and wisdom.
  • Alessandra Colfi, Ph.D., continues to expand the International Hope Made Visible™ (HMV) project: creating and sharing artful flags among cancer patients, survivors, families/friends, and caregivers. This project has created over 1,200 flags, from all over the USA, Canada, Colombia, Argentina, Guatemala, Ghana, France, Germany, The Netherlands, Italy, and Australia. These flags have been sent for exhibitions in Europe and throughout our communities for display in several venues. Hope Made Visible™ has also collaborated with Habitat for Humanity’s Veterans Program.
  • The SDCRI Integrative Volunteers will meet again for its annual “SDCRI Integrative Medicine Volunteer Appreciation Dinner”. They will again be thanked and reminded of how grateful SDCRI and the community are for their outstanding care and service. The volunteers continue to express their gratitude for the experience they had working with cancer patients over the last 15 years.
  • Dr. Vicario continues to be a Faculty speaker at the Chopra center educational program “Journey into Healing”, which takes place twice a year.
  • SDCRI has organized collaborative meetings between Dr. Ralph Greenspan, co-creator of the “Brain Initiative”, Dr. Paul Mills from UCSD CERTIH and Dr. Paul Brenner.
  • SDCRI has obtained three trademarks: “San Diego Cancer Research Institute”, “Hope Made Visible” and “The Promise of Research, The Science of Healing”.

The Integrative program volunteers and the San Diego community continued to be an integral part of SDCRI’s growth in 2016. The SDCRI board remains deeply grateful for all this support and looks forward to its continued growth in 2017.

Daniel Vicario, M.D.
December 2016

Back to the top.


Our international, educational initiative started 4 years ago, inspired by the Nepalese and Tibetan flags, which symbolically bring healing blessings across lands, mountains, and reach out to distant communities.


It’s been very inspiring and rewarding to follow the developments of this initiative, with many opportunities to share and build a virtual community based on local and non-local healing, aimed at fostering empathy and resilience among cancer patients.

Local workshops have been periodically offered through our Expressive Arts Therapist Alessandra Colfi and her programs. Sharp Healthcare was one of the first local group to join in. Currently a new series is being offered at UC San Diego Moores Cancer Center, followed by a series at UC San Diego Cancer Center in Encinitas in 2017.

Cancer patients have been engaged in guided relaxation, visualization, hands-on art making processes to create personal flags made mostly with fabric, paint, trims, quotes or personal messages.
Data have been collected in the form of narratives, patients’ feedback, and self-assessment / self-reporting tools, which Alessandra administers as surveys at the beginning and at the end of each 8-week segment for local groups; the principal tool is the Connor-Davidson Resilience Scale of 25 items (CD-RISC), created by Jonathan R. T. Davidson, M.D. and Kathryn M. Connor, M.D of Duke University, to assess depression and distress symptoms, post-traumatic stress disorder (PTSD), and patients’ resilience.
CD-RISC surveys show improvements of 6 to 20 points over 100, showing reduction in various pain and anxiety symptoms, in patients’ confidence in coping with the disease and in managing stress.


Participants’ feedback shows improvements in fostering empathy and their resilience by making and sharing flags. Expressions of patients’ feelings and emotions onto flags become catalysts for symbolic understanding and transformation.




The call to join in and sharing their cancer journeys through art flags has been answered by groups, individuals, and families; for example, MACMA, a Breast Cancer Support Group in Buenos Aires, Argentina, dedicated several sessions to create flags together and sent them all to us.


It was very meaningful and exciting when in February 2015 Alicia Galdeano, who runs MACMA, visited our Hope Made Visible™ exhibition at Front Porch Gallery in Carlsbad.


In Guatemala, Art Therapist Paulina Buonafina engaged patients at INCAN, oncology hospital in Guatemala City, making a long string of flags to add to our collection very early on. This year she embraced Hope Made Visible™ on her own, offering several workshops in the community to create flags; she plans to host a public installation with all the flags in March 2017. Another exciting development to look forward to!


In 2014, San Diego Cancer Research Institute received the invitation to exhibit Hope Made Visible™ and all artwork made by patients, at the Heritage of the Americas Museum, at Cuyamaca College in San Diego. The whole community of patients, families and practitioners came together to celebrate the healing spirit and the dedication of all the artists, and to remember those who live on in our hearts.


City of Hope requested a presentation and a training for some of their Social Workers, Chaplains, and Nurses so that they could engage their patients in creating flags; at the same time, all the flags were featured in the Atrium at the Outpatient Clinic during Spiritual Care Week in October 2014. The impact was so remarkable that City of Hope then requested to keep the flags on display for the whole month.


At the same time, in Germany, Gabriele Heyd combined flag-making workshops with outreach, marketing, and PR to share “Fahnen furs Leben” (Flags for Life) across the Country, exhibiting at a variety of venues, including a Rehab Conference in Karlsruhe in April 2015.



In March 2016 Hope Made Visible™ flags have been displayed at the American Psychosocial Oncology Society Conference – , and featured as an exhibition booth and as research poster. The only art program at the conference!

In July and August 2016, the full display of flags provided a symbolic canopy at Oceanside Public Library, adding another layer of patients’ satisfaction, pride, and feeling connected beyond cancer. It’s been especially meaningful and timely for the library staff who lost 2 of their own members to cancer this year.



Last September Alessandra presented Hope Made Visible™ to medical school students from Dokkyo University (Japan), on a week-long visit at UC San Diego Moores Cancer Center. Together they took the opportunity to learn about mind-body-spirit modalities available to support oncology patients and their families, and to make their own flags to take back to Japan to inspire colleagues and other clinicians to join in the global initiative.

Hope Made Visible™ poster was also entered in a competition at the Academy of Integrative Health & Medicine Conference “People, Planet, Purpose” – – this past October in San Diego. On November 4th, the last day of the conference, Alessandra shared about her Expressive Arts Therapy program including Hope Made Visible™ at the Consciousness and Healing Initiative Summit: The Healing (R)Evolution –

hmv21 Alessandra has just completed a 2-year program at Habitat for Humanity; Hope Made Visible was well received by Veterans experiencing homelessness, addictions, PTSD. “Thank you so much Alessandra! Your work with our veterans has been magnificent and deeply appreciated. “ (Donna Deutchman, CEO, Habitat for Humanity SF/SCV).

The invitation to create and gather flags is always open and encouraged, as well as considerations for exhibitions locally and internationally. More than 1,000 have been collected so far, all unique in their symbolic expressions of hope, healing, challenges, sorrows, joy, and resilience.

Hope Made Visible™ – Part II: Research Studies
The use of Art for healing is well documented and supported by positive impact on the health and quality of life of oncology and other patients. Besides the data already collected, there could be interesting opportunities for further research; studies would be desirable on multiple fronts:
1-Simple, low-cost tests to evaluate distress and anxiety in patients and their caregivers are necessary to identify and implement early intervention. Distress Screening has become mandatory in cancer care since 2015.
Biofeedback screening such as BioWell could be used in a study to identify, monitor, and evaluate patients’ energy, stress, and vitals.

2- Is ‘a sense of coherence’ what makes the difference in boosting patients’ resilience?
Often patients seek complementary modalities on their own and after several months of their initial diagnosis. In an integrated model of care patients can safely access complimentary modalities.
Clinicians often note higher cooperation by patients who are engaged in supportive complementary modalities like Expressive Arts Therapy.
Clinicians often report fewer pain medications prescribed and fewer visits to those same patients, thus reducing costs and increasing capacity.

