Month: June 2018

PART 3 INTERVIEW WITH PAUL ZAK, PHD — MORE ON OXYTOCIN AND HOW IT CAN IMPROVE THE PATIENT EXPERIENCE IN CANCER CARE?

By / November 24, 2020

WHY IS ONLINE SUPPORT CRITICAL TO OUTCOMES.

Question: Therapy is obviously an important component of cancer care. Can CancerLife deliver digital social therapy?

Paul: There are so many types of therapy people can benefit from. It’s imperative to draw on all the social resources around us to support patients, particularly cancer patients.

Social therapy is the new term we are using to describe human connections in cancer care. We know it can have direct impact on cancer outcomes. Cancer patients suffer from depression and anxiety and sometimes family and friends add stress. Connect with other patients going through the fight of their lives brings people closer. Cancer needs to be a team-based experience and we are just now realizing its impact….Doctors can’t provide this ALONE. They need to empower patients with a platform to achieve this.one’s quality of life as well as good outcomes in healthcare, including cancer and other diseases. Most patients receive love and care from family and friends. But patients need even more. They need to connect to other patients and cancer survivors in ways not yet realized.

PART 6: IMPROVED DOCTOR PATIENTS RELATIONSHIPS

Q: What’s the correlation between patient-doctor trust and outcomes? 

Paul: Trust is essential in cancer care. When a patient trusts the clinical team, outcomes improve. At the time of diagnosis there often is a lot emotional bonding, but this tends to diminish over time and the patient-doctor connection can weaken. 

When things go poorly in care, doctor patient trust needs to be reinforced. Doctors need to be aware that this relationship, like any relationship, needs to be developed and nurtured. 

When patients don’t trust their doctors, they experience more stress and may begin to think the doctor doesn’t care about them. We also know that a doctor patient relationship can impact behavior and medical adherence. Why should I do what my doctor says when I don’t trust him/her? In Cancer care this in some case could be life threatening.

When patients feel alone, with their lives at risk the “fight or flight response” kicks in and the stress hormone cortisol spikes that can lead to inflammation and increased tumor growth. Oxytocin is the chemical that directly reduces the stress response and good doctor patient interactions cause the brain to make oxytocin.

 WHAT CAN DOCTORS DO TO IMPROVE DOCTOR-PATIENT RELATIONSHIPS

PAUL: The human connection is part of the healing mission for the clinician. Part of that is training doctors to be empathic. 

  • Patients should not have to wait for an hour in a cold room with a thin little gown. That’s a stressor.
  • Instead of asking “Where does it hurt?, the conversation should focus on “How can I improve your life?” 
  • When a patient is worried, the conversation should focus on resolving worry because it can cascade into stress and inhibit good outcomes because mental anguish and fear are stressors.

Ideally a doctor shakes your hand, looks you in the eye and talks to you like a human being. 

Essentially that’s what is required.  What I’m advocating is that we recognize the value of  human interaction. The interaction with a doctor can be a valuable human interaction. we should embrace that as part of human culture and as part of the healing mission.

WHAT IS THE VISION FOR THE FUTURE?

Can CancerLife improve cancer care and quality of life?

Paul: CancerLife creates an environment for patients to connect to each other in a very intimate, trustworthy environment. When patients and survivors feel secure, they open up and they can connect to others in real time, all the time—even in the middle of the night.

Embracing our human social nature and facilitating a connection means that cancer patients gain those benefits. Once the brain is open to this deep sense of connection, it stays open. Whether you beat cancer of cancer beats you, in either case embracing the value of human connection can improve the quality and potentially the length of life. Connection is essential to our lives. And if it’s essential, let’s get more of it

WHAT CAN PATIENTS & SURVIVORS DO TO IMPROVE DOCTOR PATIENT RELATIONSHIPS?

PAUL: It’s hard for patients, especially cancer patients, to express how they have felt over the last month. It’s colored by how they feel right now. It’s colored by not wanting to be a burden to your doctor and complain too much. It’s affected by chemo brain. If you can just push a button to track how you feel, you’ve created a useful data stream. I think patients will embrace CancerLife’s technology to relieve themselves of the reporting burden. Doctors need to be educated, too, about the importance of patients’ quality of life. It’s valuable information that needs to be understood that should affect clinical practice

CAN CANCERLIFE PLAY A ROLE IN IMPROVING YOUR IMMUNE SYSTEM?

PAUL: One of the most exciting areas in cancer research therapy now is harnessing the immune system to kill tumors. There’s a very tight connection between social support, reduction in stress and improvement in the immune system. And that’s exactly where CancerLife is tapping into the power of connections to both support people who are going through cancer treatment but also potentially help people survive who have been diagnosed with cancer.

 CANCERLIFE’S TAGLINE IS: THE MORE YOU SHARE, THE BETTER YOUR CARE. WHY DOES THAT PROMISE SO MEANINGFUL?

