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Part 1: The Role of Yoga and Meditation in Improving Quality of Life for Cancer Patients Namaskar. Good morning. Greetings from the All India Institute of Medical Sciences, New Delhi, a tertiary care hospital in North India, often called the Harvard of the East for our visitors from overseas, especially America. You all know that Yoga is a conglomeration. It is derived from the Sanskrit word Yoga, from the Yuj Dhātu, which means Jorna (to join). In the real sense, Jorna of Īśvara, Ātmā, and Paramātmā is Yoga. There are many meanings of Yoga, the meaning for which we are sitting here today. Let us talk about it. It is a body-mind activity, a combination. There are several studies—some randomized trials, some follow-up studies—observing ladies and gentlemen suffering from cancer who were offered, along with their allopathic treatment (surgery, radiotherapy, chemotherapy), some form of yogic intervention. In some studies, they instituted instructor-based training, where a yogic instructor trained these patients in various types of yogāsana and prāṇāyāma. Going through the literature, it became obvious that different authors have used different types of yogāsana, different types of prāṇāyāma, and meditation (dhyāna). Some have used Bhavatir Dhyāna as initiated by Maharṣi Maheśh Yogī, and some used other forms, like the Art of Living by Śrī Śrī Ravi Śaṅkarjī. Various other forms of meditation have been used in combination with a combination of yoga sense. We have to keep in mind that when the literature says "yoga does this" or "yoga does that," we should be clear what we actually mean. We will have to read the small print. As we read the terms and conditions when purchasing a new machine, similarly, we must read what technique of yogic intervention and what technique of meditation these authors have used, because it is quite variable depending on where it has been offered. It has been said that, in general, yogic intervention helps in relieving the stress level of patients and thereby improves their sleep. Many of these patients, due to a diagnosis of cancer, have sleepless nights. Not only that, once they undergo major, painful operations, they again have a lack of sleep. Once they undergo chemotherapy, which causes hair loss, loss of appetite, ulcers in the mouth, diarrhea, and vomiting—which is again very distressful—they also have a lack of sleep, and their physical fitness and quality of life deteriorate. So, in general, yogic interventions along with chemotherapy and radiotherapy seem to improve some of these issues. We will go through the literature to see what the current evidence is in favor. There is some suggestion that when yogic interventions are offered for a long time to cancer survivors, it may actually reduce cancer recurrence and death due to cancer. But that data is very sparse and not very robust. We should keep that in mind when people claim that yoga cures cancer, that prāṇāyāma cures cancer. This is an opportunity for me to give a clear message and a humble request to practitioners of yoga: please do not give a false hope—or you can say hope—that your cancer will be cured. Please do not say, "Kapāla Bhāti, I have seen so many cancers cured." Please don't do this, because we are the sufferers of this kind of statement. It is going on in the country and maybe neighboring other countries also, because every cancer patient wants to get away from surgery. Surgery is a major mutilation. Chemotherapy is stressful. So, if someone tells them that we will fix it with yogāsana—"our aunt was cured"—or we are some yog guru who says in the big sabhā that we will fix it with prāṇāyāma, bhāvanā, dhyāna—they are giving wrong assurance. Please, please, for God's sake, you are doing this sin. If a yogic practitioner is telling them that with prāṇāyāma, dhyāna, and some Ayurvedic herbs—aloe vera and guloy—are saying in the Bārisabā that cancer cures it, then they are committing a grave sin in society, and we are all part of this sin. What happens then? Cancer patients come to us. Two years ago, they had it. What did you do? For six months, they went to homeopathy. Then a new bābā came. Then a yog guru came. He said, "This will be cured. Eat this herb and meditate so much. Do this much prāṇāyāma, do that for 6 months." The disease increases, then they come to big hospitals: AIIMS, BHU, Lucknow, PGI Chandigarh, Tata Memorial Hospital. They reach there. And then the disease increases a lot; the cancer demon fights them completely, and the body gets completely exhausted. Then, no medicine in the world, no medicine, no auṣadhi, is a cure. So here is a peculiar problem in some societies: that yogic instructors give a false hope, a false sense of hope, and claim that yogic interventions and prāṇāyāma and some herbal preparations can cure cancer. The cancer patient is distressed. He doesn't want to undergo the diagnosis that has been made by the allopathic modern medical practitioner, but they want to avoid surgery, which is costly, expensive, and distressing, and chemotherapy. So they follow the advice of these practitioners and undergo various prāṇāyāma for a variable period of time, only to realize that it was a false hope. The cancer grows, it spreads, becomes painful, becomes