Yoga, first described in the Vedic texts of India, has been practiced for millennia. It involves regulated breathing, moving through various postures known as asanas, and meditation, aimed at achieving physical and psychological well-being. Many styles of yoga encompass some or all of these components. Yoga can have a positive impact on quality of life (QOL) in people with and without cancer, by reducing stress and fatigue and improving symptoms of certain inflammatory conditions. In the cancer setting alone, there are at least 10 randomized trials documenting the benefits of yoga on patients’ QOL.
SUMMARY: A growing body of evidence suggests regular practice of yoga can help control migraine, carpal tunnel syndrome, osteoarthritis, multiple sclerosis, asthma, hypertension, chronic low back pain, and irritable bowel syndrome. Given the positive effects of yoga on chronic ailments, several groups have investigated its potential for improving the quality of life in cancer patients. Results are promising.
Two studies of yoga reported at the 2010 meeting of the American Society of Clinical Oncology (ASCO) found it significantly improved sleep quality and fatigue.[2,3]
A randomized, controlled multicenter trial assessed a Yoga for Cancer Survivors program in 410 nonmetastatic-cancer survivors. Participants were randomized into standard-care monitoring or standard care plus yoga, which consisted of twice-weekly 57-minute sessions including pranayama (breathing exercises), 18 gentle Hatha and Restorative yoga asanas (postures), and meditation. Yoga intervention significantly improved sleep quality, fatigue, and QOL, while reducing sleep medication use.
In the second study, from Bangalore, India, 66 breast cancer survivors with metastatic disease were randomized to 12 weeks of yoga or supportive therapy. Compared with the supportive-therapy group, women randomized to yoga showed significant reductions in fatigue severity and interference, sleep parameters, and symptom distress. Also, there were significant reductions in salivary cortisol levels only in the yoga group. While emphasizing that larger randomized controlled trials are needed, the investigators concluded that the results “offer preliminary support for stress reduction benefits of yoga intervention.”
Indeed, in studies of breast cancer patients and survivors, yoga improved mood and decreased stress levels,[4,5] and a separate study of breast cancer survivors found that a Yoga of Awareness program reduced the number of hot flashes, improved fatigue, and reduced joint pain, with benefits persisting up to 3 months.
Tibetan yoga, which incorporates controlled breathing, visualization, mindfulness techniques, and low-impact postures, improved sleep quality in patients with lymphoma. Yoga also reduced stress, increased the sense of well-being, and promoted more restful sleep in newly diagnosed cancer patients and cancer survivors. An 8-week mindfulness-based stress-reduction program involving relaxation, meditation, and gentle yoga significantly improved symptoms of stress and overall quality of life in breast and prostate cancer outpatients.
Conclusions from a meta-analysis of nine studies of yoga in cancer patients state that, although preliminary data on the effectiveness of yoga are encouraging, larger, controlled clinical trials are needed.
ADVERSE REACTIONS: Adverse effects from yoga are rare, but subcutaneous emphysema and pneumothorax have been reported.
COMMENTS: Yoga, a mind-body approach involving breath control, meditation, and physical postures, originated in India thousands of years ago and is believed to benefit physical, mental, and spiritual health. It is also an integral component of Ayurveda. Yoga is popular in the US and is offered in health clubs; in yoga centers; and in many cancer hospitals, as part of disease management.
Current evidence indicates that yoga helps to reduce a variety of symptoms in the setting of cancer, greatly improving QOL. It is advisable that patients learn the proper technique from certified instructors who have experience working with cancer patients.