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NEW YORK – Yoga is finding its way into oncology wards and cancer treatment centers all over the country, echoing the widespread popularity of this ancient practice.
Several studies presented at the annual meeting of the Society for Integrative Oncology indicate that carefully tailored yoga programs can markedly improve quality of life and overall health following conventional treatment for a wide variety of cancers.
Some of the observed benefits include reduced anxiety, improved sleep, decreased use of medications for sleep and stress, improved flexibility and balance, and attenuated side effects associated with cancer drug therapies.
"Yoga interventions have been found to improve symptoms and quality of life in cancer patients," said Stephanie Sohl, Ph.D., of the comprehensive cancer center at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. Dr. Sohl’s group has been collaborating with a team at Mount Sinai School of Medicine in New York to develop a brief yoga intervention for women who are being treated for ovarian cancer.
"The primary goal of any therapy for patients who have persistent or recurrent ovarian cancer is shifted from solely pursuing a cure to the control of symptoms and overall maximization of quality of life," Dr. Sohl said.
The Yoga Skills Training (YST) model being pioneered at Wake Forest and Mount Sinai consists of 15-minute sessions that are focused on simple, nonstrenuous yoga linked to the patients’ chemotherapy appointments.
A study of the efficacy of this intervention is underway to measure the impact on anxiety, pain, fatigue, and other quality of life parameters. Investigators are using standardized assessment scales including the Cancer Behavior Inventory, the State Trait Anxiety Inventory, the Brief Pain Inventory, and the Functional Assessment of Cancer Therapy Fatigue scale.
So far, seven women have completed the trial. Dr. Sohl noted that the yoga intervention resulted in measurable changes in mean scores for anxiety, relaxation, and self-efficacy in coping, but no significant changes in pain and fatigue.
Two other studies of longer, more intensive yoga interventions for cancer patients are ongoing at Wake Forest. But she noted that the brevity of the YST sessions may ultimately be more feasible for patients and more easily integrated into existing cancer care settings.
Researchers at Wayne State University College of Nursing in Detroit are also exploring the effect of yoga as a posttreatment adjunct, but with patients surviving non–small cell lung cancer. The Wayne State program involves a standardized yoga sequence that is designed for cancer care implemented in the clinic setting, but also practiced by the patients at home. Patients participate in weekly 45-minute sessions for a total of 8 weeks, and are encouraged to practice what they learned on their own.
In a pilot feasibility study, nine patients – all of whom had undergone standard treatment for non–small cell lung cancer – were enrolled in the program; seven completed the full 8-week intervention and 6-week follow-up. Judi Fouladbakhsh, Ph.D., who is an advanced practice registered nurse at Wayne State, noted that compared with baseline measurements, patients reported consistent and significant decreases in dyspnea and chest tension following the sessions, as well as improved sleep quality and decreased use of sleep medications.
There were no adverse effects – respiratory or otherwise – associated with the practice, and Dr. Fouladbakhsh added that six of the patients were still practicing the yoga exercises at 3 months’ follow-up.
There are significant logistical and methodologic challenges in bringing yoga into the cancer care setting. The selected postures and movements must be compatible with the limitations of strength, stamina, and stability of people who have undergone surgery, radiotherapy, or chemotherapy, many of whom are elderly and also facing other health challenges. Class leaders must be specially trained in working with cancer survivors, and the interventions must be designed to fit with the often demanding treatment schedules.
Generally, yoga gives optimal results when practiced daily or at least several times per week; long-term adherence is a challenge for many patients.
From a research viewpoint, the challenges are significant because in most cases the benefits are subjective. Most studies so far have been small, short term, and dependent on patient self-assessment, with all the attendant limitations this brings. It is also impossible to design a "blinded" study of yoga or any other exercise modality, making it difficult to evaluate the true impact of yoga practice.
To date, there have not been any studies of yoga’s impact on cancer outcomes such as survival, disease-free survival, or mortality; all available studies are on quality of life parameters. But recently, investigators have been trying to move toward objective measures.