inoperable, incurable. And then only do they land at a modern medical doctor. This is something that we need to be clear about. I like the feeling and the bhāvanā of sarvabhūthite ratāḥ. In the Bhagavad Gītā, Lord Kṛṣṇa has initiated the principle of sarvabhūthite ratāḥ. In chapter 5, śloka 25, the Lord says, "Sarvabhūt" means all beings, not only human beings but all creatures, which includes animals and plants also. "Sarvabhūt hite," "hite" means welfare, "rata" means engaged, like we say "āp karīrat hain," meaning engaged, so ever engaged in the welfare of all. That should be the spirit. That should be the bhāvanā of all modes of therapist. Whether you are a yogic practitioner, a prāṇāyāma practitioner, a dhyāna practitioner, a teacher, an instructor, or even an allopathic doctor or a homeopathic doctor, we should all be working with the feeling of ever being engaged in the welfare of all. We should at no time do any harm. In medical allopathic medicine, we take an oath, the Hippocratic oath, and then we learn the principle of "primum non nocere," which is Latin for saying, "First, do no harm." If you are a very learned yogic guru, just tell them that if you follow chemotherapy, radiotherapy, surgery as advised by an experienced doctor, along with that, if you follow this yogic intervention, you will have better treatment. That should be the spirit, not claiming that only yoga will cure. So please keep that in mind, because a lot of patients are coming to big hospitals. What are the problems that we encounter when a patient develops cancer, unfortunately, in our society? There are a number of reasons: the modern way of living, Western lifestyle, increasing pollution in the air, in water, in food items, and increasing stress levels, along with, I'll say, very bad food habits. Because the Ayurvedic principle is, in order to keep you healthy, you should have right āhāra, vihāra, and vichāra. And when required, may require auṣadhi. So āhāra, vihāra, vichāra, or if necessary auṣadhi, or if necessary śalya-kriyā. These are the principles for staying healthy. Yukta āhāra vihārasya, yukta ceṣṭasya karmasu, yukta svapnāvabodhasya, yogo bhavati duḥkhahā. Chapter 6, Śloka 17 of the Bhagavad Gītā, Lord Kṛṣṇa enunciates the principle of appropriate food, appropriate lifestyle. Vihāra means lifestyle. So, what time are you? "Early to bed and early to rise makes a man, and also a woman, healthy, wealthy, and wise." That was very good advice given by our ancestors. We are forgetting it. We remain awake until 12 or 1 o'clock, doing WhatsApp messages to our friends, and so we forget to go to bed early. Then we get up after sunrise. All the śāstras and Vedas and Patañjali yoga suggest that you should rise two to three hours prior to sunrise. That's the time, Brahma Muhūrta, and that's the best time to remain healthy. We have forgotten that. We have a very stressful life, and in big cities we are seeing that people are oriented to jobs. They take an MBA and then they want to be the CEO. Especially ladies, they don't want to marry. They delay their marriage, then, having married, they delay their first childbirth. Studies have shown that if your first child is between 20 to 22 and you breastfeed for two to three years, your chance of breast cancer and some other cancer will go down. But here we have ladies who are career-oriented, job-oriented, so they keep delaying all these natural, physiological protections. They delay all these, and as a result they become victims of diseases like cancer. And, of course, bad food habits, so we are witnessing an increasing burden of cancer in our society. This is true for Western society as well, and that crab of cancer is capturing Asian society also. It has already captured. Breast cancer is the commonest cancer of the human race now. Even in India, breast cancer is the commonest cancer. And these factors, which I just mentioned, are the culprit. As soon as the diagnosis of cancer is made, the entire family, and of course the patient, are in distress. Not only that, there is lack of sleep, lack of appetite, low energy level, and mental depression. Often, they have nausea and vomiting, especially when they are having anti-cancer drugs. And depending on which organ is involved—if you have cancer of the hand, I may have to remove your hand; if with cancer of the breast, I may have to remove that organ—there may be disability depending on which organ is involved by the cancerous process. These are some of the problems that we encounter in cancer patients. So, how can the use of yogic intervention, prāṇāyāma, and some yoga āsanas, done regularly by a trained instructor, facilitate or reduce some of these problems? Studies show improved blood flow to that organ, and muscle function in general improves. There may be improved oxygen supply to all the organs because of deep breathing, when the vital capacity and the tidal volume of the lung increase, and oxygen is taken in larger amounts and is distributed to organs which are sick. And, of course, there is reduced mental stress and anxiety level, which is very commonly seen in cancer patients. There is a sense of well-being induced by the practice of yogic activities and meditation, particularly. Some studies have shown improved physical fitness. So these are some of the