3- Is art making a catalyst for lower inflammatory response in the body?
The effect of mindfulness on inflammatory health was shown in a study by David Creswell, PhD, published in February this year. This research showed changes in brain circuitry and reduced inflammation after three days of mindfulness training, while three days of relaxation did not have the same effect. Creswell explains the difference in impact between mindfulness meditation and relaxation:
“We show that mindfulness meditation impacts measurable brain circuits more so than helpful relaxation practices, and that these brain circuit changes help us understand how mindfulness meditation improves health. Mindfulness teaches participants how to be more open and attentive to their experiences, even difficult ones. By contrast, relaxation approaches are good in the moment for making the body feel relaxed, but… harder to translate when you’re dealing with difficult stressors in your life. This new work sheds light into what mindfulness training is doing to the brain to produce these inflammatory health benefits.” (Creswell, 2016, Carnegie Mellon University)

About Alessandra Colfi

Follow news about HMV and more on the Expressive ARTS Therapy Facebook page!

Back to the top.

There is No Magic Pill for Burnout

by Jimena Galfaso, MD

Introduction to article:

When this article, There is No Magic Pill for Burnout, was shared with me by Dr. Vicario, I realized how the subject is not unique to just one group. The burnout that Dr. Jimena Galfaso so beautifully describes also effects volunteers, healers, therapists, caregivers & patients.

Read the article to find out how to “make deposits in our wellbeing bank account, nourish our bodies, minds and souls”.

~Mary Hollander

As we all know, there is no magic pill to prevent or treat burnout. If there were, many in the healthcare professions, including most physicians and nurses would be taking them. Unfortunately, the current setup of the medical system leads many practitioners to suffer from burnout for years, which is frequently associated with alcoholism and drug abuse, and can result in them leaving their profession or even committing suicide. We are all aware of this paradox, where we take care of patients’ health, but are not as good at taking care of our own. As a physician myself, I suffered from burnout for many years before I realized there was something I could do about it.

Not only is there no magic pill, but there is no formula either. There are, however, ways to start paying attention to our own health in order to prevent burnout or treat it if we’re already suffering from it. Most practitioners in healthcare are deeply committed to offering high quality service to their patients. Yet we all know that when we’re exhausted, depressed, irritable or numb we cannot provide the best
care to those who we have pledged to serve.

Burnout is caused by an imbalance between what “comes in” and what “goes out”. As healthcare practitioners we give, give and then give some more. Most of us work long hours in environments that are stressful, and where we are faced with others’ suffering almost constantly. Often, our tendency is simply to go numb and keep going, until one day we collapse, or we quit, or our partner leaves us, or we get sick. That is often what it takes for us to start paying attention. But what if we can prevent this from happening and create a practice that is fulfilling, satisfying, meaningful and that makes us feel recharged and enlivened?

I am not going to lie to you: it’s not going to happen overnight. But it can be done, if you are committed to your own wellbeing, and that of those around you. It’s important to remember that burnout not only affects us. It also affects our loved ones, our patients and our colleagues. We’re social animals and we are constantly attuning to each other. Research shows that when two people (or more) are emotionally attuned, they have the similar brain waves in an EEG. So if we’re burned out, we cannot help but pass this on to those around us, like ripples in a pond.

In order to address this imbalance between the “giving and receiving”, we need to look at the different dimensions of our humanity: physical, emotional, mental, spiritual, and social. An important question is: what nourishes us, in each of these dimensions? We need to fill the “wellbeing bank account” before we keep withdrawing funds, and most of us have been in red for quite a while already.

What nourishes you at the physical level? What foods, what kind of exercise? Do you get enough touch and physical contact? Do you get enough sleep? Enough rest during the day? What are your recharging and restoring routines?

At the emotional level: are you in touch with your emotions? Do you know how to process them so they can move through your system and not get stuck so that you have to numb yourself or repress them in order to function? Emotions are powerful information about what is happening and they are crucial when it comes to making decisions. Instead of fearing “being emotional”, we can learn to feel our emotions without allowing them to control us. They allow us to be more connected with ourselves and with others, to create more meaningful relationships – with loved ones, colleagues and patients, which in turn nourishes us and recharges us.

At the mental level, are you having significant and meaningful conversations, so that you feel inspired and are open to learning? Do you take the time to read what interests you?

Do you have relationships that nourish your heart and soul? Do you have a support system that you can rely on when you need it? Do you make time to spend with your loved ones and to make meaningful connections? Do you have the skills and tools to manage the relationships that are challenging?

Do you have a spiritual connection or practice that nourishes your soul? Do you feel aligned with a higher purpose, call it God, Mystery, Universe, or whatever you like to call It? Do you feel held by the unknowable, or do you feel alone and isolated, wondering what this is all about?

These are some of the questions that we can consider, to start making deposits in our wellbeing bank account, nourishing our bodies, minds and souls. It might feel overwhelming to consider all these questions at once. My invitation is to pick one or two, and start taking baby steps in the right direction. One of my favorite practices that has helped me tremendously in my own healing process is appreciation and gratitude. Research has shown that focusing on gratitude not only increases people’s personal wellbeing but it also improves their health.

Just like when one of your patients has terrible habits, you can’t ask them to change their diet, exercise daily and get a less stressful job all in one month, you probably can’t do that either. But if they were to eat just one more vegetable every day, imagine how different they might feel in 2 months. It might give them the extra energy to walk up their office stairs each morning instead of taking the elevator. After a few months of that, they may even feel up to walking a mile on the weekend. And then their sleep would improve. And then their cortisol levels would drop a bit. And they wouldn’t crave as much sugar. Imagine how this might continue to unfold over 12 months… and the only thing they needed to think about was adding one vegetable per day.

Similarly, what (seemingly small) action step can you take today? Maybe adding that extra vegetable, or going to bed 15 minutes earlier, instead of checking your email or Facebook right before you go to bed. Or maybe you can take a few minutes each night to think what you feel grateful for. Or tell your partner, child, colleague or friend something you appreciate about them. Again, start small. Start with changing one habit at a time, and allow that to build over time. After a while, it gets easier.

When we sacrifice our health for our calling, everyone loses. The best way to help others is to help yourself first, so that you can keep serving in a way that is sustainable and even joyful. Everyone that you touch will benefit from your investment.

About Jimena

Back to the top.

What is Yoga Therapy
and 3 important ways it helps cancer patients heal.

By Monique Lonner, Yoga Therapist

Yoga Therapy is a 4,000 year old complimentary healing modality that uses gentle body movement, breathing techniques and progressive relaxation practices to bring all the body systems into a synchronistic bio-rhythm that has been proven to engender healing.

Science has recently taken a good hard look at the healing properties of yoga in regard to many different conditions. Back pain, anxiety, depression heart disease and cancer are all areas in which therapeutic yoga has been proven to be healing and curative.

In medically published studies cancer patients who participated in therapeutic yoga practice on an on-going basis reported less anxiety and depression, lessened fatigue, improved sleep, improved physical strength, decreased treatment side effects, a favorable immune response, decreased DNA damage at the end of radiotherapy, more favorable post operative outcomes, physical and mental invigoration, empowerment and improved coping skills.

If this kind of complimentary medicine came in a pill form we’d probably line up to take it!

Why is yoga so helpful on the path of cancer recovery? There are a myriad of reasons, some known, some are still not completely understood. Let’s take a look at 3 top reasons why yoga therapy is a wonderful complimentary modality to cancer treatment and recovery.

1. Stress reduction

Stress has been scientifically proven to decrease immunity and increase inflammation.

Immunity cells help control malignant cells as they form in the body. Prolonged stress can diminish the immune system response to cancer cells because when we are stressed our immune system is busy looking outward for the imminent danger – like a tiger – rather than looking inside for a cancer or virus. It’s as if immune system prioritizes to help us escape and recover from the tiger attack first, then tend to the inner terrain second.