Mary Lou Galantino, Ph.D., and her colleagues at Richard Stockton College of New Jersey, Pomona, have been studying the effect of yoga on flexibility and balance in women with breast cancer who have suffered arthralgias associated with aromatase inhibitors (AIs).
The pilot project involved 10 postmenopausal women with stage I-III breast cancer who experienced debilitating arthralgia following treatment with AIs. They participated in twice-weekly, 90-minute Iyengar-style yoga sessions, led by certified instructors and focused on flexibility, deep breathing, and meditation. Patients were encouraged to practice at home for 15 minutes per day.
Trained physical therapists measured Sit and Reach (the distance a person can reach beyond the feet while in a seated position with legs extended) and Functional Reach (the difference, in inches, between arm’s length and maximal forward reach, using a fixed base of support) following each session. The study also included patient self-assessment of function.
From baseline to the end of the trial, the patients showed significant changes in Sit and Reach (from a mean of 22.9 to 30.1 cm) and in Functional Reach (from a mean of 25.4 cm to 39.1 cm). Scores on subjective self-assessment of function also improved.
"The preliminary data suggest that yoga may improve flexibility and balance in breast cancer survivors who experience aromatase inhibitor–associated arthralgia," Dr. Galantino said.
NEW YORK – Yoga is finding its way into oncology wards and cancer treatment centers all over the country, echoing the widespread popularity of this ancient practice.
Several studies presented at the annual meeting of the Society for Integrative Oncology indicate that carefully tailored yoga programs can markedly improve quality of life and overall health following conventional treatment for a wide variety of cancers.
Some of the observed benefits include reduced anxiety, improved sleep, decreased use of medications for sleep and stress, improved flexibility and balance, and attenuated side effects associated with cancer drug therapies.
"Yoga interventions have been found to improve symptoms and quality of life in cancer patients," said Stephanie Sohl, Ph.D., of the comprehensive cancer center at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. Dr. Sohl’s group has been collaborating with a team at Mount Sinai School of Medicine in New York to develop a brief yoga intervention for women who are being treated for ovarian cancer.
"The primary goal of any therapy for patients who have persistent or recurrent ovarian cancer is shifted from solely pursuing a cure to the control of symptoms and overall maximization of quality of life," Dr. Sohl said.
The Yoga Skills Training (YST) model being pioneered at Wake Forest and Mount Sinai consists of 15-minute sessions that are focused on simple, nonstrenuous yoga linked to the patients’ chemotherapy appointments.
A study of the efficacy of this intervention is underway to measure the impact on anxiety, pain, fatigue, and other quality of life parameters. Investigators are using standardized assessment scales including the Cancer Behavior Inventory, the State Trait Anxiety Inventory, the Brief Pain Inventory, and the Functional Assessment of Cancer Therapy Fatigue scale.
So far, seven women have completed the trial. Dr. Sohl noted that the yoga intervention resulted in measurable changes in mean scores for anxiety, relaxation, and self-efficacy in coping, but no significant changes in pain and fatigue.
Two other studies of longer, more intensive yoga interventions for cancer patients are ongoing at Wake Forest. But she noted that the brevity of the YST sessions may ultimately be more feasible for patients and more easily integrated into existing cancer care settings.
Researchers at Wayne State University College of Nursing in Detroit are also exploring the effect of yoga as a posttreatment adjunct, but with patients surviving non–small cell lung cancer. The Wayne State program involves a standardized yoga sequence that is designed for cancer care implemented in the clinic setting, but also practiced by the patients at home. Patients participate in weekly 45-minute sessions for a total of 8 weeks, and are encouraged to practice what they learned on their own.
In a pilot feasibility study, nine patients – all of whom had undergone standard treatment for non–small cell lung cancer – were enrolled in the program; seven completed the full 8-week intervention and 6-week follow-up. Judi Fouladbakhsh, Ph.D., who is an advanced practice registered nurse at Wayne State, noted that compared with baseline measurements, patients reported consistent and significant decreases in dyspnea and chest tension following the sessions, as well as improved sleep quality and decreased use of sleep medications.
