Funny Business in Cancer Care

A MAN GOES TO A doctor for an examination. After the exam, the doctor tells the man, “I’ve got your test results and some bad news. You have cancer and Alzheimer’s.” The man says, “Boy, am I lucky! I was afraid I had cancer!” Welcome to oncology humor therapy.

Numerous medical studies have shown that patients with cancer can improve their circumstances by incorporating laughter into their lives despite a serious diagnosis. In addition to physical distress, many patients experience mental duress that manifests as depression or anxiety. Although a multitude of effective medications may help relieve these symptoms, humor therapy has zero side effects, costs nothing and is readily available. Consequently, this form of complementary therapy can be well worth pursuing for patients with cancer who want to ease physical, mental and emotional symptoms.

At the Dr. Richard C. Ostenson Cancer Center in Puyallup, Washington, our staff members have naturally adopted this approach, resulting in enhanced patient-provider relationships and patient wellbeing. Many patients or family members also take a cue from staff and share their own jokes or humorous stories to add to the positive atmosphere. This has created a healing and therapeutic environment where patients, family members and staff alike can form strong alliances to more effectively treat patients on a holistic level.

A founder of this school of thought is the namesake of the 1998 motion picture Patch Adams.

Hunter “Patch” Adams, M.D., has spent his 30-year career touting the benefits of laughter and medicine. His philosophy is that the sick should be treated in an environment of fun and compassion at no financial cost.

According to Adams, “Laughter enhances the blood flow to the body’s extremities and improves cardiovascular function. Laughter releases endorphins and other natural mood-elevating and painkilling chemicals, (and) improves the transfer of oxygen and nutrients to internal organs. Laughter boosts the immune system and helps the body fight off disease (and) cancer cells, as well as viral, bacterial and other infections.” The bottom line: Laughter can relieve stress and anxiety and, ultimately, have a physical effect.

Norman Cousins, author of Anatomy of an Illness: As Perceived by the Patient and a political journalist, professor and world-peace advocate, also pioneered this area. Cousins suffered from insomnia due to pain from ankylosing spondylitis, a form of arthritis that typically affects the back. In an effort to self-treat, he began viewing Marx Brothers’ films and TV’s Candid Camera classic episodes. After 10 minutes of intense laughter, Cousins noted, he was able to obtain “at least two hours of pain-free sleep.” He ultimately recovered from his medical condition and went on to write a series of best-selling books on humor and its healing powers, which triggered several medical studies on the subject.

One published in 2013 enrolled 17 women with relapsed ovarian cancer and looked at the effects of humor used in conjunction with medical treatment. The patient-reported results showed that 14 out of 17 (82 percent) used humor to deal with their condition, and 13 (76 percent) believed that this reduced their anxiety levels.

Humor also appears to aid with muscle tension and food digestion by working the face, shoulders, diaphragm and abdomen with an enthusiastic laugh that “burns as many calories as a brisk walk,” according to Moshe Frenkel, M.D., a former leader in palliative and integrative care at The University of Texas MD Anderson Cancer Center in Houston. Because digestive issues can be problematic for oncology patients, this may be yet another reason for a daily dose of humor. Patients are not the only ones who reap the positive outcomes. Care partners, as well as medical staff, have acknowledged the therapeutic rewards of laughing with their loved ones or patients, including reduced stress and enhanced relationships. These professionals need laugher just as much as the patients do, as their responsibilities can lead to burnout and depression.

A paper in the Nursing Standard Academic Journal explained how the benefits of humor can translate into a medical setting, reporting that humor therapy “enables feelings of closeness or togetherness when shared in the context of trust between the patient and nurse. Used throughout the working day, humor can help to create a natural connection during patient interactions, which can have holistic benefits.”

Some professionals may have concerns about the appropriateness and timing of this approach, because sometimes humor is not welcomed. Medical staff must be sensitive to patients’ verbal and nonverbal cues in determining whether and when to use humor. Further, to avoid offending anyone, they should keep their jokes relatively clean and free of off-color, racist, sexist, political and religious topics.

Robert Schimmel didn’t always follow that rule, but using humor in the cancer clinic worked well for the late standup comedian and author of Cancer on Five Dollars a Day (Chemo Not Included): How Humor Got Me Through the Toughest Journey of My Life. Schimmel was in remission from stage 3 non-Hodgkin lymphoma for 10 years before his tragic death in an automobile accident seven years ago.

A firm believer in the power of laughter, he wrote about routinely reaching out to fellow patients during chemotherapy treatments through his quick wit, which often had the entire treatment unit howling with laughter. He declared, “I’m going to keep making people laugh, even if I have to stand at the microphone with a quill of IVs poking out of me. I don’t care. I’m not going down without a laugh.” So, how can other patients work this approach into their daily lives?

Cancer survivor Saranne Rothberg, CEO and co-founder of ComedyCures, has some suggestions. Rothberg, who has been in remission from stage 4 breast cancer for 18 years, credits her healing not only to her medical treatment but also to laughter. Upon learning of her diagnosis back in 1999, she began contemplating how laughter and comedy can heal psychosomatically, as well as spiritually. Soon after, she created ComedyCures, a foundation dedicated to bringing therapeutic laughter programs to children and adults living with physical and mental illnesses. She recently launched a college program based on her humor therapy work through the foundation’s LaughLine (888-HA-HAHA- HA). Rothberg recommends a daily dose of at least 100 laughs to help fight medical problems and offers the following suggestions:

- Create a personalized wellness joke book to keep at your bedside.

- Become a “humor buddy” and make an appointment to laugh with this partner every day, either over the phone or in person.

- Watch humorous movies with your buddy or alone, or read amusing books.

In addition, many health care systems offer laughtertherapy programs for patients and family members. For example, Cancer Treatment Centers of America’s laughter clubs guide participants through exercises. Patients should ask whether their treating facilities have similar programs or pursue activities such as laughter yoga (laughteryogausa. com) outside the clinic.

As Cousins maintained: “The control center of your life is your attitude.” Today’s reputable medical experts, as well as those who have gone before, have validated humor therapy as a healing complementary treatment for patients with cancer and the people who care for them. Let’s all do our best to benefit from their findings.

TAMARA MILLER, M.H.S., is coordinator of the Good Samaritan Cancer Center in Puyallup, Washington.