In preparation for the tiger attack the body is sending more blood flow to the arms and legs to prepare to run or fight and shunting it off from the organs and other non immediately necessary systems, including hormones, digestion and reproduction.

It also is readying the body with global inflammation which will help to heal cuts and tears should we be bitten and scratched.

This is great – if we’re being attacked by a tiger. But generally our everyday stress has little to do with a life-threatening animal attack. Because many of us are under constant stress this imbalance of our immune, circulatory, digestive, reproductive and hormonal systems has become chronic and can be fertile ground for cancer to form and flourish.

In recent years inflammation has come under medical scrutiny for its unique role in supporting the growth of cancerous tumors. One of the most important things that therapeutic yoga practice offers cancer patients is the “Relaxation Response”. This physiological state of harmony reverses the stress response. It stops the production of hormones and chemicals in the body that produce inflammation, reduces muscular tension and pain levels, returns blood flow to the organs and balances the body systems. Importantly it also bolsters the right kind of immune response helping the body to better fight the cancer cells.

2. Increased circulation

The heart pumps about 2,000 gallons of blood a day through 60,000 miles of blood vessels which weave throughout muscle tissue, organs and bones. The blood is the body’s delivery system of oxygen and nutrients to all the cells. When fatigue makes us more sedentary and the muscles get painful and stiff the tightness can make it harder for the heart to pump blood to all the areas that need nourishment.

The lack of oxygen and nutrients increases the fatigue and pain levels and the body gets even stiffer in a vicious circle.

Therapeutic yoga practice moves every joint with gentle motion. This helps to engender greater blood flow to the bodily tissues which in turn provides greater oxygenation and nourishment to the cells. When the cells are nourished they feel better and heal better. Adding even the gentlest amount of movement, like wiggling fingers and rotating wrists and ankles helps increase circulation.

Movement also provides relief for the heart muscle. Skeletal muscular movement acts as second pump for the circulatory system and takes pressure off the heart; this can reduce the incidence of heart disease and reduce fatigue. When movement is coordinated with breathing, as it is in yoga practice, the body finds a more harmonious bio-rhythm heightening these results.

Both the yogic and Chinese forms for complimentary medicine ascribe to the theory that stuck and stagnant life force in the body (Prana and Qi respectively) can contribute to disease and moving that life force, through yoga, qi gong and acupuncture, can facilitate healing on a very deep and profound level.

3. Lymph drainage

If the circulatory system is the main food delivery system for the cells, the lymphatic system is largely the clean up crew. The body has a large system of lymphatic vessels and lymph nodes. Within the system flows a clear watery fluid called lymph. These are all part of the body’s immune system and play a big role in fighting invaders, filtering out unwanted cells and riding the body of toxins. Since cancer treatment involves ingesting a large amount of necessary toxins a healthy lymphatic system is very beneficial to the healing process.

Unlike the circulatory system the lymphatic system has no pump of its own. Muscular movement is necessary for the movement of the lymph fluid. Stuck lymph fluid means stuck toxins in the body and can create swelling of the lymph nodes and ultimately a condition called lymphodema.

Yoga practice offers specific movements and poses which help move the lymph fluid and support a healthy immune system.

According to yogic philosophy moving toxins out of the body is even more important than bringing nutrients in. The belief is that if the body is filled with toxins then the life force becomes blocked and stagnant allowing disease to ensue. Yoga movements help remove the toxins so the life force can move freely. Then there is room for nutrients to enter and healing can occur.

These are only three of the great benefits that yoga therapy can provide someone going through cancer treatment and recovery. New studies examining how yoga therapy can aid the body in healing and preventing disease are regularly conducted and published.

As a Yoga Therapist I am always encouraged by these new studies but I am never surprised by their positive findings. Yoga wouldn’t have lasted 4,000 years if it didn’t work!

About Monique

Back to the top.

The Life of a Therapy Dog

by Isabella with a little help from my handler mom, Teri


Isabella, in full regalia

I’m Isabella. I am a Love on a Leash therapy dog. My mom says I am love and joy all tangled up on one leash.

Pet therapy is not new, it has been around for quite some time. Even Florence Nightingale wrote about the animal human relationship, and our ability to heal each other. Like you scratch my back and I’ll scratch yours.

It’s a tough job being a therapy dog but someone has to do it.
You would think it would be easy to be cute, to attract attention, to make people smile and feel better. Well, it’s not THAT easy. It was a commitment and challenge that I was up for!


Isabella and her best friend Gracey, a fellow Therapy Dog

We train!
We have to follow some rules!
First we have to be potty trained. Make no mistake, they do not want us marking up the clinic!

Then we go to school. It’s called Canine Good Citizen Training. We learn to SIT, LAY DOWN, SHAKE, STAY–I almost flunked right there. We have to sit and stay for 2 whole minutes, I felt 1 minute 45 seconds was sufficient. We couldn’t even move if there was a lot of commotion, not even to check things out. We had to learn LEAVE IT, just in case there was a pill or something on the floor we may pick up and eat. I’m pretty close to the floor so LEAVE IT was an important command for me to learn.

I had to learn that I couldn’t jump up on you and absolutely no kissing.
What I say, I’m a Frenchie, and they named French kissing after me! How can I earn your love and affection without a kiss?


Gracey shares the love with Isabella

Not only do we have to be well behaved we have to take weekly baths and get shots! That’s tough! We don’t want to bring you any germs that might make you sick.

There is real science that supports the use of therapy dogs like me in the clinical setting. You and I know it’s just more fun hanging out with a dog but now there is scientific proof!

A nurse at the University of Missouri College of Veterinary Medicine heads up the research on Animal and Human interaction, they have found that hanging out with animals can increase one of the humans hormone levels called oxytocin. She says oxytocin is a feel good hormone and when we feel good we are more trusting. 1

I love people and people love me! I love the patients, staff, even the other therapy dogs.

Did you know people who have dogs heal faster? No kidding! There is research that proves that too! Research shows that pet therapy programs help patients heal faster, and decrease anxiety and stress. No surprise to me, remember I’m a therapy dog.

According to NPR, (National Public Radio) If you pet me your blood pressure can go down. I can help you live longer by taking you out for a walk. By just interacting with me, your body heals itself. 2

Researchers have found that patients have reported decreased pain and measured decreased catecholamines which are released during the body’s stress response, along with a increase in the endorphins—that’s the feel good hormones after a visit by a therapy dog. 3

The National Institute of Health has done studies on therapy dogs and their people. We MUST be an important part of the healthcare team if the government is interested in researching things about us.

I can reduce your stress and anxiety and help you never feel alone. 2 You don’t have to limit yourself to visits with me, cats are pretty good too but don’t tell the other dogs I said that. All pets give unconditional love. We love you, you feel better and you get better fast.


Article writing is a tiresome job for Isabella

Now where are the cookies?

1. Pet Therapy: How Animals And Humans Heal Each Other, Email, March 5, 20123:44 AM ET, Heard on Morning Edition, JULIE ROVNER NPR

2. Hajar, R. (2015). Animal-Assisted Therapy. Heart Views : The Official Journal of the Gulf Heart Association, 16(2), 70–71

3. Curr Pain Headache Rep. 2013 Apr;17(4) The science behind animal-assisted therapy. Marcus DA1.

Teri Polley-Michea is a RN/Massage Therapist, Energy worker, a volunteer for Love on a Leash, Girl Friends Care, and North County Cancer Fitness. As a nurse massage therapist she specializes in oncology massage and massage for clients with complicated medical histories. She incorporates Reiki, and Healing touch into her healing sessions. Teri teaches oncology massage and medical massage courses at several local massage schools and privately. Teri has worked with UCSD’s Center for Integrative Medicine as a Massage Therapist, Director of Massage, and Massage Program Manager. Teri is in private practice full time in Carlsbad, Ca. Isabella meets and greets all of her massage clients.
More about Isabella mom, Teri Polley

Back to the top.


by Blanca Noel

As human beings gifted with the powers of assimilation, we travel in and out of dimensions interwoven in a present of activity and stillness, sound and silence, light and darkness, participation and stagnation, desire and indifference, connection and disconnection, ability an inability, joy and sadness, health and unhealthiness, freedom and oppression, relaxation and stress and many more steps in the staircase of life.