There were no adverse effects – respiratory or otherwise – associated with the practice, and Dr. Fouladbakhsh added that six of the patients were still practicing the yoga exercises at 3 months’ follow-up.
There are significant logistical and methodologic challenges in bringing yoga into the cancer care setting. The selected postures and movements must be compatible with the limitations of strength, stamina, and stability of people who have undergone surgery, radiotherapy, or chemotherapy, many of whom are elderly and also facing other health challenges. Class leaders must be specially trained in working with cancer survivors, and the interventions must be designed to fit with the often demanding treatment schedules.
Generally, yoga gives optimal results when practiced daily or at least several times per week; long-term adherence is a challenge for many patients.
From a research viewpoint, the challenges are significant because in most cases the benefits are subjective. Most studies so far have been small, short term, and dependent on patient self-assessment, with all the attendant limitations this brings. It is also impossible to design a "blinded" study of yoga or any other exercise modality, making it difficult to evaluate the true impact of yoga practice.
To date, there have not been any studies of yoga’s impact on cancer outcomes such as survival, disease-free survival, or mortality; all available studies are on quality of life parameters. But recently, investigators have been trying to move toward objective measures.
Mary Lou Galantino, Ph.D., and her colleagues at Richard Stockton College of New Jersey, Pomona, have been studying the effect of yoga on flexibility and balance in women with breast cancer who have suffered arthralgias associated with aromatase inhibitors (AIs).
The pilot project involved 10 postmenopausal women with stage I-III breast cancer who experienced debilitating arthralgia following treatment with AIs. They participated in twice-weekly, 90-minute Iyengar-style yoga sessions, led by certified instructors and focused on flexibility, deep breathing, and meditation. Patients were encouraged to practice at home for 15 minutes per day.
Trained physical therapists measured Sit and Reach (the distance a person can reach beyond the feet while in a seated position with legs extended) and Functional Reach (the difference, in inches, between arm’s length and maximal forward reach, using a fixed base of support) following each session. The study also included patient self-assessment of function.
From baseline to the end of the trial, the patients showed significant changes in Sit and Reach (from a mean of 22.9 to 30.1 cm) and in Functional Reach (from a mean of 25.4 cm to 39.1 cm). Scores on subjective self-assessment of function also improved.
"The preliminary data suggest that yoga may improve flexibility and balance in breast cancer survivors who experience aromatase inhibitor–associated arthralgia," Dr. Galantino said.
NEW YORK – Yoga is finding its way into oncology wards and cancer treatment centers all over the country, echoing the widespread popularity of this ancient practice.
Several studies presented at the annual meeting of the Society for Integrative Oncology indicate that carefully tailored yoga programs can markedly improve quality of life and overall health following conventional treatment for a wide variety of cancers.
Some of the observed benefits include reduced anxiety, improved sleep, decreased use of medications for sleep and stress, improved flexibility and balance, and attenuated side effects associated with cancer drug therapies.
"Yoga interventions have been found to improve symptoms and quality of life in cancer patients," said Stephanie Sohl, Ph.D., of the comprehensive cancer center at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. Dr. Sohl’s group has been collaborating with a team at Mount Sinai School of Medicine in New York to develop a brief yoga intervention for women who are being treated for ovarian cancer.
"The primary goal of any therapy for patients who have persistent or recurrent ovarian cancer is shifted from solely pursuing a cure to the control of symptoms and overall maximization of quality of life," Dr. Sohl said.
The Yoga Skills Training (YST) model being pioneered at Wake Forest and Mount Sinai consists of 15-minute sessions that are focused on simple, nonstrenuous yoga linked to the patients’ chemotherapy appointments.
