09 April 2021

Can Laughter Improve the Quality of Life in Cancer Patients?




Written by Rebecca Bowles


Has anyone close to you ever had cancer? You’re not alone if you’ve answered ‘yes’: cancer is the fastest growing disease worldwide (Popat et al., 2013). Whilst cancer is scary, it’s comforting to know that cancer patients are living longer than they used to (Allemani et al., 2018). However, they typically experience a lower quality of life than the rest of us (Jansen, 2010). Low quality of life is characterised by various secondary health problems, such as impaired cognitive function, pain, anxiety, and depression (Morisima et al., 2019). Therefore, the silver lining that cancer patients live longer is clouded by these symptoms. Keeping this in mind, you can understand the importance behind improving the quality of life in cancer patients, especially when the cancer patient is someone you care about.
 

You may have heard the saying “Laughter is the best medicine” but you probably haven’t heard of laughter therapy. Laughter therapy involves participation in activities, usually within a group (such as laughter yoga or watching comedic performances), that aim to make people feel good from laughing. However, can laughter improve the quality of life in cancer patients?



This question was answered by Morishima et al. (2019) who measured the effect of laughter therapy on the quality of life in cancer patients. They selected 56 cancer patients from a cancer institute in Japan and randomly assigned them to the laughter therapy group or the control group. Those in the laughter therapy group took part in laughter yoga and watched comedic performances 4 times over 7 weeks, whereas those in the control group received no laughter therapy. Throughout this time, both groups were asked to complete questionnaires to rate how frequently they experienced symptoms associated with low quality of life.



The researchers found that cancer patients in the laughter therapy group reported a decrease in symptoms that characterise low quality of life (such as pain and cognitive deterioration), whereas cancer patients in the control group reported that these symptoms got worse. Therefore, it seems that laughter therapy can improve the quality of life in cancer patients!


However, the results should be taken with a pinch of salt in some respects, as there is a weakness in how the study was conducted: the researchers didn’t measure how much people laughed. This means it’s impossible to know if some people laughed more than others and subsequently received more improvements in their quality of life. This leads me to question whether a different aspect of laughter therapy influenced participants’ quality of life. For example, improvements in quality of life could be due to the social interaction during the therapy rather than laughter itself. Therefore, future research should limit social interaction and measure the amount of laughter and its’ direct influence on quality of life.



On a more positive note, this study was the first to measure the effect of laughter therapy on quality of life in a randomised control trial, which is a type of a study that allows comparison of results to a control group. This enables the author to conclude that the improvement of quality of life can be attributed to laughter therapy, because the only difference between the groups was that the control group received no laughter therapy.



Research has linked quality of life to life expectancy (Kaplan, 2003), so if laughter therapy improves quality of life; it could improve the prognosis of a cancer patient. In light of this, it’s worth remembering what you’ve read here, as it could help someone close to you or yourself. After all, if you were a cancer patient, wouldn’t you try a painless therapy to improve your quality of life?





References:


Allemani, C., Matsuda, T., Di Carlo, V., Harewood, R., Matz, M., Nikšić, M., Bonaventure, A., Valkov, M., Johnson, C. J., Estevé, J., Ogunbiyi, O. J., Azevedo e Silva, G., Chen, W-Q., Eser, S., Engholm, G., Stiller, C. A., Monnereau, A., Woods, R. R., Visser, O.,… Coleman, M. P. (2018). Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. The Lancet, 391(10125), 1023-1075. https://doi.org/10.1016/S0140-6736(17)33326-3


Jansen, L., Koch, L., Brenner, H., & Arndt, V. (2010). Quality of life among long-term (⩾ 5 years) colorectal cancer survivors–systematic review. European Journal of Cancer, 46(16), 2879-2888.

Kaplan, R. M. (2003). The significance of quality of life in health care. Quality of Life Research, 12(1), 3-16.

Morishima, T., Miyashiro, I., Inoue, N., Kitasaka, M., Akazawa, T., Higeno, A., Idota, A., Sato, A., Ohira, T., Sakon, M., & Matsuura, N. (2019). Effects of laughter therapy on quality of life in patients with cancer: An open-label, randomized controlled trial. PloS one, 14(6), e0219065.

Popat, K., McQueen, K., & Feeley, T. W. (2013). The global burden of cancer. Best practice & research Clinical anaesthesiology, 27(4), 399-408.