PAUL: It’s a very powerful benefit because it directly improves patients’ quality of life. Not only will patient care be better from caregivers and support groups, but CancerLife’s app also gives the gift of connection from patients to caregivers. Because we all need that connection, it’s not selfish to be sharing and ask for help. 

Part of the narrative art, the hero’s journey, is a request for help. And when have the request for help, people will almost always respond to it. People know that it’s important to reach out and feel and connect. It’s good for patients and caregivers to know that asking for help is the right thing to do. It doesn’t show you are weak. It’s not being needy. It’s just expressing your wishes and almost everybody—other than people who are really unhappy or are having a bad day — will try to respond and help you.

We find that when people volunteer to helping others, there’s evidence that their brain tends to release more oxytocin in other settings. By asking for their help, you are actually helping other people build stronger connections in other parts of their lives. You’re giving them the ability to release oxytocin and feel the value of connecting to other people.

PART 2 – INTERVIEW PAUL ZAK, PHD – WHAT IS OXYTOCIN ? HOW CAN IT IMPROVE QOL AND HEALTHCARE OUTCOMES?

Leave a Comment / By / November 24, 2020

Question: What is oxytocin?

Paul: Oxytocin is a mammalian neurochemical that your brain makes and is released during almost any positive social interaction. It motivates us to engage with other people.  When your brain makes oxytocin, you have an increased sense of empathy for about ½ hour and reduced stress. During that time, you are more motivated to connect to people around you . The release of oxytocin also activates a much larger network in the brain, called the HOME Network: Human Oxytocin Mediated Empathy system. Oxytocin facilitates the mid-brain to release a chemical called dopamine that is essentially the reward signal. It makes us feel good. Nature has set up a system that rewards us we connect to others, as we relax and feel good.

The HOME Network directly improves the systems of depression, anxiety, and loneliness. It can also directly impact and potentially slow tumor growth by reducing the production of the stress hormone cortisol. 

Question: What has your oxytocin research uncovered about face-to-face relationships vs. online community relationships. 

Paul:  What we discovered when measuring oxytocin levels is that the brain is not picky about the type of connection it gets. An in-person connection is the more impactful. But, when people share emotions, stories and videos in an online community, the brain will also produce oxytocin. In short, humans are so sensitive to social information that the source of the information is less important than the information itself. The key is that it must be genuine, trustworthy information

PART 3: HUMAN CONNECTIONS & CANCER CARE

Question: Can you explain why “strangers in the same situation” can develop powerful, rapid bonds?

Paul: There’s something about strangers who are in the same situation that creates very intimate and rapid bonds that the CancerLife app directly speaks to and that’s brilliant. 

Research shows that there are things patients can share with a stranger who’s also going through cancer, that you can’t say or don’t want to say to a family member because it won’t make sense to them. Or, it may appear to a family member that you are not grateful; when in fact, you really are grateful.

Having an app that allows patients, who initially are strangers to each other and are going through similar kinds of situations, to connect to each other is very powerful.

Question: Can interactions among like-minded strangers have an impact on quality of life?

Paul: Empirical evidence indicates that when a community of like-minded people—for example, cancer patients and survivors—become engaged by sharing stories, behaviors and moods, they can feel better over time; their outcomes can be better, their neurologic state can improve, and their brain tends to release more oxytocin. This is what the CancerLife App and CancerLife Communities are all about and that’s brilliant.

Question: Can a single post in an online community ignite a positive ripple effect in a cancer community?

Paul: Yes, any community member who views a conversation can benefit. Technically, there’s a bi-directional flow of information where the person who shares information and the person who receives it— both benefit.  When you share something intimate, the receiver’s brain also produces oxytocin; which increases their sense of empathy and emotional connection with you. This motivates a reciprocal emotional connection. Sharing what one is going through can provide a real emotional lift.

That kind of reciprocal connection has downstream effects. First is sense of understanding. If a person understands me, I can see it in his or her face, body language or what they have said to me online. They are not just being nice to me or patting me on the shoulder saying you’ll be okay. But they really understand what I’m going through.

Oxytocin release in the brain motivates a desire to take action to help alleviate another’s suffering. Once I’ve told you the story of my cancer, if you understand this story or relate to that story, you’ve just created a helper for your situation. And again, that can be done very rapidly within 15-30 seconds. 

Then both of the people who have been interacting get some additional downstream benefits. One is a reduction is physiologic stress. So, oxytocin says this is a safe environment. You are comfortable around this person or these people; and so, physiologic stress falls and we know that when your stress falls you have an improvement in the immune system.

 How can sharing stories and emotions improve feelings of well-being?

Paul We found that stories that have genuine emotion and feature human conflict or suffering are very effective stimulants for oxytocin release. Patients who hear or see a story can truly benefit from experiencing a genuine, heartfelt story.  A video that is genuine can be so powerful, so moving, it can be act like a sledge hammer stimulant for oxytocin production.

Sharing stories and moods in CancerLife Communities can have a profound, ripple effect among all members of the community. Those posting their intimate stories feel better and so do those hearing them.