The very mention of the word exercise is enough to drive people to seek solace in a cup of coffee and a chocolate chip muffin.
Yet there’s no getting away from the fact that keeping the body physically active is important if you want to live a long, healthy life.
But what if there was a way to improve cardiovascular and lung function in a way that people enjoy and look forward to? And what if there were also profound social, emotional and spiritual benefits? And what if the advantages of this pursuit actually include healing effects in people with cancer?
Well there is such an activity — it’s singing in a chorus.
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More popular than football
Chorus America states that its mission “is to build a dynamic and inclusive choral community so that more people are transformed by the beauty and power of choral singing.”
A lot of Americans appear to be listening, because there are 270,000 choruses in our country, with more than 32 million adults and 10 million children taking part.
It’s the most popular form of performing arts participation. More Americans sing in choruses and other vocal groups than engage in football, baseball or any other sport.
Clearly there’s something about choral singing that meets important human needs.
A force for healing since antiquity
Music has been a force for healing for thousands of years. In 400 BC, the Greek physician Hippocrates prescribed music for his mentally ill patients, and records of choral singing in Greece go back to the second century BC.
In more modern times, John Harvey Kellogg, best known as the inventor of cornflakes, but also a medical doctor who incorporated nutrition and holistic healing methods into his practice, wrote in 1931:
“I have been particularly impressed with the value of singing. It is not only a diversion and wholesome mental occupation, and on this account health promoting, but is also excellent lung gymnastics and promotes not alone breathing but the circulation as well. It especially aids circulation through the liver, stomach and other digestive organs, and so promotes digestion.”
It wasn’t until 1948, however, with the publication of Music and Medicine, that a scientific approach was proposed for reaping the health benefits of music.
In 1996, the British Medical Journal published a study of the survival benefits from attending various cultural events, reading, and making music/singing in a choir.
Although the study didn’t single out the benefits of choir singing, the authors found that people who sometimes engaged in musical activities had an 11% reduced risk of mortality compared to those who rarely got involved.
An 11% reduced risk of dying is impressive. If they could put it in a bottle, the drug companies would make billions from it.
Social, emotional, physical and spiritual benefits
In 2001, members of a university college choir in England were asked in two surveys to complete questionnaires about their experience.
- 87% agreed that it benefited them socially (mainly by getting to meet new people)
- 75% emotionally (mostly by feeling happier, being more positive, raising mood and reducing stress)
- 58% physically (primarily by controlling and improving breathing and lung function)
- 49% spiritually (a range of answers that included phrases such as being more positive about life, therapeutic, in harmony, happier, less stressed, connected, worthwhile, contributes to society)
In the second survey, respondents were asked to rank choral singing for its impact on a list of 32 benefits. The top four were a positive mood, a moving experience, feeling happier and good for the soul.
The other main benefits mentioned by the singers were a sense of achievement, helps to relax, something to look forward to, improved lung capacity and breathing, mental well-being, reduced stress, able to forget worries and feel calmer.
Stephen M. Clift, Professor of Health Education at the University of Kent, who jointly conducted the study, said that “Just as walking is now prescribed, the benefits of singing for health are slowly being rediscovered by health practitioners.”
Professor Graham Welch, Chair of Music Education at the Institute of Education, University College London, has studied the effects of singing for 30 years. He found that as well as psychological benefits there are physical benefits.
“Singing has physical benefits because it is an aerobic activity that increases oxygenation in the blood stream and exercises major muscle groups in the upper body, even when sitting.”
It’s only in recent years that the impact of choral singing has been specifically looked at for its effects on cancer patients.
In 2012, cancer survivors were assessed after three months of choral singing.
Quality of life improved in terms of bodily pain, mental health, social functioning and vitality. They also experienced reduced anxiety and depression, and improvement in the strength of respiratory muscles. Choir members also reported feeling uplifted, with greater confidence and self-esteem.
Choir singing in the “land of song”
Tenovus Cancer Care is the leading cancer charity in Wales. It conducts research and offers care and support for patients and their families.
Wales is known as the “land of song,” because singing is an important part of Welsh identity. So it seemed natural to add choir singing to the cancer charity’s list of projects.
In 2011 they conducted research into its benefits. Findings were so positive they went on to form 16 Sing With Us choirs throughout the country.
One of their studies found that patients saw an improvement in their overall mental health, greater vitality and less anxiety. They felt participation was an uplifting experience and very supportive.
While these benefits were not unexpected, the charitable group was keen to learn if there were any biological effects, particularly regarding stress levels, mood and immune function.
To find out, they enrolled 193 choir members in a study. Saliva samples were taken from each participant and then again after one hour of rehearsing. The singers also completed a questionnaire about how they felt both before and after the rehearsal.
The subjective and biological findings were as follows:
- The stress hormone cortisol was lower at the end of the rehearsal
- Beneficial changes were found in the levels of endorphins and oxytocin. These hormonal modifications indicate an increase in social bonding
- Positive impact was seen on biomarkers relating to immune function and inflammatory response which could be linked to an improved ability to fight cancer and other illnesses
- Participants were less fearful, anxious, stressed, confused, angry, sad, tense, tired, alone. They reported feelings of improved energy, happiness and relaxation
- Those with the highest feelings of depression saw the greatest improvement in mood. These changes were associated with lower inflammation levels
Study authors praise choir singing
Three of the study authors commented on their findings.
Dr. Daisy Fancourt, Research Associate at the Centre for Performance Science, said, “Many people affected by cancer can experience psychological difficulties such as stress, anxiety and depression.
“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.
“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 wellbeing and quality of life amongst patients and put them in the best position to receive treatment.”
Dr. Ian Lewis, Director of Research at Tenovus, said, “We have been building a body of evidence over the past six years to show that singing in a choir can have a range of social, emotional and psychological benefits, and now we can see it has biological effects too.
“We’ve long heard anecdotal evidence that singing in a choir makes people feel good, but this is the first time it’s been demonstrated that the immune system can be affected by singing. It’s really exciting and could enhance the way we support people with cancer in the future.”
Rose Dow, Head of Sing with Us at Tenovus, added, “This research…echoes everything all our choir members tell us about how singing has helped them.
“I’ve seen peoples’ lives transformed through singing in our choirs, so knowing that singing also makes a biological difference will hopefully help us to reach more people with the message that singing is great for you – mind, body and soul.”
Whether you are already affected by cancer or just want to improve your chances of preventing it, singing in a choir seems to be one of the finest activities available to achieve this, as it works on so many levels that impact health. Why not seek out a choral group in your local area and get singing?