Due to natural conflicts and disruptions of daily living, a deterioration in the human alignment begins to take place, causing a variety of malfunctions of the self that will eventually be manifested in a woven web of energetic entanglements, that will create unhealthy situations requiring intervention.

It is precisely at this point, when skilled integrative methods of healing become essential in the process of regeneration or reintegration.

CranioSacral therapy with its subtle management of the spinal fluid, promotes thru the pathways of nerves, vessels, muscles, bones, organs and lymphatic regions a dramatic embodiment of optimum well-being. Forming a bridge of energy between patient/client that clears and cleanses the impurities that have produced cell changes and dysfunctions.

When the use of Semiprecious Healing Stones is added to CST ( CranioSacral Therapy ), the process of well-being moves a step higher, healing stones are the flowers of the center of the earth, that thru millions of years have encapsulated the planetary energy that can be transmitted during a therapeutic procedure.

The special stones are applied in different areas of the body in accordance to the needs of the individual, the stones different vibrational rates and ranges will accelerate the healing process. Not all stones are created equal, some have the ability to heal and others are objects of beauty.

The stone color, size, weight, brilliance, translucency and opaqueness, have much to do in the effectiveness of treatment. The therapist, the stones and the client/patient become interconnected in waves of multidimensional healing.

The birthing places of the stones leave an electromagnetic imprint that ameliorates the physical, mental or emotional difficulties exhibited by the client/patient, such is the value of their proper use, they are perfect gifts from mother nature to alleviate human disorders.

Healing stones are not only place on the individual seeking comfort, but are also placed under the therapy table and in different areas of the therapy room.

Stone essences may also be made to promote further improvement.

Tibetan Healing bowls, bells, gongs, chimes and rain sticks, may be implemented as part of the healing method. As with the stones the bowls can be on or around the person, and may be played to soothe the soul by following the inner dialogue between the client/patient and the therapist.

Flower essence sprays may be used to unify all the techniques used during therapy, they are the dancing drops of joy and peace that wrap the session, allowing the person seeking assistance to go deeper into the dimension of optimum wellness.

Blanca Noel uses all the methods described above, and has been able to make of her practice a daily meditation, she communes with the celestial assistance and flows with the energy that surrounds us all. As an instrument, her hands assist in repairing energetic disruptions in the filaments of the aura. She enters into a silent soul dialogue with her clients, that has allowed her to develop the “Art of Soul Dialoguing”, taught by her in Encinitas and in Colombia.

Blanca’s web site is:

Back to the top.

Bone Broth

by Kim Taylor, DAOM, L.Ac.

Bone broth is by no means a recent trend. It is an ancient super food that is simple, delicious, and effective, and has been a mainstay among traditional cultures worldwide for thousands of years. If you have ever been satisfied by a comforting bowl of chicken soup when you have a cold, then you have already experienced this ancient wisdom. Science and tradition tell us that bone broth is very nourishing, but how nourishing will vary depending on the diet and lifestyle of the animal, how it is processed, and what other vegetables, herbs and spices are added to the broth (Fallon, 2014).

Cooking with bones is akin to cooking with the “roots” of the animal. Bones should be from locally sourced, grass-fed animals, and wild caught fish. Broth is then slow simmered with a touch of apple cider vinegar for many hours to maximize the extraction of amino acids and minerals. Because these parts of the animal often go to waste, this becomes a sustainable practice from an ethical and economical perspective. Bones are often less expensive than muscle and organ meats, and practically any vegetable scraps may be added to the broth for flavor and nutrients (Chen and Mojica, 2016). Medicinal herbs and spices may also be added to target specific health concerns. The savory, umami taste is derived from glutamates released during the simmering process, in similar concentrations to those found in breast milk, making a tasty bone broth the ultimate comfort food (Agostini, et al., 2000 as cited in Chen and Mojica, 2016).

In today’s world of growing epidemics of mental and physical illness, where people are regularly taking antibiotics and other pharmaceutical drugs, and where food is laced with chemicals unrecognizable to our bodies, an increasing number of people have damaged, abnormal gut flora dominated by pathogenic microbes (Boynton and Brackett, 2014). This results in the inability to nourish the body properly, and may produce toxins that absorb into the bloodstream and cause inflammation and disease (Chen and Mojica, 2016). Inflammation is linked to many types of diseases, including cancer, arthritis and other autoimmune conditions. Patients receiving chemotherapy are exceptionally vulnerable to stomach damage and leaky gut issues, loss of appetite and taste. Eating can feel like more of a chore than a pleasure, which may compromise nutrition and quality of life. In addition, with aging and poor health, the body loses some of its ability to repair connective tissue such as bone, tendon, ligament, cartilage, skin, hair and nails.

Bone broth is rich in collagen, cartilage, bone, and marrow, which are the building blocks needed to rebuild and rejuvenate. The highest concentration of iron is found in the marrow, and is responsible for the transport of oxygen and production of red blood cells. Marrow is prized as a sacred, energizing and regenerative food by native cultures around the world, and is the first part to be eaten, instinctively, by animals after a kill (Fallon, 2014). Marrow is the site of hematopoiesis, or the process by which stem cells produce the cellular components of all of the different blood cell types and tissues critical for survival. These include but are not limited to the erythrocytes (red blood cells) for oxygen transport and lymphocytes (white blood cells), including the natural killer (NK) cells, T cells, and B cells needed for a strong immune system. Today’s research on stem cells places marrow at the center of some of the most far reaching work of modern science, as well as to the center of the table in many of today’s fine restaurants. According to Anthony Bourdain, “If God made butter, it would taste exactly like bone marrow.”

Bone broth contains four key amino acids: Glutamine, glycine, proline and alanine. Glutamine is fundamental for rebuilding a gastrointestinal tract damaged by stress or illness. When combined with glycine, the body synthesizes glutathione, which is the body’s primary detoxifying antioxidant, so bone broth not only nourishes, but also detoxifies the body. Glycine facilitates the production of other amino acids involved in many bodily functions, such as building blood, aiding in the production of glucose, enhancing gastric acid secretion, assisting in wound healing, and detoxification of the liver (Chen and Mojica, 2016). Healthy people should not be deficient in glycine, but during stress, illness or exposure to toxins, the body may not synthesize sufficient amounts. Proline and glycine are the building blocks of cartilage and collagen, responsible for healthy joints and skin. Proline is found in virtually all animal and plant proteins, so deficiency should be rare. However individuals not eating enough protein, either from a high carbohydrate, low protein, low fat or vegan diet may be lacking. Common sense tells us that millions of people suffering from stiff joints, skin diseases and other diseases related to cartilage and connective tissue, may not be healthy enough to manufacture sufficient amounts of proline and glycine (Fallon, 2014). Alanine assists in liver function and glucose metabolism. Bone matrix also provides other trace minerals such as boron, phosphorus, calcium and magnesium, necessary for nerve transmission, gland function, and healthy bones and muscles.

