Nature therapy: an under-utilized treatment for cancer patients?
According to a study published in the journal "BMC Cancer", nature therapy has been found to improve quality of life for cancer patients.[1] Whether gardens, hikes or water, nature therapy can be used to supplement treatment plans and help reduce stress, anxiety and depression in cancer patients.
"Findings propose nature’s role as a “secure base” offering patients a familiar and nurturing context from which new perspectives can emerge and caring connections can be made with themselves, others, the past, and the future."
Nature therapy is a form of complementary treatment for all kinds of patients that has been found to even reduce the risk of certain cancers. In a study published in the journal "Environment International," the amount of greenness surrounding someone's home was associated with the risk of developing prostate cancer. Those with higher levels of natural vegetation within a 1000 meter radius had lower risks, independent of lifestyle factors.[2]
When it comes to fighting cancer, we have incredibly effective interventions including chemotherapy and radiation therapy. While these treatments can be effective, they also come with a number of side effects. For some people, these side effects, including nausea, weakness, hair loss and fatigue, are too difficult to tolerate. Spending time walking through a forest or listening to the sounds of waves crashing can ease the body and mind without side effects.
What is nature or eco-therapy and how does it work?
Nature therapy, also known as ecotherapy or green therapy, is a form of treatment that uses nature to help improve mental and physical health. It can be used to complement the impacts of a variety of conditions, including anxiety, depression, stress and cancer.
Eco-therapy works by providing patients with an opportunity to connect with nature and engage all five senses. There are many ways cancer patients can receive nature therapy. One way is to go on hikes or walks in nature, whether with a group, your friends or alone. Though if you do go alone, always make sure someone knows where you are hiking and when you are expecting to return. Cancer patients can also take part in gardening programs or visit botanical gardens. There are even some hospitals that have started using nature therapy rooms, where patients can go to relax and find peace. These might include a combination of live indoor plants, window views, pictures and wall art, and even furniture with natural elements including stone and wood.
When nature is damaged, so are we.
There are a number of environmental toxins that can impact our health. Some of these common toxins are found in our air, water, and food. They can cause a variety of health problems, including cancer. The impacts of exposure to environmental toxins like heavy metals, pesticides, pollution, medications in drinking water and more expose us to long-term dangers.
Exposure to environmental toxins can increase our risk of developing cancer. Some of the most common environmental toxins include:
Heavy metals: Lead, mercury, and cadmium are examples of heavy metals that can be found in our environment. They can be inhaled or ingested, and can build up in our bodies over time, medically referred to as bioaccumulation.
Pesticides: These are chemicals that are used to kill insects and other pests. They can be found in our food, water, and air.
Pollution: Air pollution, water pollution, and soil contamination can all expose us to harmful toxins like nitric oxide or even ozone.
Medications in drinking water: Medications that are flushed down the drain can end up in our drinking water. This can expose us to microscopic doses of a variety of drugs, including antibiotics, hormones, and painkillers.
The exposure to pesticides was further explored by a team of researchers out of France. They discovered that those who lived closer to open field crops were at a higher risk of developing a brain tumour known as a meningioma. Rates of primary brain tumours like meningioma's are increasing in many countries, and this data may encourage us to collaborate with the land. Less pesticide exposure would potentially mitigate some of this increased risk.[3]
How do cancer patients benefit from nature therapy?
Cancer patients can benefit from nature therapy in a number of ways.
First, it can help reduce stress, anxiety and depression. This can improve quality of life and allow patients to focus on their treatment plan. An inpatient cardiopulmonary rehabilitation program involving garden therapy improved patient mood.[4]
Second, nature therapy can provide a distraction from treatment-related stressors and ease illness related strain. This can be helpful for cancer patients who are coping with a lot of stress.
Finally, nature therapy can provide opportunities for positive social interaction. This can be helpful for cancer patients who are dealing with isolation or loneliness. A study published in "Psychooncology" showed that social support and interaction is closely tied to breast cancer survivor prognosis.[5]
Tips for cancer patients seeking to practice eco-therapy
Talk to care team about whether nature therapy might be right for you.
Research different types of nature therapy and find one that appeals to you.
