# Take a Breather—Physiological Correlates of a Conscious Connected Breathing Session in a Trained Group of Breast Cancer Patients

## TL;DR

This study shows that a breathing therapy called Conscious Connected Breathing can reduce stress and improve immune function in breast cancer patients.

## Contribution

The first study to analyze the acute physiological effects of Conscious Connected Breathing in breast cancer patients.

## Key findings

- CCB caused mild overbreathing, with reduced CO2 and O2 levels and increased blood pH.
- Prolactin levels increased, while cortisol and IgA levels decreased during CCB.
- These changes suggest CCB may improve hormonal balance and immune function in cancer patients.

## Abstract

This study examined the effects of a single session of Conscious Connected Breathing (CCB), which is part of Integrative Breathwork Psychotherapy (IBP), on stress levels and immune responses in breast cancer patients. Stress and negative emotions can weaken the immune system, partly due to increased cortisol levels. In contrast, prolactin may support immunity. Seventy-seven patients undergoing radiotherapy participated in a ten-session IBP program, which included rhythmic breathing through the nose and emotional expression. Blood and gas measurements were taken before and during the final session. The results showed that CCB led to mild overbreathing, with reduced carbon dioxide and oxygen levels, as well as increased blood pH. Notably, prolactin levels increased, while cortisol and IgA levels decreased. These changes suggest that breathwork may positively influence hormonal balance and immune function. This is the first study to analyze such physiological effects during CCB, indicating its potential as a complementary therapy for cancer patients. Further research is needed to assess the long-term benefits.

Introduction/Goal: Stress and negative emotions have been shown to exert a substantial impact on cancer patients, affecting their ability to adapt to therapy and the overall effectiveness. Elevated cortisol levels, a stress-induced hormone, have been shown to suppress immune system function, potentially reducing the body’s capacity to combat cancer cells. On the contrary, prolactin, a hormone that stimulates the immune system, has shown potential in this context but requires further study. The objective of this study was to investigate the acute physiological changes that occur during a single Conscious Connected Breathing (CCB) session, as part of a larger investigation on Integrative Breathwork Psychotherapy (IBP), a novel integrative psychosomatic intervention designed to improve psychosomatic and immune status in cancer patients. Methods: The project involved 93 breast cancer patients hospitalized for postoperative radiotherapy who participated in a ten-session IBP program. Fifty-six patients agreed to participate (response rate: 60%). During the experiment, 8 patients were excluded from the analysis. IBP consisted of small group sessions (up to six participants) conducted three times weekly. Each session included 45 min of CCB—defined as rhythmic circular nasal breathing at a depth exceeding resting tidal volume, without breath-holding, performed in a state of mindful acceptance—followed by 15 min of free emotional expression (verbal articulation of emerging feelings and sensations). This was a within-subject pre-post design: physiological measurements were obtained immediately before and 30 min into the tenth session (when participants had achieved technical proficiency) in all participants, who served as their own controls. Outcome measures included: arterialized capillary blood gas parameters (pH, pCO2, pO2, ctO2, COHb, HHb, cH+), serum cortisol and prolactin concentrations, and immunoglobulin A (IgA). Results: During the CCB session, blood gas analysis revealed significant changes consistent with mild respiratory alkalosis: decreases in pCO2 (p = 0.003), pO2 (p < 0.001), cH+ (p < 0.001), ctO2 (p < 0.001), COHb (p = 0.03), and HHb (p = 0.004), alongside an increase in pH (p < 0.001). Concurrently, prolactin levels increased significantly (p < 0.001), while cortisol (p < 0.001) and IgA (p < 0.001) decreased. Conclusions: This study is the first to analyze acute changes in capillary blood gas parameters and neuroendocrine balance during Conscious Connected Breathing sessions in cancer patients, revealing measurable immunostimulatory and stress-modulatory effects. The observed shift toward respiratory alkalosis, combined with increased prolactin and decreased cortisol, suggests that CCB may facilitate favorable neuroendocrine-immune interactions. These findings support the potential of breathwork as a complementary therapy for cancer patients. Further research is needed to explore underlying mechanisms and assess long-term psychological and immunological impacts.