Choir singing may boost cancer patients' health, well-being

Cancer remains one of the biggest challenges of our time. This year, it is estimated that more than 1.6 million new cases of cancer will be diagnosed in the US alone, and almost 600,000 Americans will die from the disease.

As well as searching for new, more effective treatment strategies for cancer, researchers are on the hunt for ways to improve patients' responses to current cancer treatment and enhance their overall quality of life.

Now, the new research suggests something as simple as choir singing could help fulfill this need.

For the study, coauthor Dr. Ian Lewis, director of research and policy and Tenuous Cancer Care in Cardiff, UK, and colleagues enrolled 193 individuals who were part of five different choir groups.

Of the participants, 55 were cancer patients, 66 were bereaved carers of cancer patients and 72 were current carers of someone with cancer.

The researchers took saliva samples from each participant just before and after a 1-hour choir session. The team used the samples to measure levels of hormones associated with stress - such as cortisol - as well as levels of cytokines, which are proteins associated with immune response.

Additionally, using a number of psychological assessments, participants' mental health and well-being was assessed before and after singing.

Choir singing increased cytokine activity

The researchers identified significant reductions in cortisol levels across all participants after singing, which correlated with an improvement in mood and well-being.

Fast facts about cancer

§ Cancer is the second most common cause of death in the US, after heart disease

§ Up to January 1, 2014, around 14.5 million people with a history of cancer were living in the US

§ Between 1991-2012, the cancer death rate in the US fell by 23%, largely due to reductions in smoking.

Learn more about cancer

Furthermore, the team found singing was associated with reductions in the "love hormone" oxytocin and levels of beta-endorphin.

While higher levels of oxytocin have previously been associated with social bonding and attachment and increased beta-endorphin levels have been linked to a feeling of euphoria, the researchers note that they are also involved in stress regulation.

They explain that increased oxytocin and beta-endorphin can occur in response to stressful stimuli, "serving to dampen blood pressure, heart rate and norepinephrine levels."

"[...] it seems likely that the decrease found here was as part of a generalized down-regulation of stress response which may have over-ridden any social bonding or happiness-associated increase," the researchers add.

The key finding, however, was that participants also showed an increase in cytokine activity after singing - an indicator of a stronger immune system.

Furthermore, the team found that participants with the lowest levels of mental well-being and greatest levels of depressionprior to singing experienced the greatest improvement in mood, which was associated with a lower pro-inflammatory response.

"High levels of inflammation are associated with many mental health conditions, including depression," note the authors.

'Exciting' findings demonstrate biological effects of singing

The researchers believe their findings are good news for individuals affected by cancer, as they suggest that a simple 1-hour activity could benefit their health.

"Many people affected by cancer can experience psychological difficulties such as stress, anxiety and depression," notes study coauthor Dr. Daisy Fancourt, of the UK's Centre for Performance Science - a collaboration between Imperial College London and the Royal College of Music.

"Research has demonstrated that these can suppress immune activity, at a time when patients need as much support as they can get from their immune system," she continues.

"This research is exciting as it suggests that an activity as simple as singing could reduce some of this stress-induced suppression, helping to improve well-being and quality of life amongst patients and put them in the best position to receive treatment."