mechanisms. There is some suggestion that yogic exercises can boost your immunity by improving the sense of well-being and pituitary and hypothalamus function in the brain and increasing your appetite. It may boost your immunity, so you may better combat the ill effects of chemotherapy, radiotherapy, and surgery; healing power improves and your immunity improves. This is interesting, that these activities are seen more commonly in younger patients. This fact is particularly important for our country and Asian countries, where about 30-40% of patients in Asia are actually younger, below 50 years of age. Because the onset of cancer in our society is about 10-15 years earlier than seen in the Caucasian populations of Europe, Germany, America, and England. So we have younger patients becoming victims of cancer. And if there is greater benefit of yoga and prāṇāyāma in younger patients, that's beneficial. So yogic intervention may be particularly useful for the patients of our country. Just to show you what the trend of cancer onset is in our country, we have about 30 to 40 patients, younger ladies affected at the age of 30 to 40, the very prime of life, the prime of youth. This is particularly important. In Delhi alone, the highest age-adjusted rate is very high. Second is Chennai, Madras, Bangalore. So these big cities have a very high incidence of cancer in younger patients. I have taken the data from a large study which conglomerated, which joined the results of most of the randomized trials. Randomized trials are trials where you offer, say, yogic intervention and prāṇāyāma to one group of people, and then a control group where those yogic prāṇāyāma and interventions are not done. So that other group serves as the control. This is called a randomized trial. When you have several randomized trials, we can pool the data from several trials. Suppose we have 100 patients in 10 trials. So there are small trials of 100 patients, 10 such trials. When you pool the data, you take a total of 1000 patients. So together, your power to say the truth increases. That’s the simplest meaning of meta-analysis in plain English. It’s a statistical tool for pooling the data from several studies; it’s called meta-analysis. I have taken the opportunity of giving you the summary of one such large meta-analysis, which studied 16 papers, of which 13 were randomized trials. Twelve of these, the majority, had studied patients suffering from breast cancer, and one trial had also studied patients from lymphoma. Lymphoma is a tumor of the lymph glands. The lymph glands are tiny glands; when you have a sore throat or some cough, you have tiny glands here, lymph glands in the neck. A cancerous disease of the lymph gland is called lymphoma. One such author had studied the role of yogic prāṇāyāma and intervention in patients suffering from lymphoma. Of these, some studies were done on patients who were undergoing therapy, during which chemotherapy and radiotherapy were being done; during that time they were given prāṇāyāma and yogāsana. Some studies were done in which their therapy was completed, and they were done after that. Some studies included patients who were receiving anti-cancer drugs, chemotherapy, or radiotherapy, or who had just finished their surgery, and then they were offered a combination of yoga and prāṇāyāma and yoga āsanas. Some studies had taken long-term, up to 5 years, 6 years of patients after they had completed their cancer therapy. The average age of the subjects studied in these various studies ranged from 44 to 63, and 11 studies—because mostly they were studying breast cancer—were actually studying ladies. The methodology was, in most of these studies, a supervision of intervention of yogic activities, yogāsana and prāṇāyāma. So, in most studies, they had a yoga guru, a yoga teacher, who introduced them to the method of yoga prāṇāyāma and dhyāna bhāvanā, dhyāna adhi, and made them do yoga prāṇāyāma in a supervised manner. The duration ranged from six weeks to six months, studying for about one hour every day. So most studies involved a supervised intervention of yogic activities by a trained instructor, and in general, on average, they were offered one hour daily of yogic activities and prāṇāyāma. The control group in these patients were those who were waiting to undergo chemotherapy, surgery, or radiotherapy and were not offered yogic intervention or prāṇāyāma. They were just advised a coping mechanism: "Don’t worry, don’t worry, you will be cured, everything will be fine." But no yogāsana prāṇāyāma was done. This is necessary so that we can know, without yogāsana and prāṇāyāma, how much decline there is in health and how much benefit we can take from yogāsana and prāṇāyāma. So whenever we do any medical research, we keep a control group so that we can compare how much benefit we get from yoga, prāṇāyāma, and āsana. You can see in the results: physical functions were improved by a statistically significant P less than 0.01, which is highly significant. The other was psychological outcomes, distress level and anxiety level. So physical function, distress, and anxiety—these three parameters were shown to be significantly improved. In those who were given yoga, prāṇāyāma, etc., their physical work improved a lot, their mental stress