Efeitos da meditação prânica sobre o bem-estar físico e emocional e os níveis de melatonina de sobreviventes de câncer de mama

Abstract

Introdução. O câncer, caracteristicamente, afeta todas as dimensões da saúde humana. O crescimento tumoral compromete a saúde física pela dor e pelas diversas disfunções celulares e orgânicas associadas à condição da sobrevivente do câncer de mama, inclusive a alteração do sistema imunitário. Também afeta a saúde mental-emocional, o que se expressa pela ansiedade, depressão e pelas manifestações de tristeza, cansaço, raiva, desesperança, medo, ressentimento, amargura e culpa, que podem também comprometer a saúde interpessoal dos pacientes de câncer, assim como a saúde espiritual de todos envolvidos. Esse comprometimento multidimensional da saúde justifica a adoção de terapias complementares multidimensionais. A meditação desempenha esse papel com excelência. Objetivos. O propósito do presente estudo foi avaliar o efeito da meditação prânica, uma nova modalidade de meditação secular baseada nos antigos ensinamentos védicos sobre a qualidade de vida, a saúde mental e as concentrações de melatonina de sobreviventes de câncer de mama. Metodologia. O delineamento experimental foi o de um estudo prospectivo observacional do tipo antes e depois, que consiste na aplicação de determinados testes em um grupo, em seguida submetê-lo a uma intervenção e, no período pós-intervenção, avaliar as possíveis mudanças ocorridas. Foram incluídas 75 mulheres, que estavam recebendo tratamento convencional para câncer de mama ou sob controle pós-terapia, e que, concordaram em praticar meditação prânica por 20 minutos, de manhã e à noite, após receberem um treinamento formal. A qualidade de vida das participantes foi avaliada pelos questionários EORTC QLQ-C30 e EORTC QLQ-BR23, e os parâmetros de saúde mental investigados pelo Questionário geral de saúde de Goldberg e pelo Inventário de sintomas de stress para adultos de Lipp. As concentrações de melatonina salivar foram determinadas por radioimunoensaio. Resultados. Após oito semanas de prática de meditação prânica, as praticantes apresentaram melhora significativa dos escores de qualidade de vida que incluíam as funções física (p=0,0007), emocional (p=0,002), social (p=0,004) e de melhora das atividades de vida diária (p=0,01), além de melhora do estado global de saúde (p=0,005), fadiga (p<0,0001), dor (p=0,007), constipação (p=0,03), distúrbios do sono (p=0,01), imagem corporal (p=0,01) e dos sintomas associados ao braço xiii (p=0,007) e à mama (p=0,002). Apresentaram também redução dos efeitos colaterais da terapia sistêmica (p=0,02) e do desconforto associado à queda do cabelo (p=0,02). Algumas praticantes apresentaram melhora cognitiva, entretanto esta condição não pode ser comprovada na análise do grupo como um todo. Não foram observadas melhoras nos resultados da função sexual (p=0,83) e perspectivas (p=0,09). A meditação foi associada à melhora dos parâmetros de saúde mental que incluíam o estresse psíquico (p=0,001), ideação de morte (p=0,02), falta de confiança na capacidade de autodesempenho (p=0,001), distúrbios psicossomáticos (p=0,02) e gravidade dos distúrbios mentais (p=0,0003). As praticantes de meditação prânica também apresentaram redução dos sintomas de estresse psíquico nas últimas 24 horas (p=0,02), na última semana (p=0,009) e no último mês (p=0,03), o mesmo acontecendo com o estresse físico, que apresentou redução nas últimas 24 horas (p=0,002), na última semana (p=0,0009) e no último mês (p=0,009). Esses ganhos foram mantidos, observando-se poucas melhoras quando as práticas de meditação foram estendidas de oito para 15 semanas, sugerindo que os efeitos benéficos das práticas já estavam próximos ao máximo na oitava semana. Houve ampla variação nas concentrações de melatonina salivar das praticantes, detectando-se aumento em 27,7% dos casos, ausência de alteração em 63,9% e redução em 13,8%. Conclusões. Nossos resultados mostraram que as sobreviventes de câncer de mama apresentaram benefícios significativos relacionados à sua saúde mental e qualidade de vida, após um curto período de oito semanas de prática de meditação prânica, consistindo de exercícios simples e de fácil aprendizagem. Embora pesquisas adicionais para esclarecer os possíveis efeitos da meditação prânica em pacientes com câncer sejam desejáveis, os benefícios já demonstrados autorizariam sua adoção como uma terapia complementar para pacientes com câncer, já que nenhum efeito colateral indesejável foi constatado. _______________________________________________________________________________________ ABSTRACT

