Pain Management With Cancer Diseases

Introduction-

Cancer is a major public health problem in the US and many other countries of the world. It is one of the leading causes of morbidity and mortality worldwide.

Cancer is expected to the most important barrier to increasing life expectancy in the 21st century. According to estimates from the World Health Organization in 2015, cancer is the first or second leading cause of death before age 70 years in 91 of 172 countries, and it ranks third or fourth in an additional 22 countries. There will be 18.1 million new cases and 9.6 million cancer deaths worldwide in 2018. Incidence is the number of new cases occurring in a specified period and geographic area, conveyed either as an absolute number of cases per annum or as a rate per 100,000 persons per year1.

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Ayurveda describes cancer as 'Vriddhi' or 'Arbuda'. In this condition, the blood becomes impure due to aggravation of one or more Dosha. This impurity of the blood is actually related to subtle part of blood (Rakta Dhatu), and is not detected by physical tests. The impure blood along with aggravated Dosha circulated in the whole body and relocates in a region that has week immunity.

Due to localization of improper Rakta Dhatu, Prana reaching the cells of that particular region also becomes impure. This leads to improper cell division termed as cancer2.

Pain-

- Pain is unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain has two dimensions-

1. Unpleasant sensory (Physical)
2. Emotional experience (Psychological)

Pain is a multifaceted phenomenon that involves biological, psychological, and social consequences like as unrelieved severe pain may associated with disturbed sleep, redused appetite, irritability and depression3.

Pain In Cancer-

Pain occur in estimates indicate that 50% of patients during process and in upto 75% of patients with advanced cancer. According to the International Association of Nurse in Cancer Care, 90% of pain could be treat with standred measure4. Observational data on the incidence of cancer pain survivalance indicate that a patients experience pain at some point during their course of treatment, and that pain impairs quality of life. For many cancer patients and survivors, the occurrence of pain firstly may raise concerns about disease progression and Second, biological factors e.g., tumor progression and invasion, or related treatments, it often persists after patients are believed to be cured of their cancer. Finally, because patients and health care professionals underestimate the impact of psychological distress on cancer pain and do not consider the potential benefits of using psychological treatments to manage cancer pain. Untreated pain leads to unnecessary hospital admission, emergency visits and requests for physician-assisted suicide.

Pain is one of the most feared and burdensome symptoms in cancer patients and often has a negative impact on patients functional status and quality of life. Supported attention to pain is the first priority to established quality improvement efforts. Being diagnosed and living with a life-threatening illness such as cancer is a stressful event that may affect of an individual's life. Pain in patients with cancer is a stressful event which can affect patients life style also cause discomfort, loss of control, fatigue, and sexual activity, loss of interpersonal relationships and the concept of life, reduced performance, sleep and daily activities in them which has a negative impact on their recovery process Evaluating the severity, characteristics, and impact of pain is the effective treatment to manage pain in cancer patients. Proper pain management may require a multidisciplinary approach5.

Relation of Psychological Distress with pain-

Researchers have conducted numerous studies showing that there is a strong association between cancer pain and psychological functioning. Some of the major findings of these studies are as follows:

• Loss of work Social & Familial
• Financial concern Spiritual state
• Physical disability & disfigurment Fear of death & Pain

These findings indicate that the cancer pain is linked to high levels of psychological distress, including higher levels of depression, anxiety, fear, and negative mood and fear of the future or pain progression. Effective relief of pain is depends upon a comprehensive assessment to identify physical, psychological, social, and spiritual aspects and multidisciplinary interventions. Healthcare providers working with cancer patients need to be alert to signs of psychological distress. Careful assessment and management of psychological distress represents an important component in cancer pain management6.

According to National Cancer Institute stress also can be lead to unhealthy behaviours, such as smocking or alcohol, that may affect cancer risk but can stress be a cause in and of itself. So along with herbal medicine patient will be treated with various unconventional therapies to control the defect in brain controlling mechanism.

Principles of Management in Ayurveda-

The living body is considered as amalgamation of earth, water, fire, air and space and they make not just the physical composition but also the mind and the soul7. So, the body as a whole includes mind, soul, behaviour and consciousness of an individual where the environment also plays a major role in making of a person. The body is combination of Sharir, Indriya, Satva, Aatma. If any of these components are imbalanced or unconnected it can cause negative effect, such as disease. Charaka Samhita states that Satva or mind, Aatma or soul and Sharira or body are just like the legs of tripod, on which the world rests8. Five elements combine with each other to give rise to three functional bio static energies(humour) of the body. These are responsible for all the physical, psychological function of body and mind.

Ayurvedic system is the first system to emphasize health as the perfect state of physical, psychological, spiritual component of Human being. It is important to maintain the strength of the patient during treatment. Cancer is not just a physical disease It is a disease of the mind and souls much as it is of the body.

