Herbert Benson, MD

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Prostate Cancer and Stress
Massachusetts Prostate Cancer Symposium May 11,
2007

• Herbert Benson, MD
• Associate Professor of Medicine,
• Harvard Medical School
• Director Emeritus
• Benson-Henry Institute for Mind Body Medicine
• at Massachusetts General Hospital

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The Three-Legged Stool
Overall Health
Surgery
Pharmaceuticals
Self-care
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Unbalanced Three-Legged Stool
Overall Health
Pharmaceuticals
Surgery
Self-care
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Between 60-90 of healthcare visits are related
to M/B stress-induced conditions
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STRESS-RELATED CONDITIONS

• Anxiety
• Depression
• Hostility
• Heart Attacks
• Hypertension
• Cardiac Arrhythmias
• Chronic Pain
• Insomnia

• Premenstrual Syndrome
• Infertility
• Surgery and X-Ray Procedures
• Side Effects of Cancer Therapy
• Side Effects of AIDS Therapy

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Relaxation Response
Pre
Post
Psychosomatic Medicine (1974) Vol. 36, No. 2,
115-120
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Relaxation Response
Pre
Post
Psychosomatic Medicine (1974) Vol. 36, No. 2,
115-120
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Relaxation Response
Pre
Post
Psychosomatic Medicine (1974) Vol. 36, No. 2,
115-120
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O2 Consumption During Sleep and The Relaxation
Response
Change in Oxygen Consumption ()
?
Sleep
?
?
?
?
?
?
Relaxation Response
0 1 2 3 4
5 6 7
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TWO BASIC STEPS NECESSARY TO ELICIT THE
RELAXATION RESPONSE

• The repetition of a word, sound, prayer,
  thought, phrase or muscular activity
• The passive return to the repetition when other
  thoughts intrude

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When these two basic steps that elicit the
relaxation response are followed, the train of
everyday thought is broken.
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DIFFERENT TECHNIQUES ELICITING THE PHYSIOLOGIC
CHANGES OF THE RELAXATION RESPONSE
Oxygen Respiratory Heart
Slow Brain Blood
Consumption Rate Rate
Waves Pressure
Progressive Relaxation Decrease
Decrease Decrease Not
Decrease
Measured Autogenic Training
Not Decrease
Decreases Increases Inconclusive
Measured
Results Zen and Yoga
Decrease Decrease Decrease
Increase Decrease Presuggestion P
hase of Decrease Decrease
Decrease Not
Inconclusive Hypnosis

Measured Results Transcendental
Decrease Decrease Decrease
Increase Decrease Meditation
Simple Generic Decrease Decrease
Decrease Increase
Decrease Techniques
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Frontal
Frontal
Control End
Control Beginning
Occipital Frontal
Occipital Frontal
RR Beginning
RR End
Occipital
Occipital
Vertical color bars indicate beta power (white
highest, black lowest). Note At RR End (lower
right), beta power is significantly
(plt.0129) decreased in frontal areas. Jacob, et
al, 1996
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Experimental Paradigm
Two identical 42-minute scans, each with two
epochs of meditation and control. Meditation
periods (12 min.) consist of observing the breath
and repeating a mantra. Control periods (6 min.)
consist of silently generating the names of
animals.
Fix Control Meditation
Fix Control
Meditation Fix
0 1 7
19 22 28
40 42
Statistical Comparisons
Meditation vs Control compares the entire
meditation period to the entire control
period. This identifies regions with increased
signal during the meditation period relative to
the control period. End vs Beginning compares
the last 2 minutes of the meditation period to
the first two minutes of the meditation period.
This identifies regions whose signal increases
during the meditation practice.
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(No Transcript)
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Signal Increases During Meditation
Meditation vs. Control, n 5
0 1 7
19 22
28
40 42
plt 10-5 plt 10-13
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Results Lazar et al 2005

The right BA 9/10 superior frontal and middle
gyri and sulci and right anterior insula are
significantly thicker in meditators versus age,
gender and education matched controls.
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Results Lazar et al 2005

• Significantly thicker
• Right BA 9/10 superior frontal and middle gyri
  and sulci (attention)
• Right anterior insula (interoception)
• Occipito-temporal sulcus (vision)
• Left temporo-parietal junction (auditon)
• Right area 3a (central sulcus, somatosensation)
• Just below threshold
• bilateral medial prefrontal cortex (mPFC)
• left orbitofrontal cortex (OFC)
• right retrosplenial cortex
• right temporo-parietal junction
• precuneus

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Relaxation ResponseOxygen Consumptionand
Exercise
PRE INTERVENTION POST
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VO2 ( Change)
?
?
0
?
-10
-20
?
?
Control group
Experimental group
10
20
30
MINUTES
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Yerkes-Dodson Law
Stress-Performance Curve
High
EFFICIENCY
PERFORMANCE
Low
Low
High
STRESS / ANXIETY
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CONDITIONS IN WHICH THE RELAXATION RESPONSE IS
AN EFFECTTIVE THERAPY

• Anxiety
• Depression
• Hostility
• Heart Attacks
• Hypertension
• Cardiac Arrhythmias
• Chronic Pain
• Insomnia

• Premenstrual Syndrome
• Infertility
• Surgery and X-Ray Procedures
• Side Effects of Cancer Therapy
• Side Effects of AIDS Therapy

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Results Nitric Oxide

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Oxygen Consumption and Nitric Oxide

There is an inverse relationship between
decreases in oxygen consumption and increases in
nitric oxide when the relaxation response is
elicited.
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Summary Basic Science