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The biological effects of Sing with Us

Since we set up our first Sing with Us choir in 2010, we’ve wanted to find out more about the benefits of singing for people affected by cancer. Our choir members have always told us that singing and being a member of the choir makes them feel better, and our previous research has proved that. But we wanted to understand the biology behind what people were telling us.


Biological effects

We wanted to know if singing in our choirs made any biological difference to people affected by cancer, specifically their mood, stress levels and immune function. All really important things when someone is dealing with cancer.

The study

We worked with the Royal College of Music in London to test 193 choir members from five of our Sing with Us choirs. We took saliva samples from each choir member before and after a one-hour choir rehearsal. We also asked them to complete questionnaires about how they felt, before and after.

We sent their saliva to a lab and measured changes in biomarkers. A biomarker is a naturally occurring chemical, protein or piece of DNA in your body that can be used as an indicator of how the normal processes in your body are functioning. We chose biomarkers which told us about changes in mood states, specifically the level of different stress hormones such as cortisol and other chemicals that indicate immune function.

The results

  • This research has shown that our Sing with Us choirs are effective at reducing peoples' anxiety and depression, and have a positive impact on biological markers related to stress, immune function and inflammatory response.
  • The study found that the level of choir members’ cortisol (a stress hormone) was lower after the rehearsal.
  • There was also an impact on choir members’ endorphin and oxytocin levels, which relate to social bonding.
  • Excitingly, there was also a positive change in a range of biomarkers related to immune function and inflammatory response in the body, both of which may be linked to the body’s ability to fight serious illnesses including cancer
  • The information from the questionnaires revealed that after singing choir members felt less afraid, confused, sad, angry, tired, tense, anxious, stressed and alone, and felt more energetic, happy and relaxed. 
  • We found that improvements in mood as a result of singing led to lower inflammation in the body. We know that high levels of inflammation are associated with many mental health conditions including depression.
  • The study also found that those with the lowest levels of mental wellbeing and highest levels of depression experienced the greatest short-term improvement in mood across the singing session, and that these changes were associated with lower levels of inflammation.
  • We now need to find out whether singing on a regular basis leads to larger and more sustainable improvements in mood and whether this affects inflammatory response.

Whilst this study has only measured one hour of singing, the results offer a very strong indication that the psychological and social benefits, we’ve previously shown through a study with Cardiff University, are driven by biological changes brought about by participating in our Sing with Us choirs.

This study has been published on e-cancer.


What next

Our research has shown the positive benefits our choirs bring to people affected by cancer. But we don’t want to stop here. We want to expand this research and look in more depth at the effect of choir singing over several months. We look forward to seeing the results of this study with the Royal College of Music and the Royal Marsden Hospital in 2019.