The principle of Ayurveda believe that in the case of Cancer, the root cause may not necessarily be inside the body, factor could be the external factor. Cancer patients deal with various problems in different individual, family and social areas and also with the reduced life quality

Nonpharmacologic interventions are important adjuncts to treatment modalities for patients with cancer pain. A variety can be used to reduce pain and concomitant mood disturbance and increase quality of life. The experience of pain is widely accepted as a major threat to quality of life, and the relief of pain has emerged as a priority in cancer.

Shadchakras-

The word Chakra literally means as wheel or disc and a spinning sphere of energetic activity emanating from the major nerve ganglia branching of the spinal column. The Chakras are considered to be a point or nexus of biophysical energy are arranged along the spinal cord from bottom to top of the human body. The cerebrospinal system with nerve is the power supply system for the factory of the humen body and the main switch in chakras.

Chakras

Sthana

Elements

Vayu

Senses

1

Muladhara chakra

(Pelvic plexus)

Guda

Prithivi

Apana

Rasana

2

Swadhishthan chakra

(Hypogastric plexus)

Pedu

Jala

Vyana

Netra

3

Manipura chakra

(Coeliac plexus)

Nabhi

Agni

Samana

Twaka

4

Anahata chakra

(Cardiac plexus)

Hridaya

Vayu

Prana

Karna

5

Vishuddha chakra

Kanth

Akash

Udana

6

Agya chakra

Bhrumadhya

Mahattatva

7

Sahasrara chakra

Kundalini is the coiled serpent power that is supposed to be awokened through the practice of meditation. According to ancient science prana changes in consciousness, operate through the two canal of ‘ida and pingala’ in humen being9.

Intervention Of Shadchakra Healing In Purview Of Epigenetics-

Epigenetic is the study of the expression of genes without changing the sequence of the DNA or the genetic code. “Epi” word comes from the Greek word meaning over. Epigenetic (Lifestyle) is a new biological field that is exploring the Effect of the environment on cells. The environment includes one's physical, social, and electromagnetic environment as well as confidence, awareness, lifestyle, habits, behaviors, and mind-body practices such as Pranic healing. If your environment can change your genetic expression, then it seems wise to surround yourself with a healthy environment rich in peace, love and delight rather than stress, brutality and weariness10. In Ayurveda individual prakriti roughly resembles our DNA, or our genes. According to Ayurvedic concepts Each us of is born with a unique constitutional balance and the individual constitution or Prakruti, is based on physical and psychological characteristics (Vata, Pitta, Kapha, Sattva, Raja, Tama)

In cancer survivals Radiations, Chemicals, Poor life style, Mental Stress, Oxidative stress cause disturbance the energy field (Shadchakras) and weakimmunity

• Disturbs the Prakriti (Genotype) due to disturbance of
• (Phenotype)Vata, Pitta, Kapha Satwa, Raja, Tama
• DNA mutation
• Cancer

Management Of Cancer Pain-

Radiological, chemotherapy, harmones, and surgery all used to treat and palliate cancers, Combining these treatments with pharmacological and non-pharmacological methods of pain control. Cancer treatments, such as surgery, chemotherapy, radiation therapy, cause suffering and distress that lead to impaired quality of life for cancer survivors.

Complementary and alternative medicine (CAM) is a group of medical and health care systems, practices, and products that are not currently considered to be part of conventional medicine Personal belief and appraisals, emotional reaction, coping behaviors and social contextual factor are the primary targets of psychological interventions.

A combination of pharmacologic and nonpharmacologic treatment modalities for cancer pain is the standard of care, as presented in World Health Organization guidelines.

Nonpharmacologic interventions are important adjuncts to treatment modalities for patients with cancer pain. It can be used to reduce pain and concomitant mood disturbance and increase quality of life.

In the classification of complementary medicine, energy healing class includes treatments in which the energy emanates from the human body (biofield) or is originated from an external source such as therapeutic touch, Reiki, shadchakras healing etc. (10)

These Chakras are very important for energy balance and perfect synchronization of interior and exterior rythmus or HEF (Human Energy Field) and UEF (Universal Energy Field)11.

Human beings are systems of energy and that the energy field extends a few inches beyond the skin’s surface. Shadchakras energy healing process is a standardized biofield therapy that uses in the patient’s “energy field” with the goal of restoring balance in the patient’s energy system and strengthening the patient’s “healing capacity”(35) and to reduce distress and fatigue during chemotherapy (24).

* Shadchakras energy healing process -

Scientific evidence provide tangible proof of the existence of body’s energy and its relation to the health & well being.(Article -Discovery of existence of Human energy field-Unique journal of Ayurveda and herbal medicine) Energy Healing is an important component in the treatment of cancer. stress can damage the aura, causing gaps and interrupting Prana, the life-force. Clearing balancing and energizing the subtle body facilitates in restoring health12.

