Examining the Relationship Between Relaxation Combined With Biofeedback or Wheat Germ Juice to the Immune Indices and Quality of Life Measures in Patients With Colorectal Cancer Who Receive Prophylactic Chemotherapy After Surgery

The immune system plays an important role in the fight against cancer. According to certain studies, Levels of cytokines secreted by the immune cells were found as predictors of prognosis and survival among cancer patients, as well as disease recurrence1. Pro-inflammatory cytokines, such as IL-6, IL-8 and IL-10 were found to be negative prognostic factors in different cancer types, including colorectal cancer, while IL-12 was found in several studies to be a positive prognostic factor. However, inconclusive results were found for the role of IL-12 and anti-inflammatory cytokines in cancer prognosis.

Previous studies, including meta-analyses, reported that chronic emotional stress or depression were associated with higher levels of pro-inflammatory cytokines2; furthermore, there is some, albeit inconclusive, evidence that they may predict lower survival rates3. Moreover, there is further evidence that personal resources such as optimism and control perceptions may have an effect on psychological and physical well-being (i.e., low level of psychological or physical symptoms in reaction to stressful events) and dysregulate immune functions such as levels of pro-inflammatory cytokines.

Practicing relaxation was found to decrease psychological symptoms among cancer patients, such as depression, anger, hostility and anxiety symptoms, as well as physical symptoms, including fatigue, insomnia and pain. In addition, relaxation may reduce nausea and vomiting following chemotherapy.

Several studies of cancer patients have reported positive associations between relaxation-based interventions and immune measures, such as an elevated rate of T-cell subpopulations as well as increased IL-4 production and decreased IL-10 production4. Similarly, biofeedback-assisted relaxation was associated with enhanced natural killer cell activity, lymphocyte responsiveness, and the number of peripheral blood lymphocytes5. However, results are not always conclusive, and the few studies investigating the relationship between relaxation training and immune measures have often included small and uncontrolled samples.

Wheatgrass juice is an extract squeezed from the mature sprouts of wheat seeds (Triticum aestivum). Currently, there are only a few laboratory and medical studies that examine the beneficial effects of wheatgrass consumption. These studies tend to report positive effects with minimal side effects among patients with arthritis, thalassemia and ulcerative colitis. Lab research has demonstrated that wheatgrass consumption caused a prolonged latent period of skin cancer in mice. Controlled clinical trials have found that wheatgrass juice may reduce chemotherapy-induced myelotoxicity, accompanied by fever and infection without harming the chemotherapy effectiveness among breast cancer patients6.