The wonderful thing about preparing bone broth is that it leads to so many delicious dishes, and with a bit of practice, anyone can have broth on hand at all times. The goal to making a good broth is to make sure it sets up as a solid gel when you put it in the refrigerator. The gelatin content is what makes the broth the most nutrient dense. For a gelatinous broth, use bones that have plenty of cartilage. Meat contains only about 1% by weight of collagen while bones contain 20% collagen. Pig and chicken skin contain approximately 30% cartilage, and veal knuckles and pig’s feet contain a whopping 40%. This means that for chicken stock, include backs, wings, necks and feet, and for beef stock, use knuckles or tailbones (sold as oxtail) and feet, along with more meaty bones like shanks or ribs (Fallon, 2014). You can easily make chicken or turkey stock by boiling up a left over carcass, then adding in feet, wings or backs to your stock pot to make broth. Broth is traditionally made in a large, stainless steel stock pot and cooked on a gentle simmer, 4-6 hours, (6-10 hours for beef broth) or longer, if desired. Some people advocate cooking broth for a full 24 hours, for maximum extraction of nutrients. People new to broth should use shorter cooking times at first, because some people have a slightly allergic reaction to the higher levels of glutamine found in longer cooked broth. Broth can also be made in a slow cooker, ladling off what you eat each day and replacing with water. Discard bones after 5-7 days.

Basic Chicken Broth Recipe (Fallon, 2014):

1 whole chicken (pasture raised), or 3-4 pounds bony chicken parts such as necks, backs, breastbones,

2 chicken feet or chicken head, or one split pig’s foot (optional)

2 tablespoons apple cider vinegar

4 quarts filtered water, or just enough to cover the bones

2 large onions, coarsely chopped, skin may be left on

2 carrots, coarsely chopped

2 celery sticks

1 bunch parsley sprigs, thyme sprigs and bay leaf, tied together with kitchen string

1 tablespoon whole black peppercorns, crushed

Remove innards for other uses. Place chicken in a large stockpot. Add vinegar and enough filtered water to cover the bones. Let stand for 30-60 minutes. Place over medium heat, uncovered and bring to a simmer. Remove any scum that rises to the top. Add the vegetables and return to a simmer, then lower heat to low. Cook at a simmer with lid off or askew for 4-6 hours, occasionally skimming scum as needed. Check that the water always covers the top of the bones. Remove chicken bones with a slotted spoon and reserve the meat for other dishes. Strain the broth through a mesh strainer into 2 quart Pyrex containers or mason jars. If not using right away, cool to room temperature and freeze. Bone broth can also be purchased in the frozen food section of many markets, such as Jimbo’s and Whole foods, or ordered online and delivered frozen. Broth and bouillon found on supermarket shelves and not frozen contain none of the nutrition of real bone broth, are usually full of sodium and other preservatives, and should be avoided.

Bone broth belongs to the current trend toward sustainable, farm to table, organic cooking and farming, and the traditional foods movement, oftentimes called “the return to grandmother’s kitchen.” This way of eating is based in the foods of gardens and farms, and represents a system of balance, that emphasizes the value of meat, grain, beans, vegetables and fruits. While other diets and eating philosophies restrict animal products, such as vegan and vegetarian diets, or restrict grains and dairy such as the Paleo diet, the traditional foods movement encourages all of these foods as well as the purchase of locally produced meats, milks, cheeses and fats from grass-fed and pasture-raised animals. While the raw foods movement restricts cooked foods, the traditional foods movement embraces them, honoring the place of cooking as one of balance and partnership with raw foods, and fermented foods as well (McGruther, 2014). Bone broth has also gained media attention lately as a sipping broth, for a satisfying coffee alternative. Sipping bars are cropping up around the country and broth is being combined with many different flavor pallets and ingredients for a healthy snack on the go. A cup of broth is packed with essential nutrition, heals the gut, and calms the soul.


1. Fallon, S. (2014). Nourishing broth, an old-fashioned remedy for the modern world. New York, NY. Grand Central Life and Style.

2. McGruther, J. (2014). The nourished kitchen. New York, NY. Ten Speed Press.

3. Chen, T. & Mojica, L. (2016). Bone deep broth: healing recipes with bone broth. New York, NY. Sterling Epicure.

About Kim

Back to the top.

From Tennis Player to Caregiver

by Suzi Martel

The sandwich generation, that’s us; baby boomers who find themselves sandwiched between careers and caring for our parents or other family members who can no longer care for them-selves. Caregiving is a full time job in and of itself; one which we take on with gusto and a full heart.
Taking on the role of caregiver usually means putting your own life aside for a season. Time once spent on the court, is now time spent sitting in doctor’s office waiting rooms, multiple trips to the pharmacy or ER, or learning to cook and shop for specialized meals.

Keep Your Sanity ~ Get Organized

Caregiving also takes an incredible amount of organization and attention to detail, especially if the one you are caring for requires multiple medications and has multiple medical specialists.
In my seven years of caring for my brother, who had up to nine simultaneous medications, some requiring daily dosage changes; four doctors – specialists in their respective fields – visited monthly; regular lab visits; two pieces of medical equipment to maintain; weight, liquid, and sodium intake charts to update daily; weekly reports and daily phone calls to one of his specialists; and a specialized diet to prepare – organization was as important as were his medications.
My saving grace was a 3-ring binder with color coded tabs. Each specialist was assigned a color, which correlated with the color of ink used to document each doctor’s appointment dates and times on my month-at-a-glance calendar – yes the good old hardcopy variety!
Since each doctor was associated with a different medical group, exchanging information from my brother’s appointments with each other didn’t always happen, and having the left hand know what the right hand was doing was essential. Given today’s technology, every doctor’s office receptionist has the ability to print out the doctor’s notes from that visit before you leave the office. Conveniently enough, they also all have 3-hole punches! My notebook was always with me and updated immediately with each doctor’s notes. Not only did this help me keep my brother’s medical issues organized in my overloaded brain, the doctors loved my notebook! I took it to every visit we had with every doctor. The cardiologist always knew what was happening with the pulmonologist and the oncologist, including the individual lab reports each one of them had ordered; which gave them the ability to adjust their recommendations accordingly.
My, not so little, notebook also helped me in other ways. I had a tab for meal plans that kept with-in my brother’s dietary restrictions, and recipes that were nutritious and palatable for everyone. I had a section for contacts that were easy to access in an emergency, people and organizations that offered help when needed, insurance documents, and notes of the nurses and doctors favorite things, said in passing, to reference for gift ideas at Christmas time.

Employing Your Tennis Racquet Bag off the Court

As you can imagine, this was a lot to haul around! Not wanting to carry a very large purse or high school style backpack, it was time for my, very fashionable, tennis racquet bag to come out of the closet. It was perfect, stylish, and held everything I needed while sitting in a waiting room for hours on end. Did I mention it was stylish?
I kept my bag packed and ready to go at a moment’s notice, which made trips to the ER less frantic. Aside from my notebook, I always had new bottles of water, my Kindle, an extra pair of reading glasses, money for parking, my favorite tea bags, some chocolate (always a blessing during long nights in the ER), a sweater and a pair of warm socks – as hospitals are often cold – and an extra house key – don’t ask.

There’s an App for That!

Since the days of caring for my brother I have discovered an app called CareZone Mobile – . Since an android version of the app wasn’t available during the time I cared for my brother I have not used it personally (the app is now available for android and apple products). However it looks like it will store all the information the binder did and then some – and it’s free!
Whether you use the binder system or an app to keep yourself organized, I still recommend having a bag packed with ER trip essentials; just in case.
As caregivers, we may not be serving up victories on the tennis court, but we are serving up a lot of love!

