Re: Breast cancer clinical trial: Fivefold reduction in 3-year mortality for breathing normalization group

Metastasized breast cancer clinical trial: Fivefold reduction in 3-year mortality for breathing normalization group

Medical professionals have failed to understand and explain to the general public and cancer patients that over-breathing (or hyperventilation) REDUCES tissue oxygenation due to 3 fundamental laws of respiratory physiology:

1. When we breathe more than the medical norm, we cannot improve, to any significant degree, oxygen content in the hemoglobin of the arterial blood since red blood cells are about 98% saturated with oxygen during normal breathing.

2. Overbreathing reduces CO2 content in the arterial blood causing constriction of arteries and arterioles as CO2 is a vasodilator. Hence, hyperventilation leads to reduced perfusion and oxygen supply (confirmed by dozens of published medical studies) for the brain, heart, kidneys, liver, stomach, colon, and other vital organs.

3. Reduced CO2 value in the tissues causes a shift in the oxygen dissociation curve to the left causing so-called suppressed Bohr effect (a reduced oxygen release by the red blood cells in the capillaries).
 
Hence, the more one breathes, the less oxygen is provided for brain, heart, kidneys, liver, and other vital organs. Reduced cellular oxygenation naturally leads to anaerobic mitochondrial metabolism, elevated lactic acid, formation of free radicals, and cellular acidosis or lowered pH in cells.

Cancer patients, as it has been shown by numerous published studies, breathe more frequently than the norm. Typical breathing frequencies in advanced cancer patients are about 26-30, in some studies more than 40 breaths per minute. (This parameter cannot be measured by the cancer patient herself, due to changes in the breathing pattern, but can be easily defined by others when she is at rest or during non-REM sleep. The official norm is 12 breaths per minute at rest.)

Since growth of tumors primarily depends on tissue oxygenation, chronic hyperventilation promotes growth of malignant cells. Therefore, breathing normalization must be a central part of any successful anti-cancer program.

Let us consider how breathing normalization influences survival and other parameters of cancer patients in this clinical trial.

The clinical trial was conducted by Sergey Paschenko, MD, a pupil of Dr. Konstantin Buteyko (the author of the Buteyko breathing method). The study was published by the Ukrainian National Journal of Oncology (Kiev, 2001, v. 3, No.1, p. 77-78, “Study of application of the reduced breathing method in a combined treatment of breast cancer”). The PDF file of this article (in Russian) is available at http://www.oncology.kiev.ua/archiv/9/s_9_020.php.

Clearly, it is not the name of the breathing technique, but practical achievement of normal breathing parameters that should matter most for wellbeing of the patient, body oxygenation, and cancer prevention.

In this study, Dr. S. Paschenko applied a modified breath retraining technique based on the same principal idea: reduced breathing. Reduced breathing sessions are based on breathing slightly less than usual, while having correct posture and an empty stomach. Instead of having large inhalations, the patient is suggested to have shorter inhalations using the diaphragm only and to continuously maintain a light, but comfortable desire to breathe more frequently (or air hunger) coupled with relaxation of the diaphragm for exhalations and all other parts and muscles of the human body. In this clinical trial, the total duration of breathing exercises ranged from 60 minutes up to 2.5-4 hours per day for 3 years. Breathing sessions ranged from 20 to 30 min long.

One hundred twenty patients with breast cancer (T1-2N1M0) participated in this study. (These letters and numbers relate to cancer parameters. For T1-2: the tumors are less than 5 cm or 2 inches in size; N1: cancer has spread to 1 to 3 axillary (underarm) lymph node(s), and/or tiny amounts of cancer are found in internal mammary lymph nodes (those near the breast bone) on sentinel lymph node biopsy; M0: no distant metastasis.) All patients had a standard anti-cancer therapy that included surgical removal of tumors. However, in addition to this therapy, the breathing retraining group (67 patients) practiced breathing exercises. Their parameters were compared with the control group (remaining 53 patients).  

Results and Discussion

From my view, as I also teach breathing retraining, the most amazing fact of this study is that the breathing teacher and his students were persevering with breathing retraining for at least 3 years, indicating their courage and self-discipline. The breathing retraining group almost doubled their exhaled CO2 content. If we assume that their metabolic rate (or CO2 production rate) remained the same, their minute ventilation (amount of air inhaled in one minute) was reduced about 2 times. Hence, as a result of breathing retraining they started to breathe about 2 times less. Unfortunately, the author did not specify the details of his CO2 measurement method. Most likely, his CO2 values relate to CO2 concentrations during the last part of the exhalation (not total CO2 content of all exhaled air). This assumption allows us to evaluate the CP changes before and during breathing retraining.

The CP (control pause or body oxygenation index) is the breath holding time after usual exhalation and is discontinued at the first signs of stress or discomfort (without pushing yourself for larger numbers). Practical evidence, as well as physiological laws indicates that the less one breathes, the higher the CP. Hence, it is logical that the Buteyko breathing method is based on activities and life style factors that make breathing lighter, while the CP test is the main test to measure personal progress.

When people have normal breathing (the official medical norm corresponds to 6 breaths per min at rest for a 70-kg man), their CP is about 40 seconds (s). Normal CO2 content in the second half of the exhaled air is about 5-5.5%. Such breathing is invisible and inaudible. It is so tiny that normal breathers do not have the sensation of air movements and generally claim that they feel their own breathing. (People who practice breathing exercises sharpen their sensations and can feel air flow and miniscule breathing movements.)

For this study, the patients had significantly lower CO2 concentrations in the exhaled air, indicating presence of chronic hyperventilation. The predicted initial CPs for both groups was between about 10 and 20 seconds. After 3 years of breathing retraining, the patients who practiced breathing exercises breathed even less than the official medical norm and closer to the Buteyko’ breathing norm (or 4 l/min for minute ventilation, 8 breaths/min for breathing frequency, and 60 s for the CP).

When the health state of some patients dramatically worsened (metastasis), their exhaled CO2 content dropped about 2 times from their initial values. This indicates severe chronic hyperventilation and their CPs were down to 5-10 s only.

Due to technical difficulties, the author did not provide expired CO2 values during last hours of sleep. However, numerous medical epidemiological studies have shown that exacerbations of chronic diseases, as well as highest mortality rate for heart disease, asthma, COPD, stroke, diabetes, epilepsy, and many other conditions, take place during early morning hours (from about 4 to 7 am), when breathing is heaviest and the CP is shortest (morning hyperventilation effect). Practically, evening-to-morning CP drops in the sick and can vary from 3 to about 15 s or about 2 times in average. Since cancer has some similarities to severe inflammatory diseases (large masses of abnormal cells), intensification of breathing during night sleep and large overnight CP drop are normal.

These general observations in relation to breathing rates, CO2 values, CP numbers and quality of life factors, mentioned by the author, are in agreement with the Buteyko Table of Health Zones. Three-year mortality rate for the breathing normalization group was 4.5% and for the control group 24.5%. Hence, breathing normalization decreased 3-year mortality by more than 5 times. All patients who normalized their breathing survived.