Finding Strength Through Music

Leilany Uscinski remembers the day she felt like singing again after two months of chemotherapy and radiation. “Two weeks after my last treatment, the pain ended, and a song came into my heart. I felt a sense of relief, and I wanted to sing. I’ve always found comfort and strength in music.”

Other cancer survivors find that same solace through the Music Therapy Program Uscinski participates in at Sylvester Comprehensive Cancer Center. Sylvester is part of the University of Miami Health System.

What is music therapy?

Sylvester’s music therapy program promotes well-being in patients undergoing cancer treatment and in those recently treated. It is directed by Music Therapist and leader of the Sylvester Survivorship Choir Mary Adelyn Kauffman, DMA, MT-BC, NMT.

She defines music therapy as “the use of research and clinical, evidence-based, individualized music interventions to achieve non-musical goals.” A cancer survivor herself, Kauffman brings a special empathy to her practice. “She is much more than a clinician. She’s a wonderful person who goes above and beyond her job,” Uscinski says.

Kauffman and her fellow therapists modify their interventions to each client’s strengths, needs, and preferences. They use different techniques to produce a variety of benefits:

• Individual sessions with singing, songwriting, playing an instrument, moving to music or Music-assisted Relaxation (MAR) to reduce stress, anxiety, pain, nausea, and discomfort and to promote relaxation while maintaining cognitive and fine motor skills.
• Breathing exercises to aid relaxation, improve focus, and strengthen the lungs and muscles after radiation
• Memorizing and singing lyrics to improve memory and cognitive abilities after chemotherapy
• Meditation to manage anxiety and stress by promoting the relaxation response
• Participation in the Sylvester Survivorship Choir to instill confidence, boost mood, and build a support system

Uscinski benefitted from these approaches.

“Mary always had something I could do. There’s a purpose behind everything she does. It made me feel so good that I remembered the lyrics to a whole song. Performing in the choir built my confidence and gave me a sense of purpose, as well as the support of a community of survivors.”

When Uscinski nervously anticipated her first scan after treatment, Kauffman invited her to come by for a session.

Together, they played the tongue drum, an instrument widely known for its therapeutic use.

To a casual observer, it might appear as if the women were simply tapping gently on a small drum, but much more was happening. “Listening to or playing music facilitates the relaxation response through repetitive rhythmic, melodic, and harmonic structures.

Patterns in music encourage the subconscious mind to follow the patterns, which helps the mind stay focused. Temporal music structures can be used to entrain breathing and heart rate, promoting deeper breaths and increasing blood flow to the brain.

Listening to music also stimulates the production of dopamine, endorphins, and serotonin, the ‘feel good’ hormones,” Kauffman says.

It worked for Uscinski. “The next thing I knew, I felt better after playing the drum.”

Healing Harmonies

Kauffman often relies on Music Assisted Relaxation (MAR) to help clients. Using live or recorded music and spoken instructions, she’s able to promote the relaxation response.

“The relaxation response aims to encourage the body to maintain balance between the sympathetic and parasympathetic nervous systems in stressful situations. It increases blood flow to the brain and releases neurotransmitters and hormones that slow muscle and organ activity,” Kauffman says.

MAR has been widely studied in clinical trials. Research shows it improves sleep quality, decreases preoperative anxiety, and reduces nausea and vomiting in patients undergoing chemotherapy.

Regular practice of the relaxation response can reduce blood pressure, heart rate, and breathing rate.

In addition to those physical improvements, research by University of Miami Frost School of Music alumna Julie Stordhal, Ph.D., MT-BC, reported on music’s positive effect on relaxation, which improved mood and overall well-being in women following breast cancer treatment.

Keep Calm and Carry On

What Uscinski learned in music therapy helped her manage stress brought on by the pandemic. At a time when a trip to the grocery store could prove life-threatening, especially for a cancer survivor, Uscinski used the techniques to stay calm and focused. “Even though I’m not currently going through cancer, the breathing, meditation, and other techniques I learned help me deal with anxiety.”

When COVID safety measures shut down music therapy in clinical areas, Sylvester’s Cancer Support Services staff shifted all weekly classes, group meetings, and events into a virtual format. Videos were created and posted on Sylvester’s YouTube channel featuring music therapy and other therapeutic outlets. Patients participated at home, on their own schedule, or joined online meetings in real time.
Kauffman says this change allowed more people to participate. Survivors, caregivers, and families who could not travel to Miami or Sylvester’s locations in person could access services.

As a result, the number of outpatient survivors in Kauffman’s weekly music therapy sessions has more than tripled, compared with the previous year.

“This has been a great win for Cancer Support Services in general and the music therapy department in particular,” Kauffman says.

The Survivorship Choir practices regularly on Zoom. They performed via Zoom during the holidays, broadcasting their performance to survivors’ laptops, smartphones, and computers, and to inpatient room television screens. Uscinski recalls some pre-pandemic moments with the choir. “We sang the National Anthem at a Panthers hockey game, and sang for patients in the chemotherapy unit. To see a survivor thriving gives them strength and gave me a sense of purpose.”

When the pandemic subsides, Kauffman foresees using a combination of in-person and online survivorship services, so all survivors can benefit.

Reflecting on the last year, Frank J. Penedo, Ph.D., professor of psychology and medicine and associate director for Cancer Survivorship and Translational Behavioral Sciences, says, “It has been very reassuring for our patients and survivors to access these critical services during the pandemic. Continuity of support services retains a sense of normalcy under what have been challenging times. We are fortunate to have such dedicated cancer support and survivorship programs that thrive and expand despite the pandemic challenges.”

Four years after being diagnosed with cancer, Uscinski remains cancer-free. She continues to draw strength from music. “Whenever I experienced a significant event in my life, I always went back to singing in a choir.”

Fortunately, for Uscinski and others like her, the therapists at Sylvester will continue to harness the power of music to share hope and healing.

For questions about Sylvester’s music therapy program, email Mary Kauffman.

Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the Centers for Disease Control and Prevention. Her writing also appears in the Chicago Tribune and U.S. News & World Report.

Tags: cancer care in Miami, Mary Adelyn Kauffman, music therapy, Sylvester Cancer, Sylvester Singers Survivorship Choir