About Suzi:
Suzi Martel is a freelance lifestyle writer who was a caregiver for her brother for over seven years. She has a heart for helping others and has made it her quest to write informative, entertaining copy on a variety of topics.

Back to the top.

Your Complete Guide to Mastering Healthy Eating on a Budget:

by Chef Jessica Leibovich

Many families spend up to half of the money they earn monthly on meals making it one of the largest expenses. It doesn’t have to be, though, there are ways to keep the food costs down and still eat healthy delicious meals. Healthy eating isn’t rocket science, but our stressful and busy lives make convenience items and restaurants seem more appealing than a healthy and budgeted home prepared meal. If you make healthy eating convenient and affordable at the same time, you’ll have no problem switching to better food. It will just become a regular habit.
Healthy doesn’t always mean expensive, but it always means real. Real food is healthy. Eating whole is eating healthy. If it is in a box or a bag, just because it does not have a lot of calories, does not mean it is healthy. Make your own food! Eat fresh, eat whole.
If you are not used to cooking your own food, there will be a bit of an initial investment in stocking the kitchen but you will quickly see it pay off as you eat from home more and more often.
I also strongly suggest you get a good kitchen knife. This will make cooking more enjoyable. You do not need to buy an expensive set. Having just one chef’s knife and a good paring knife, is really all you need.
Here are two great knives that will literally last a lifetime (if you treat them well).
Chef’s Knife:
Paring Knife:

Chef Jessica’s Top Ten Tips to Healthy Eating on a Budget:

  1. Do your own grocery shopping and cooking for as many meals as you can: I recommend all breakfasts (breakfast out is almost never healthy), 5 lunches, and 5 dinners all be made from home. That gives you 4 meals a week to eat out. This is the most I would suggest. To me, this is a lot! Does this sound challenging to you? If so, you are probably spending too much on food and not eating as healthy as you could.
  2. Shop from the circular: Before you even head into the grocery store, you should read the circular or weekly ad and find out which items on sale you would like to buy. You can view it online or grab one in the store before you start to shop. I will often plan my meals from the circular. This alone will save you a ton of money!
  3. Go to more than one store to find the best price: Often different stores have different items on sale. Finding what stores or farmers market vendors have the best prices for your favorite item is the most cost efficient way to shop. Limiting this to two stores will minimize time constraints as running all over town will defeat the purpose. In my community of Carlsbad, I love Sprouts for meat and produce, Costco for a few staples, and Farmer’s markets for additional veggies
  4. Keep a rotation of favorites and plan your meals: Honey Chicken Mondays, Taco Tuesdays, Flank Steak Wednesdays, Dad’s Famous Chicken Sundays, etc. They don’t always have to be on the same day if something is not looking fresh at the store or another item is on sale but having a solid 5-7 meals that everyone loves on a weekly rotation will ensure you have many of the pantry items available which saves time and money. It also is less to think about when answering the big question “What’s for dinner?”.
  5. Shop seasonally: Asparagus is $1.97 a pound in the Spring but $4.99 in the Fall. Often shopping seasonally will naturally happen if you shop from the circular but by shopping in the season you are using nature’s bounty to your advantage.
  6. Be Mindful of your portions: When food goes into the trash that is just like throwing money away. Try shopping more often like two or three times a week, each trip just getting what you need for the next few days. If you have a stocked pantry, you will mostly be filling up on fresh items such as produce, meats, dairy, and nuts. Using smaller plates for meals, especially for dinner will not only help you keep your weight optimal, it will reduce waste of food. Take smaller portions and if you want seconds, go for it, but if not, use the leftovers as the lunch for the next day. This will save you money as well.
  7. Avoid Impulse Buying. The best way to avoid impulse buying is to prepare yourself before you do the grocery shopping. Make a list and stick to it and eat before you go shopping. Try not to shop when you are hungry! If you are in a big chain supermarket, sticking to the ends of the market and staying away from the middle will help with this objective.
  8. Keep an organized fridge and pantry. Leftovers and make ahead meals to freeze are always great, but it totally defeats the purpose if they get lost in the back of the fridge. Label leftovers and keep your fridge organized to help minimize food waste. Go through the fridge weekly and the freezer twice a month to utilize items before they go bad.
  9. Stock your kitchen with a variety of different items to make it easier to pull together meals on the fly. Keeping your kitchen stocked with staples and a variety of items you use every day.

Here is a sample list of some great things to keep on hand. Keep in mind, this is just a short list of suggestions and you can change this and customize it to your family’s preferences.

Staples: pasta, lentils, rice, sweet potatoes, polenta, quinoa, bread, peas, potatoes

Vegetables: tomatoes, cucumbers, green beans, broccoli, corn, fresh spinach, celery, and carrots

Dairy and eggs: cheese in bulk, Greek yogurt, eggs, organic cream and butter

Fruit: apples, bananas, oranges, seasonal fruits such as berries

Pantry: peanut butter, almond butter, tuna, beans, coconut milk, broth, canned tomatoes, tamari, honey and nuts

Meat: Chicken whole or butchered, ground turkey, grass fed ground beef, flank steak, lamb stew

Spices: salt, pepper, paprika, cumin, chili powder, lemon pepper, cinnamon

Cooking: olive oil, garlic, onions, Dijon mustard, Balsamic vinegar, rice wine vinegar, apple cider vinegar, coconut sugar

(All of the food mentioned here also happens to be great for fitness and muscle building, boosting your immune system and aiding in post workout recovery.)

And my final rule for mastering healthy eating on a budget….

10. Grow Your Own Food. It’s cheaper than frozen and it tastes better and you control what chemicals are sprayed. Plant your own trees that grow berries, walnuts & apples. Buy chickens for free eggs & meat. Google Square Foot and Container Gardening for more ideas.

Thanks so much for reading! What is your favorite money saving tip?

About Jessica

Back to the top.

Tapas Acupressure Technique®: Did I just heal that?! Really??

Chris Lewis, P.A.-C.

It is pleasant to think that once the experience of a trauma finally ends for us, our reaction to it also ends. However, past traumas can and do intrude on our current life. For most of us, these intrusions—sometimes referred to as “re-experiencing” a trauma—are inevitable, usually unpleasant and definitely persistent.

Although recurring cycles of re-experiencing may be powerful and painful, they are also the very moments in which we may profoundly shift our lives. In those moments, we may permanently heal cycles of re-experiencing for the last time.


The relief and surprise associated with suddenly healing the pain of traumas, unwanted behaviors and emotions as well as dispelling related symptoms of physical stress are common with the use of Tapas Acupressure Technique® (TAT®). Although the notion seems illogical or even impossible, experiencing a prompt, sustained healing of issues is exactly what we see for many of our patients.

What happens?

How do these transformations occur?

Why are they necessary?

Perhaps to reach the best perspective, it may be useful to begin at the beginning. Although it could happen at any age, let’s say there is a traumatic incident most likely at a young age—something that happens to us or to someone we love and care for, or even to someone we don’t know. Let’s also assume that in the moment of the incident, you become quite clear that you do not want to experience the physical, emotional and mental stress related to this event again—not ever. What can we do?

We may not be aware of it, but we create a response. We do it easily as if it were in our nature to do so. Well, it is in our nature, it is primitive, and we believe in the moment that it contributes to our survival. We are instinctively self-protective and will do our absolute best to create safety or at least the illusion of safety in the moment. Further, in the absence of any truly effective solution, the illusion of safety is one we will allow ourselves to accept. We will go so far as to defend it even if we suspect in some small way that in the end it may not really work to save us.