Shadchakras have close relation with nervous system & collaboration with Yogic nadis Ida, Pingala & Sushumna and perform essential physical, mental and autonomus function. These nadis are tubular organ of the body like an artery or vein and medium for flow of pranic energy. Everyone practically experience various changes in the mental state like emotions, peaceful mind, excitation, remembrance etc. Due to dominance of Ida- Pingala activities. In pranic healing exercise both are equally flowing, balanced, sympathetic and parasympathetic activities is established13.

Chakras are the switches in path of energy flow, If these switches are off in normal person, they obstract the flow of energy, but when they are on, energy can ascend in susumna nadi. A normal developed and opened Chakras always spins clockwise and gains pranic energy from UEF while counterclockwise movement of a Chakras makes energy flow out which makes a Chakra closed, sick and abnormal.

The activities of the human body in the form of vayu. Pranavayu flows continuously in Ida, Pingala, and Sushumna14. The energy is situated in muladhara chakra called Kundalini shakti, it is static energy, make it kinetic by arousing with meditation and spiritual practice and ascends in opened chakras and reach to sahasrara through these following processes-

1. Activation of the chakras- Balancing and activating the chakras restores the natural healthy equilibrium of the body. divine spiritual energy run through the entire body, activating Chakras.
2. Treatment of the infection- the infection is treated from its roots. The immune system of the body is boosted. Body’s normal functioning is restored and any abnormality in the biological processes is corrected by divine spiritual energies.
3. Healing including regeneration of the cells and the damage caused by the infection or abnormality is treated. This final stage of healing oversees the complete renewal of the body's infected systems.

Each and every cell in the body requires the right quota of its Prana to carry on its biochemical processes in an efficient way. Prana is meta-physical energy that is responsible for living activities. Prana can be described as vital energy that flows continuously inside the body and keeping us alive. It is fire of life (Jeevan Agni) that manifests in the vitality. According to Yogic texts, the energy back up required for live cellular activity is supplied from the six energy centres (Shad chakra). This Prana energy influences our Neuro-hormonal system to balance hormonal profile and regulates different physiological functions in a living body. Prana and plays a vital part in all psycho-physical processes.

Prana influence our Central nervous system by acting on subtle tasks such as perception, planning, execution, learning and memory. It increases alertness along with relaxation. Prana is stored up in the Shad-Charkas and shows a reduction in sympathetic activity, it is key management of stress related disorders.

The human aura has layers of physical, emotional, mental and spiritual elements. One aura are made up of many colours and many shades of colores that are constantly changing and change colour depending on the emotion an individual is experiencing16. If patient have detected such energy impurities in the aura of patient, they may be cleared out and removed from patient patient’s field using an shadchakras energy healing procedure known as aura clearing in the following way-

As patient lay the hands on the chakra point during the normal course of treatment- visualise the energy that is following upward through the spine, at that chakras, flowing through the chakra, the blockage in the chakras being removed.

• Pain management through spirituality: SHADCHAKRA
• Yogic healing is an ancient spiritual skill achieved by the yogis through countless years of meditation & spiritual practice.
• The concept of body according to Tantra shastra is the Atisukshma (finest) form.

Tantra shastra is the minutest and most powerful way of understanding the human body. It focuses at the finest level of creation and deals mostly at the level of the mind, which is closest to the Atman. The language and expressions of tantric textbooks are filled with symbolizations, ritualism and has numerous esoteric meanings. The five Mahabhoota, mind and soul are represented in the form of seven energy centers in the central axis of the body. The concept of Chakra have been used in the management of various disorders by means of Daivavyapasraya chikitsa and by means of various systems of sadhana. The seven Chakra respectively symbolizes the five Mahabhoota, the mind and the self, the seven levels of existence. The various letters of Sanskrit alphabet associated with the Chakra represent various frequencies of the matter energy wave which expresses itself as the world. The mastery over this is called as Mantra Shastra and the physical expression of these frequencies is known as Yantra Shastra17.

The concept of a chakra system of energy or consciousness centers exists in many forms in different indigenous systems including Egyptian, Chinese, Native American, Su, and Kabbalah. The chakras have been discussed both from religious and psycho-spiritual perspectives for several thousand years18..

Conclusion-

Ayurveda describe three modalities of treatment namely the Daivavyapasraya, Yuktivyapasraya and Satvavajaya respectively correspond to these three levels of interference into the nature of living systems. Based on this review, A statement can be made regarding the use of shadchakra healing as a non-invasive intervention for improving the health status in patients with cancer. It seems that this method can be used as a safe method in the management of physical function, pain, anxiety, depression and nausea in cancer patients and increasing a sense of well-being. those interested to the field can possibly be of great help in caring for cancer patients and reducing complications of the disease. However, further studies are needed to explore the impact of shadchakras healing on additional clinically relevant measures.