Find a group or partner to explore the wilds with. This can help make the experience more enjoyable.
Make time each day to spend in nature. Even if it's just a few minutes, it can make a difference!
Keep a journal of your experiences with nature therapy so you can track your progress.
Remember that nature therapy is not a replacement for traditional cancer treatment, but rather an adjunct treatment.
Try horticultural therapy!
Horticultural therapy (HT) is a form of nature therapy that uses plants and flowers to help improve mental and physical health, guided by a certified Horticultural Therapist. More specifically, the Canadian Horticultural Therapy Association defines as, "...a formal practice that uses plants, horticultural activities and the garden landscape to promote well-being for its participants." The formal piece is key in this definition as the guides are professionals who have specific credentials and training to provide this therapy.
Horticultural therapy has been around for millennia, with documented use dating back to ancient Mesopotamia in 2000 BC. In the early days, it was used primarily as a form of relaxation and stress relief. Persian cultures in 500 BC created gardens that included water features, fragrances and provided pocket oases. In Japan, the traditional courtyard gardens first appeared during the Heian era (794 - 1192), known as tsuboniwa (坪庭). They provide spots of nature acting as the centre of the larger urban dwelling. These mini-gardens are also as unique as their owners with some more rock-dominant, while others include shishi-odoshi (鹿威し) and Japanese maples.
In the past few decades, there has been a growing body of research that suggests HT can be an effective treatment for a variety of mental and physical health conditions. The first horticultural therapy curriculum in the United States was created in 1972 when the Menninger Foundation partnered with the Horticultural Department at Kansas State University. They designed a curriculum to train undergraduate students pursuing mental health careers.[6]
A typical session with a horticultural therapist may involve a variety of activities, depending on the client's needs and goals. However, some common activities include:
Preparing and planting plants
Weeding and watering
Pruning
Arranging plants in a garden or landscape
Observing and discussing
The research continues to evolve and expand with every passing year. Scientists have explored how therapeutic landscapes shape the daily lives of those battling breast cancer.[7] They have conducted urban gardening programs to explore cancer survivors perceptions of their own health [8], and even adolescent cancer patients' participating in an outdoor adventure therapy program.[9] The major themes to emerge from the adolescents' study was a stronger sense of togetherness, developing connections, rebuilding self-esteem and creating memories with their peers. All of these themes invaluable in the long-term prognosis of adolescent patients and their daily battle.
Nature therapy is an underutilized treatment for cancer patients. It can help reduce stress, anxiety and depression; provide a distraction from treatment-related stressors; and promote positive social interaction. As a proud member of Park Prescriptions, I help my patients incorporate nature-focused principles into their life and reconnect with the world around them.
References
Blaschke, Sarah. "The role of nature in cancer patients' lives: a systematic review and qualitative meta-synthesis." BMC cancer 17.1 (2017): 1-13.
Demoury, Claire, et al. "Residential greenness and risk of prostate cancer: A case-control study in Montreal, Canada." Environment international 98 (2017): 129-136.
Carles, Camille, et al. "Residential proximity to agricultural land and risk of brain tumor in the general population." Environmental research 159 (2017): 321-330.
Wichrowski, Matthew, et al. "Effects of horticultural therapy on mood and heart rate in patients participating in an inpatient cardiopulmonary rehabilitation program." Journal of Cardiopulmonary Rehabilitation and Prevention 25.5 (2005): 270-274.
Nausheen, Bina, and Anila Kamal. "Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample." Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer 16.9 (2007): 859-862.
Detweiler, Mark B., et al. "What is the evidence to support the use of therapeutic gardens for the elderly?." Psychiatry investigation 9.2 (2012): 100.
Pascal, Jan. "Space, place, and psychosocial well-being: Women's experience of breast cancer at an environmental retreat." Illness, Crisis & Loss 18.3 (2010): 201-216.
Spees, Colleen K., et al. "Health behaviors and perceptions of cancer survivors harvesting at an urban garden." American journal of health behavior 39.2 (2015): 257-266.
Stevens, Bonnie, et al. "Adventure therapy for adolescents with cancer." Pediatric blood & cancer 43.3 (2004): 278-284.