**11. Summary – Cancer-sssociated fatigue and its treatment**

Nutritional supplements have been used in a variety of diseases to provide patients with a natural, safe alternative to pharmacological drugs. In patients with cancer nutritional supplements are often used for specific purposes or to improve quality of life. For example, cancer-associated fatigue is one of the most common symptoms in all forms and stages of cancer, but few patients receive assistance for their fatigue. Cancer-associated fatigue is associated with cellular oxidative stress, and during cancer therapy excess drug-induced oxidative stress can cause a number of adverse effects, including: fatigue, nausea, vomiting and more serious effects. Cancer-associated fatigue and the adverse effects of cancer therapy can be reduced with Lipid Replacement Therapy, a natural lipid supplement formulation that replaces damaged membrane lipids along with providing antioxidants and enzymatic cofactors. Administering dietary Lipid Replacement Therapy can reduce oxidative membrane damage and restore mitochondrial and other cellular functions. Recent clinical trials using cancer and non-cancer patients with chronic fatigue have shown the benefits of specific Lipid Replacement Therapy nutritional lipid supplements in reducing fatigue and restoring mitochondrial function.

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**11** 

*Japan* 

**The Relationships Between Stress** 

**Program and Mental Health Status** 

Ando Michiyo, Kira Haruko and Ito Sayoko

*St. Mary's College, Kurume University,* 

*Okinawa Junior College,* 

**Reduction Induced by Bedside Mindfulness** 

Patients receiving anti-cancer treatment experience physical problems such as pain, fatigue and nausea, and psychological problems such as anxiety, depression, distress (Speca, et al., 2006) and spiritual pain. A mindfulness approach is one of the most effective interventions to alleviate these problems. The Mindfulness-Based Stress Reduction (MBSR) program was modeled on the work of Kabat-Zinn (Kabat-Zin, 1990; Kat-Zinn, et al., 1998) and colleagues at the Center for Mindfulness-Massachusetts Medical Center. The program is based on the principal of mindfulness, defined as moment-to-moment, present-centered, purposive nonjudgmental awareness. The goal of the MBSR program is to guide participants to achieve greater awareness of themselves, their thoughts, and their bodies through class discussion,

For cancer patients, the MBSR have effects on mood disturbance stress symptoms (Speca, et al. 2000), or on QOL and the immune profile (Carlson, et al., 2004). The Mindfulness-Based Art-Therapy (MBAT), which includes mindfulness and art therapy, also produces a significant decrease in symptoms of distress and improvements in key aspects of healthrelated QOL (Monti, et al., 2006). Moreover, the MBSR affects stress symptoms, mood, post-

However, since the duration of the program in these studies are from at least 4 weeks to 8 weeks, patients were sometimes hard to continue to participate. And they were easily to be tired because of chemotherapy or radiation therapy. Then we developed a mindfulness cyclic meditation program, in which participants could participate in the program even sitting on chair. After this program, anxiety and depression improved

However, some of patients with advanced cancer stage were hard to participate, because their physical strength was very low and they could not sit or walk. Thus we needed to develop a new program for cancer patient with advanced cancer stage, and we developed a novel mindfulness program, a Bedside Mindfulness program (Figure 1). A yoga instructor and a clinical psychologist discussed about program, and made the leaflet with drawing by

trauma growth, and spirituality (Garland, et al., 2007; Matchim, et al., 2011).

**1. Introduction** 

(Ando, et al., 2009).

an illustrator.

meditation, and yoga exercises (Garland, et al., 2007).