decreased, and anxiety decreased. These three results were seen in a very good way. In the rest, not much improvement was seen. Part 2: Yoga, Prāṇāyāma, and Herbal Support in Cancer Care: A Research Proposal and Perspective We observed that depression and mental depression improved significantly, and the sense of overall quality of life also improved. There are scores for assessing overall quality of life that also improved significantly in these patients who were offered yoga and prāṇāyāma. In the group where yoga prāṇāyāma was done—what we call the quality of life of the whole body—it improved a lot, whereas the rest of the prāṇāyāma practices did not benefit as much. While examining these prāṇāyāma practices, we wish to make a proposal through AYUSH. Since our current data is not very powerful or statistically robust, we have a proposal for the AYUSH ministry to launch large, population-based intervention trials. We are working on aims in collaboration with the National Institute of Cancer Prevention. Professor Rath was chief of that center, ICPO, formerly called the Institute of Cancer Cytology and Preventive Oncology; now it’s called the National Institute of Cancer Prevention. It is an ICMR-funded, central government institute located in Noida City Center. Our doctors go there regularly and help in cancer screening and prevention trials. Therefore, we can perform a prevention trial under the National Institute of Cancer Prevention. My proposal is to have three groups of people, in three villages, with about 30,000 people each. I have already spoken to the chairman of the Maharṣi Āyurveda Corporation. They have offered to provide Maharṣi Amṛt Kalaś, which is a rich source of antioxidants, a combination of 50 herbs. It is called Maharṣi Amṛt Kalaś; it is a mixture of 50 herbs. Brahma Rasāyana, which was described in the Brahma Saṁhitā, is the form of Maharṣi Amṛt Kalaś. Over more than 20 years, scientific studies have been conducted in America and India. Professor Rath was himself involved. We have found that if you give Maharṣi Amṛt Kalaś along with chemotherapy to breast cancer patients, they show significant improvement. Their overall health improves, their appetite improves, their diarrhea and vomiting are reduced, their mouth ulcers also reduce, they have a better appetite, and they gain body weight. Generally, cancer patients on chemotherapy lose weight because they are not eating; they have ulcers in the mouth and vomiting, so they lose weight. But in this group, our randomized trial showed that women receiving chemotherapy and Maharṣi Amṛt Kalaś actually put on weight. This is statistically significant and published in medical journals; you can find it online. We are now proposing a prevention trial because numerous animal studies show that animals fed this product and then exposed to carcinogens did not get cancer. So it acts as a cancer-preventive herbal formulation. We propose a combination approach. It is said that many cancers occur due to stress levels, including stress in early childhood. There is data that in breast cancer, girls who experience stress in early life are more likely to develop breast cancer later in life. If that is true, then we can offer them de-stressing prāṇāyāma and dhyāna, bhavatī dhyāna or transcendental meditation as initiated by our yoga gurus. That combination will reduce stress along with yogic activities, and some herbal products in collaboration may act in reducing cancer incidence. This is one such proposal. We may study the incidence of a number of cancers: cancer of the breast, oral cavity, cervix, and ovaries. They are all related to stress and the modern way of living. Along with that, it may also reduce non-communicable diseases such as diabetes and hypertension. Because if you have good āhāra (diet), vihāra (lifestyle/recreation), and vicāra (thought), you will reduce all bad diseases. It may also reduce the commonly increasing problem of metabolic syndrome, overweight, and, of course, it will reduce psychological diseases such as depression and anxiety. In summary, Honorable Chairpersons, my teacher Prof. Raj, Prof. Nayak, Gurujī, I humbly submit that most of the data in the literature suggest a strong beneficial effect in reducing stress levels, anxiety, and depression in cancer patients if they are offered yogāsana and prāṇāyāma. The effect on reducing and improving fatigue and emotional-social function is less pronounced, and there is a small effect on improving functional well-being. Studies have failed to show any significant improvement in physical function and sleep. So, in summary, as far as research has been done, it seems there is a lot of benefit for mental stress. We need more robust studies with larger samples, which are statistically powerful and may be nationwide. Population-based studies are required. I also noticed that most studies used different yogic interventions and different types of prāṇāyāma and meditation regimens. If all studies used the same yogic intervention and the same meditation, then we may demonstrate a better effect with statistical power. If all these yoga practices, if only one type of meditation and prāṇāyāma were taught to everyone, then we would be able to say with more certainty which yoga method, which prāṇāyāma, or which meditation