Background. Cancer characteristically affects all dimensions of human health. The tumor growth compromises the physical health by causing pain, and several cellular and organic dysfunctions, including impairment of the immune system. Cancer also affects the mental-emotional health, as manifested by anxiety and depression, and several distressing feelings as sadness, fatigue, anger, hopelessness, fear, resentment, bitterness, and guilt. These feelings, by their turn, may compromise the interpersonal health of cancer patients, as well as their spiritual health. This multidimensional impairment of the health of cancer patients supports the adoption of complementary multidimensional therapies. Meditation plays this role with excellence. Objectives. The purpose of the present investigation was to assess the effect of pranic meditation, a novel method of secular meditation based on the ancient Vedic teachings, on the quality of life, mental health, and melatonin concentrations of breast cancer survivors. Methodology. The experimental design was of a prospective single-arm observational study using before and after measurements. The subjects were 75 women, submitted either to breast cancer therapy or to post-therapy control, who agreed to practice pranic meditation for 20 minutes, twice a day, during eight weeks, after receiving a formal training. The quality of life of the practitioners was assessed by the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires, and the mental health status by the Goldberg’s General Health Questionnaire and by the Lipp’s Stress Symptoms Inventory. Salivary melatonin concentrations were quantified by radioimmunoassay. Results. After eight weeks of pranic meditation practice, the subjects showed a significant improvement of their quality of life scores that included physical (p=0.0007), role (p=0.01), emotional (p=0.002), and social functioning (p=0.004), as well as global health status (p=0.005), fatigue (p<0.0001), pain (p=0.007), sleep disturbances (p=0.01),constipation (p=0.03 body image (p=0.001), arm symptoms (p=0.007) and breast symptoms (p=0.002). They also showed a reduction of the side effects of systemic therapy (p=0.02), and upset by hair loss (p=0.02). Some practitioners showed improvement of their cognitive xv functioning, but this condition could not be demonstrated in the group as a whole. Meditation was associated with improvement of the mental health parameters of the practitioners that included psychic stress (p=0.001), death ideation (p=0.02), performance diffidence (p=0.001), psychosomatic disorders (p=0.02), and severity of mental disorders (p=0.0003). The practitioners of pranic meditation also showed reduction of the symptoms of psychological stress over the last 24 hours (p=0.02), over the last week (p=0.009), and over the last month (p=0.03), as well as of physical stress that was reduced over the last 24 hours (p=0.002), over the last week (p=0.0009), and over the last month (0.009).These gains were maintained, with a little improvement, when meditation practices were extended from eight to fifteen weeks, suggesting that the beneficial effects of the practices had nearly reached their maximum by the 8th week. A wide variation of salivary melatonin concentrations was detected. This pineal hormone was increased in 27.7% of the practitioners, unchanged in 63.9%, and decreased in 13.8%. Conclusions. Our results showed that breast cancer survivors presented significant benefits related to their mental health and quality of life scores, after a short period of practice of pranic meditation, consisting of simple and easy-to-learn exercises. Background. Cancer characteristically affects all dimensions of human health. The tumor growth compromises the physical health by causing pain, and several cellular and organic dysfunctions, including impairment of the immune system. Cancer also affects the mental-emotional health, as manifested by anxiety and depression, and several distressing feelings as sadness, fatigue, anger, hopelessness, fear, resentment, bitterness, and guilt. These feelings, by their turn, may compromise the interpersonal health of cancer patients, as well as their spiritual health. This multidimensional impairment of the health of cancer patients supports the adoption of complementary multidimensional therapies. Meditation plays this role with excellence. Objectives. The purpose of the present investigation was to assess the effect of pranic meditation, a novel method of secular meditation based on the ancient Vedic teachings, on the quality of life, mental health, and melatonin concentrations of breast cancer survivors. Methodology. The experimental design was of a prospective single-arm observational study using before and after measurements. The subjects were 75 women, submitted either to breast cancer therapy or to post-therapy control, who agreed to practice pranic meditation for 20 minutes, twice a day, during eight weeks, after receiving a formal training. The quality of life of the practitioners was assessed by the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires, and the mental health status by the Goldberg’s General Health Questionnaire and by the Lipp’s Stress Symptoms Inventory. Salivary melatonin concentrations were quantified by radioimmunoassay. Results. After eight weeks of pranic meditation practice, the subjects showed a significant improvement of their quality of life scores that included physical (p=0.0007), role (p=0.01), emotional (p=0.002), and social functioning (p=0.004), as well as global health status (p=0.005), fatigue (p<0.0001), pain (p=0.007), sleep disturbances (p=0.01),constipation (p=0.03 body image (p=0.001), arm symptoms (p=0.007) and breast symptoms (p=0.002). They also showed a reduction of the side effects of systemic therapy (p=0.02), and upset by hair loss (p=0.02). Some practitioners showed improvement of their cognitive xv functioning, but this condition could not be demonstrated in the group as a whole. Meditation was associated with improvement of the mental health parameters of the practitioners that included psychic stress (p=0.001), death ideation (p=0.02), performance diffidence (p=0.001), psychosomatic disorders (p=0.02), and severity of mental disorders (p=0.0003). The practitioners of pranic meditation also showed reduction of the symptoms of psychological stress over the last 24 hours (p=0.02), over the last week (p=0.009), and over the last month (p=0.03), as well as of physical stress that was reduced over the last 24 hours (p=0.002), over the last week (p=0.0009), and over the last month (0.009).These gains were maintained, with a little improvement, when meditation practices were extended from eight to fifteen weeks, suggesting that the beneficial effects of the practices had nearly reached their maximum by the 8th week. A wide variation of salivary melatonin concentrations was detected. This pineal hormone was increased in 27.7% of the practitioners, unchanged in 63.9%, and decreased in 13.8%. Conclusions. Our results showed that breast cancer survivors presented significant benefits related to their mental health and quality of life scores, after a short period of practice of pranic meditation, consisting of simple and easy-to-learn exercises. Although a further research to clarify the possible mechanisms of pranic meditation on cancer patients is desirable, the benefits already showed warrant its adoption as an adjunct therapy for cancer patients, since no undesirable side effect was detected.