A study of the efficacy of this intervention is underway to measure the impact on anxiety, pain, fatigue, and other quality of life parameters. Investigators are using standardized assessment scales including the Cancer Behavior Inventory, the State Trait Anxiety Inventory, the Brief Pain Inventory, and the Functional Assessment of Cancer Therapy Fatigue scale.
So far, seven women have completed the trial. Dr. Sohl noted that the yoga intervention resulted in measurable changes in mean scores for anxiety, relaxation, and self-efficacy in coping, but no significant changes in pain and fatigue.
Two other studies of longer, more intensive yoga interventions for cancer patients are ongoing at Wake Forest. But she noted that the brevity of the YST sessions may ultimately be more feasible for patients and more easily integrated into existing cancer care settings.
Researchers at Wayne State University College of Nursing in Detroit are also exploring the effect of yoga as a posttreatment adjunct, but with patients surviving non–small cell lung cancer. The Wayne State program involves a standardized yoga sequence that is designed for cancer care implemented in the clinic setting, but also practiced by the patients at home. Patients participate in weekly 45-minute sessions for a total of 8 weeks, and are encouraged to practice what they learned on their own.
In a pilot feasibility study, nine patients – all of whom had undergone standard treatment for non–small cell lung cancer – were enrolled in the program; seven completed the full 8-week intervention and 6-week follow-up. Judi Fouladbakhsh, Ph.D., who is an advanced practice registered nurse at Wayne State, noted that compared with baseline measurements, patients reported consistent and significant decreases in dyspnea and chest tension following the sessions, as well as improved sleep quality and decreased use of sleep medications.
There were no adverse effects – respiratory or otherwise – associated with the practice, and Dr. Fouladbakhsh added that six of the patients were still practicing the yoga exercises at 3 months’ follow-up.
There are significant logistical and methodologic challenges in bringing yoga into the cancer care setting. The selected postures and movements must be compatible with the limitations of strength, stamina, and stability of people who have undergone surgery, radiotherapy, or chemotherapy, many of whom are elderly and also facing other health challenges. Class leaders must be specially trained in working with cancer survivors, and the interventions must be designed to fit with the often demanding treatment schedules.
Generally, yoga gives optimal results when practiced daily or at least several times per week; long-term adherence is a challenge for many patients.
From a research viewpoint, the challenges are significant because in most cases the benefits are subjective. Most studies so far have been small, short term, and dependent on patient self-assessment, with all the attendant limitations this brings. It is also impossible to design a "blinded" study of yoga or any other exercise modality, making it difficult to evaluate the true impact of yoga practice.
To date, there have not been any studies of yoga’s impact on cancer outcomes such as survival, disease-free survival, or mortality; all available studies are on quality of life parameters. But recently, investigators have been trying to move toward objective measures.
Mary Lou Galantino, Ph.D., and her colleagues at Richard Stockton College of New Jersey, Pomona, have been studying the effect of yoga on flexibility and balance in women with breast cancer who have suffered arthralgias associated with aromatase inhibitors (AIs).
The pilot project involved 10 postmenopausal women with stage I-III breast cancer who experienced debilitating arthralgia following treatment with AIs. They participated in twice-weekly, 90-minute Iyengar-style yoga sessions, led by certified instructors and focused on flexibility, deep breathing, and meditation. Patients were encouraged to practice at home for 15 minutes per day.
Trained physical therapists measured Sit and Reach (the distance a person can reach beyond the feet while in a seated position with legs extended) and Functional Reach (the difference, in inches, between arm’s length and maximal forward reach, using a fixed base of support) following each session. The study also included patient self-assessment of function.
From baseline to the end of the trial, the patients showed significant changes in Sit and Reach (from a mean of 22.9 to 30.1 cm) and in Functional Reach (from a mean of 25.4 cm to 39.1 cm). Scores on subjective self-assessment of function also improved.
"The preliminary data suggest that yoga may improve flexibility and balance in breast cancer survivors who experience aromatase inhibitor–associated arthralgia," Dr. Galantino said.