method benefits us the most. Thank you. Part 3: Yoga, Palliative Care, and the Molecular Perspective We simply gave him morphine and advised some yogic principles. You can see he came back for morphine tablets and evaluation after only seven days. Compare this face to this face; there is a lot of change in just seven days. Although the patient was suffering from advanced cancer, yoga helped him. Sickness releases endorphins, and we gave morphine. That combination helped him. You can see yoga can prevent suffering. At least, you can change this person back to his former self. It was the combined effect of morphine and yoga, so both should be prescribed. This is a visit after two weeks. You can see he has become much like a normal man, talking to our team members very jovially. You cannot make out whether he’s suffering from cancer or not because he is so jovial. The pain was gone, his mind was calm from practicing yoga. He was a rickshaw puller from Bhadrak and had gone back to his profession. He died, of course, after about seven to eight months, but he was working. His family was also not bothered for him. Because of morphine and yoga, his anxiety vanished, and he was comfortable. He died a peaceful death. His body left this world in a peaceful status without any problem for the patient or the family. One more patient with cancer, fungations, was given palliative care, morphine, and yoga. You can see the spine in this photo, taken about one month before death. This again shows combined therapy can be given: yoga and allopathic medicine treatment. As I just explained, yoga can prevent cancer at three levels. Primary prevention involves proper screening, vaccinations, and preventing the incidence of cancer. Secondary prevention involves early diagnosis, prompt treatment, and halting the disease's progress. Even if cancer is diagnosed, it can be caught at an early stage and cured, removed from the body. At the tertiary level, which is my domain, when the patient has advanced cancer and we cannot remove it, we can at least remove the sufferings and the pain. We can prevent the suffering of not only the patient but also the family, so everybody is comfortable. Yoga is uniquely applicable to all three stages. We should apply yoga for primary, secondary, and tertiary prevention. That is my last slide. Thank you very much. Chairperson's Remarks He started with the incidence of cancer in India, which is around 120 per 100,000. However, the cancer rate in the United States is around 500 per 100,000. We are the same individuals, but the incidence is almost one-fourth here. We are trying to study why, between the two countries—though their life expectancy is a little more—it cannot explain a four-times higher incidence. Probably, some of our hypotheses are due to yoga and our vegetarian nature. You will never see curcumin or haldi being used in an American kitchen. Americans won’t know what haldi is. Whereas in Indian food, if you put your finger, it will become yellow. Any food you take, probably that’s the reason. But we want to again scientifically prove it because the world wants evidence. We are in the process of producing evidence for that. Number two, I myself experienced this in Maharishi Mahesh Yogi’s ashram in Noida. We had a very senior vaid called Vaid Triguna. He had a ward there, and I saw two lung cancer patients I was following up. My friend, Dr. Mahāpatra, was a close disciple of Maharṣi jī. I had darśan of Maharṣi and was observing those two patients. They were given nothing but pañcakarma and yoga, and the CT scan showed a definite decrease. I was younger then and didn't keep those pictures, but we will do such studies here. To do it in our institute, we must go through all ethics clearances. We have completed all formalities for an Ayurvedic coded drug with CCRAS and our ethics committee, so we’ll carry on this study here also. Genome Instability and Cancer: Restoring Balance at the Molecular Level by Yoga Good morning. At the onset, I thank the organizer, the Ministry of Ayush, and especially my Gurujī, Dr. Nagendra, for this platform. I bow humbly to the eminent chairperson, Dr. Rath, a pioneer in cancer biology, Dr. Arya, and my co-speakers. In the next 900 seconds, I will show you pictures, as they speak thousands of words. These colorful pictures are paintings of DNA painted with fluorescent probes, showing how they behave when the cell functions. I acknowledge my collaborators: Dr. Hande, Dr. Rosen, Dr. Sridevi Hegre, Dr. Madhavananda Kerr, and Dr. Tapas Kundu. This is my lab; these are the people who work. There has been a transition from cell-based to DNA-based diagnosis. Today we are more precise in knowing what’s happening in the body. DNA has been very popular. While Bill Clinton was president, the Human Genome Project was declared. He said, "We now know how to read the book of life," but we are far from it. We only know how to read the letters. There are 3.4 billion letters in one cell. A 65 kg individual has 10^14 cells. Each cell has one DNA molecule with 3.4 billion bases. If DNA is the software, who wrote the code? We are still searching. Our life is made of four letters. God has written the entire universe with only these four letters, from bacteria to man, from trees to animals. We all start our journey