Are we aware of all this? Do we do any of this consciously? For instance, do we as young children readily respond to trauma logically and with sophisticated coping strategies? That sort of response points to higher levels of consciousness and situational awareness not normally demonstrated in children of younger age. If we are honest with ourselves, we as adults presumably with greater understanding of life’s situations, continue to respond to difficult circumstances in a fairly emotional way and not much beyond that. However, leaving aside the possible lack of specifics and logic in our response to trauma, what we do create is a personal, implicit or non-conscious knowing related to these events. It is a sensible, meaningful, well-defined construct or schema, which is emotional, perceptual, physical and nonverbal yet rarely shows up in our conscious experience; that is we don’t necessarily know we’re doing it. Nonetheless, we have our newly created protective response (or construct) tight in hand and we are prepared.

If a future event comes along that looks anything like the original traumatic event, we have a plan (our implicit personal construct or scheme); a mostly unconscious plan and, again, it is the best plan we could create in the moment of the event. Without realizing it, our plan or construct literally becomes a new reality for us: “Because of what happened, this is my reality now.” etc. We want to believe that if we live life through our new reality it will spare us the particular brand of discomfort we first experienced. In sounds reasonable, but there’s a catch. If we peer behind the curtain of our new protective response we may discover it is not much more than a symptom generator and in this case, it’s not the good kind.

As we’re going through life, things happen that may be similar to the original trauma event and suddenly, we are responding. We are reactivated and our protective construct is in full charge. Painful emotions, body sensations and thoughts are all happening just as before. Consciously or not, we experience the original event in all its glory and are seemingly unable to control what we feel. We begin to take action, say things or perhaps move physically in a way that is consistent with our protective response—run, cower, fight, etc. If anger is involved, we may find ourselves yelling at someone or perhaps simply fuming inside trying to control ourselves. What may appear to others as irrational, out-of-control symptoms are to us sensible, sound, orderly expressions of our existing response or construct—our perceived reality. Do we not believe our actions justified or compellingly necessary while we are in the throes of such an experience? Are we not, once again, doing the best we can for ourselves?

No matter how much we may wish it otherwise, our perceived realities tend to run our lives. A corollary belief is that we can do nothing about relieving the pain they generate with each recollection. They seem permanent. Besides, if we did not take care of ourselves in these situations, what else would we do? Do we return to being unprotected? Not likely. How do we deal with this?

Until you make the unconscious conscious it will direct your life and you will call it fate.
~ C.G. Jung.

Neuroscientists believe that our emotional learnings (e.g., trauma) drive the vast majority of unwanted behaviors, emotions, thoughts and physical symptoms. As many of us concluded through personal experience, they too believed these emotional learnings were permanent. However, in the late 1990’s researchers discovered that the brain provides a key for unlocking this permanence. Knowing the how to use that key makes it is possible for us to discontinue unwanted symptoms and behaviors permanently. That is to say, they are erased—not just changed, but erased, eliminated. The study of TAT and other evidence based energy psychology modalities (e.g. Thought Field Therapy, Emotional Freedom Technique) show that it is possible to activate the ability of the brain to unlock and erase unwanted emotional learnings.

So, in brief, the cycle is this: A negative or trauma event happens; an emotional learning occurs. In response, a protective construct is created that later becomes a generator of symptoms when a perceived set of environmental conditions are present—that is, when we suffer a re-experiencing. By design, this whole apparatus is locked or consolidated in certain parts of our brain and waits. As soon as our construct perceives certain reactivating environmental conditions, it generates a set of symptoms felt to be compellingly necessary. We cease producing these symptoms as soon as there no longer exists any construct of reality in which our symptoms are necessary to have.

In the hands of an experienced practitioner, this cycle may be broken with TAT. During a typical session, the goal might be to resolve a known trauma (perhaps the shock of receiving a diagnosis of cancer), the patient briefly focuses on the manifestation of the trauma, its origins, and the locations in which it has been stored in both the body and mind. Through the TAT process, the tension surrounding the event relaxes and allows energy to move freely through related physical, mental and emotional spaces once again. There is suddenly room around the issue, so to speak, and the part of you that has been dealing with all of this relaxes too. There is sense of relief as the issue moves toward resolution.

In neuroscience research, an issue is resolved or erased with TAT when it has adheres to three well defined criteria. The three criteria must be met for an emotional learning to be verified as erased or resolved:

1. Emotional non-reactivation.

If a set of conditions shows up in our life that would normally trigger our protective construct, we no longer react to it and there is no need to work at keeping ourselves from reacting. Instead, we just don’t react because there simply is no need to react nor is there resistance to reacting. It becomes more passive, an observation, a simple noticing that we didn’t react this time and we did nothing to make sure that happened.

2. Symptom cessation.

The symptom, originally part of the protective construct (symptom generator), simply no longer occurs in the presence of required environmental conditions.

3. Effortless permanence.

Our issue remains resolved with no effort on our part. In fact, the issue becomes historical, a simple uncharged memory of the issue. We remember it, but it there is no compelling need to deal with it.

One question we ask at the beginning remains open: Why is it necessary to do anything about the unwanted issues, the emotional learnings we find in our lives? The simple answer is we do it because they disturb our peace. On a deeper level, they disturb our ability to love.


One of my professors once told us, “We are Divine beings having a human experience.” Looking back on my own life at that moment and reflecting on a few events within it, I wasn’t so sure about the divine part, but I was clearly having a human experience. The scenario above is something we may use as an example of what can disturb our peace and our ability to love, but many things in our daily lives can upset us. Until recently, unwanted responses to those events were believed by science and us to be permanent. I am grateful for this technology and for the opportunity to heal my own barriers.
With Love and Respect,

Chris E. Lewis, PA-C
Senior Physician Assistant
Integrative Oncology
UCSD Cancer Center
Encinitas, CA

For more information about TAT:

To contact Chris Lewis, PA-C for an appointment or for more information about his private practice:

About Chris
Back to the top.

Cancer Treatment, Cancer Survivors, and Lymphedema: the Truth About Your Risks

Dana Wylie, Certified Lymphatic Therapist

These days, when clients come to see me, many are coming in specifically to either reduce the effects of lymphedema or to mitigate their risk of developing lymphedema. Once I leave the office, however, the level of overall awareness in the community of cancer survivors drops dramatically. Outside of my office, roughly 1 in 4 cancer survivors that I talk to who are at risk of developing lymphedema are completely unaware that the condition exists, and that risk will last a lifetime. If I factored in the amount of misinformation that I hear, the numbers grow.

What is Lymphedema?

Lymphedema is a high protein accumulation of fluids in the interstitium (skin) causing swelling (edema). The swelling generally manifests in the limbs, but can occur anywhere in the body including the trunk, breasts, head and neck, or even genitals.

The lymphatic system is responsible for the removal of interstitial fluid from tissues. It also transports infection-fighting white blood cells to and from the lymph nodes. Lymphatic fluid is generally transported out of an area through the network of vessels and ‘cleaned’ by lymph nodes along the way. During surgery and/or radiation, the system becomes damaged. Lymphatic vessels are cut.
Often times, those vessels can re-route themselves but may also become obstructed by scar tissue. Lymph nodes are surgically removed. Radiation can alter the nature of tissue in its field rendering some vessels and/or lymph nodes unable to function properly. Unlike the lymphatic vessels, however, lymph nodes that are removed or irradiated are unable to regenerate.
It is the damage to the lymphatic system that can render an area of the body incapable of fully dealing with infection, trauma, and fluid accumulation in the tissues. Once the high-protein fluid begins accumulating, it attracts more fluid, and the result is lymphedema.

What is My Risk?

Among the possible causes of lymphedema, the number one cause in Western world is cancer treatment. Of those cases of lymphedema, 79% will result from breast cancer treatment, 3% will be from head and neck cancers, and the remaining 18% from treatment of other cancers.