with a single cell. Half the chromosomes are from your father and half from your mother. We become multicellular, and then we become aware of ourselves. When a child first recognizes itself in the mirror, the ego comes in: "This is me, and I want..." This "I want" leads to bizarre lifestyles, inducing DNA damage. As Dr. Naik mentioned, DNA damage creates genome instability. Physical breaks in the DNA cause diseases. Life is responding to what you are doing. I’m at a yoga conference, so here is the yoga. You look at postures, people bending their body to mend the mind. Āsanas activate different hormonal and physiological centers in your body, which ultimately affect your brain. Your brain is the central processing unit, and your DNA is the software. You connect to your brain by bending your body. Now you are in front of a guru. You sit with him, and there is an energy dynamics going on; your DNA is also part of it. So, bend the DNA to mend the genes and evolve. This is our hypothesis. Talk to your DNA. Your soul print is your signature, but your chromosomes are also very personal. Every human being tries to evolve, to find goals, to develop physically, personally, emotionally, and spiritually. They condition their mind. Age, gender, development, environment, health, and food all play big roles. A recent study in the British Journal showed that aerobic exercises, yoga, tai chi, music, relaxation, massage, and dance given to cancer patients during treatment help. They may be weak during treatment, but once they recover, they do really well. The circles change. The evolution of consciousness involves DNA activation. We inherit DNA from our parents, who inherited from theirs, through thousands of birth-death cycles. Even viral DNA integration, proto-oncogenes, and oncogenes are signatures of past infections, perhaps from 500–600 years ago. Your DNA has captured this. There are now efforts worldwide regarding the god gene, spirituality genes, and janma. You will be happy to know that Nature Genetics had an Indian god, Śiva, the god of immortality, on its cover. Telomerase is an enzyme found in the telomeres of your chromosomes. The tails shorten as cells divide; that’s why we age and die. Telomerase can prolong telomeres, stop aging, and make a cell immortal. Cancer cells activate it; the person dies, but the cancer cells don’t. Telomeres and genome instability are the crux of my talk. Telomeres protect your chromosomes and are part of genome integrity. You lose telomeres every time a cell divides. A child has longer telomeres; a 70-year-old has shorter ones. It’s not only length but function that matters. We knocked out telomerase from mice, and they developed cancer and died prematurely—a remarkable discovery published in Cell in 1997. The discoverer, Carol Greider, a postdoc of Elizabeth Blackburn, got the Nobel in 2007. Telomeres are the basis, and 95% of cancers are telomerase positive. Telomeres help in DNA damage recognition, repair, and genome integrity. They function to protect your genome, keep stem cells reserved, and regulate cell death and tumor processes. As early as 2007, we published that people undergoing radiation have different telomere responses. We must know who will respond and how. Some Nobel laureates collaborate with us, and I am happy to learn from them. Aging is the biggest carcinogen. Most epithelial tumors occur later in life because telomeres are short and dysfunctional. Aging is irreversible; we can only age and die. This is a famous Indian cricketer; see how he aged fast in eleven years due to stress. Life stress, a bizarre lifestyle, and his response to the world stressed him. Then he left captaincy and recovered. Dr. Devi Shetty works hard but has not aged as fast because he balances himself. These are the models I show. Life must be active, aging with your genome health balanced. It’s not how long you live, but how well you live. Stress affects our nervous, immune, and endocrine systems—this trilogy—and has a psychoneuro impact on your genome. Cancer is one result. There are different modes of stress; you are yogīs and know this. People lose natural abilities because of stress; they change the basic balance. We proved and published last year that a prolonged inflammatory microenvironment is important for pro-neoplastic or cancerous growth. Keeping cells in a microenvironment with hormonal stress or irregular cytokines may cause cancer. I propose this stress cycle. Most people are in it: hypertension, type 2 diabetes, cardiovascular disease, obesity. It’s a vicious cycle. You have background junk: eating, smoking, genetic, and environmental factors. Sedentary lifestyles, work pressure, and deadlines. You take your body for granted, but it responds differently. My approach: people go for a master health check to see organ homeostasis. Can you see the function of the genome? Can you assess genome health? We do genome health assessment. We found that diabetes, cardiovascular disease, hypertension, and obesity have common driver genes, which we call the stressome. This is important to know why we age faster and develop diseases early. They are regulated by different gene network centers. We are looking at networks rather than single molecules. Genome health index is important; that’s what we are looking to.