There’s a lot of misinformation circulating out there, and while the numbers may vary between studies and certified lymphatic therapists, the basics remain the same.

You are at risk for developing lymphedema if:

– You have had at least one lymph node removed
– You have had radiation treatment, whether it was internal or external

In the oversimplified version of risk assessment, we may use a standard 4% per lymph node surgically removed as a guideline which is increased significantly with radiation. The truth is more of a matrix.

Risk increases:

– By increasing numbers of lymph nodes removed
– Additionally by radiation treatment

Risk decreases:

– By the amount of time that has elapsed since the time of surgical or radiation intervention.

There is no such thing as ‘zero risk’ with only one or a few lymph nodes removed. I have had clients with one lymph node removed come out of surgery with lymphedema. The risk is simply lower over all.

There also isn’t a magic number of years when the risk is not present. I have met people who developed lymphedema 25 or more years after their cancer treatment. The risk simply decreases gradually over time.

The Good News: Knowledge is Power!

It’s so very important to understand if you are at risk of developing lymphedema so that you can consciously take precautions and do activities that improve the health of your immune system.

– Exercise/Deep breathing: Movement and breath are the ‘pumps’ of our lymphatic system. Regular exercise is key.
– Learn to properly perform Self Manual Lymphatic Drainage: manually guide lymphatic fluid from compromised regions to healthy regions of your lymphatic system
– Get monthly professional manual lymphatic drainage: while it may seem like a luxury, it’s a medical necessity to work with a professional on a regular basis. The quality of what a professional Certified Lymphatic Therapist or Certified Manual Lymphatic Drainage Therapist will do is generally different and much more thorough that what you can perform at home.
– Get compression garments and wear them during activities that can trigger or aggravate lymphedema such as air travel, long car rides where changes in elevation occur, and exercise.
– Avoid extreme hot and cold to the affected area: sun bathing, hot tubs, saunas, heating pads, etc. and frost bite.
– Avoid needle sticks, scratches, cuts, punctures to the affected area(s): these can include blood draws, pet scratches, and gardening injuries (wear gloves!), etc. that cause inflammation or give opportunity for bacteria to enter
– Avoid constriction on the affected areas: blood pressure cuffs, rubber bands, jewelry/watches/clothing that is too tight
– If possible, avoid trauma to the affected area
– Don’t overwork muscles in the affected area: avoid lifting heavy objects to the point of getting sore muscles
– Practice healthy skin care: use hypo-allergenic lotions to keep skin supple and moistened and to avoid cracking or other break down of tissue.
– Report any changes you experience to your health care provider: swelling, heaviness, achiness, and skin sensitivity should be evaluated by a professional

While it sounds like a lot to overcome, it can easily become second nature to take care of your lymphatic system to reduce your risks, and there are professionals and organizations that are around to help. One of my favorite resources is the National Lymphedema Network ( for guidelines, research, and resources of professionals in your community.

About Dana

Back to the top.

Qigong for Cancer Treatment and Recovery

by Fay McGrew, M.A., Certified Qigong Teacher, Q.T.P. (Medical Qigong)

What is QiGong?
Qigong or Chi Kung [pronounced Chee–kong]’ “Qi” means life force or bio-field energy, “gong” means cultivation, practice, effort.

It is based on the ancient Yang Sheng [Nourishing Life] longevity practice that includes meditation, energizing breathing techniques, gentle invigorating movements, nutrition, and sleep patterns all in harmony with the rhythms of nature. When these aspects are integrated it strengthens the core and enhances natural healing abilities for the body, mind and spirit.

Today Qigong is regarded as a branch of Traditional Chinese Medicine, the self-care practice to support acupuncture and other healing modalities.

If you search “Qigong and Cancer” on the internet, the results are overwhelming with numeorus articles and evidence based studies on its benefits.

So, why is Qigong so effective?
It is because the jewel of the practice is how to use your mind to heal through cultivation of life force energy. This is why Dr. Vicario sites Qigong as a vehicle for epigenetics, how to change your DNA and body chemistry to heal from or prevent potential health challenges.
Qi is also strengthened by release of stagnated energy through gentle flowing easy to follow exercises and self massage of key acupuncture points, it’s like acupuncture without needles.

There are many different styles and approaches to Qigong. I learned classical Qigong, movement oriented practice, but fell in love with a modern therapeutic system called Zhineng “Intelligence-Wisdom” Qigong. It was developed in a clinical setting by Dr. Pang Ming, trained in Chinese and Western medicine as well as a Qigong master, proving very successful to the thousands of patients who resided at his Healing Center. I also teach several systems of Women’s Qigong supporting gynecological and breast health. These exercises are not only excellent for recovery but prevention and maintaining optimal women’s health .. see article I wrote Light Connection.

I was honored to teach Qigong at the San Diego Cancer Research Institute for 10 years when we offered those services. As much as the patients enjoyed the movements, they truly appreciated the guided imagery and healing intention portion of the class, and applied these techniques while waiting for an MRI, during chemotherapy treatments, or at home resting.

faye Fay teaching Qigong at the San Diego Cancer Research Institute while patients were receiving IV treatment.

Today I mostly teach active duty servicemen and women recovering from their mental and physical injuries. We ask them to report levels of pain, discomfort, anxiety and depression before and after each Qigong class. Most levels drop with “anxiety” significantly decreasing. There is so much stress in all aspect of one’s life when undergoing treatment for serious conditions, and this stress as Dr. Vicario points out is as damaging as the health challenge itself. Learning how to relax your body and mind builds resiliency which is life saving!

Why haven’t you heard about Qigong before? In the West, Qigong is conflated with Taiji Quan or T’ai Chi Chuan. Even the Western medical research community confuses these modalities as Qigong exercises are used as warm up and cool down during Taiji classes. Both arts share the same premise of how to move the body as a way to enhance energy and remove blockages. However, the specific techniques are different because Tai Chi is a martial art, and Qigong is exclusively for health.

But now you know about Qigong! Want to try it? Its really simple and can be for whatever amount of time you have. The key to get the most benefit from it is to do it everyday.

Qigong Healing Breathing Practice

Sit in a chair with back straight, support your lower back with pillow if needed.
Relax your entire body, especially your shoulders.
You may close your eyes; or keep them open with a soft focus gazing down at a 45 degree angle.
Bring awareness to your breath. Focus on your diaphragm (attached to the bottom of your lungs) moving down as you inhale and up as you exhale. Experience how this deep relaxed breathing is massaging and detoxifying your organs.
Notice how your body is responding, being nurtured by needed oxygen.
Observe how your brain, needing the most oxygen is responding to this deep relaxing breathing.
Feel each inhalation nourishing and healing every cell in your body.
Experience each exhalation releasing all that does not serve your body, mind and spirit.
Continue for as long as you have time for, suggested 15 minutes.
Open your eyes.

Grounding Exercises (modify to your physical ability)

Raise your leg and slowly move it from the knee up and down, then isolate turning ankles 3x in each direction; repeat the same on the other foot.
Slowly bend down from your waist as far as you can, relax your head forward resting on your chest or as close as possible.
Pause and notice how your spine is gently stretching as you relax more.
Slowly raise up opening each vertebrae keeping your chin as close to your chest as possible, the last to come up is your head.
Say or think “All is well, all is well, I am well”.

Where can I find out more about Qigong and find a local teacher?
There are 3 organizations where you can find more information about Qigong and locate certified teachers:
National Qigong Association
Qigong Institute
American Tai Chi Qigong Association

Enjoy your Qigong journey of empowerment, optimum health, healing, and inner peace.

All is well, all is well, you are well.

Sending you loving healing Qi,

About Fay

Back to the top.