Yoga therapy may alleviate symptoms of breast cancer treatment, and improve quality of life new review of the research shows.
Breast cancer is the most common form of cancer worldwide, with nearly 2 million women and men being diagnosed each year. Even though survival rates continue to climb, the impact of the disease and its treatment can be both physically and mentally challenging. A review of the research finds that yoga therapy may help to effectively alleviate depression, anxiety, and other stress-related symptoms, and increase overall quality of life.
The review examined a total of 38 articles published in English between 2009 and 2014 in which yoga therapy or mindfulness based stress reduction (MBSR) were used as an adjunctive therapy for patients with breast cancer. This included 20 randomized controlled trials, 6 non-randomized trials, 7 systematic reviews or meta-analyses, and 5 other unspecified “articles of reference”.
To be included in this review, studies needed to have at least 15 participants, use either yoga or MBSR as a primary intervention, and measure either physical or psychological outcomes related to breast cancer and/or its treatment. Although no specific information regarding the types of yoga therapy were provided in the review, yoga or MBSR interventions included either meditation, breathing exercises, and “movement” or their combination.
A total of 2 studies introduced yoga prior to radiation therapy, 6 studies introduced yoga concurrently with radiation, and 7 offered yoga 2 to 18 months following cancer treatment. The median intervention lasted 6 weeks, and spanned from 4 weeks to 6 months.
The key outcomes of interest in this review included psychological and physiological measures of stress, overall quality of life, sleep quality, depression, anxiety, social and emotional functioning, and DNA damage.
Yoga for Stress
The greatest and most consistent benefit of yoga therapy for those with breast cancer was a reduction in perceived stress. In addition to a decline in perceived stress, a number of studies reported significant decreases in salivary cortisol, a biomarker of stress, following a yoga intervention.
These findings were mixed, however, with some researchers reporting little to no positive change. This may be due to the fact that some sample sizes were small, and that cortisol measurement strategies differed by study.
Yoga and Overall Quality of Life
In general, the research provides considerable evidence for the link between yoga interventions and an improved quality of life among breast cancer patients. A prior review of the impact of yoga found strong support for the link between regular yoga practice and short-term improvements in global, health-related, social, and spiritual quality of life.
Yoga and Sleep Quality
To date, very few studies have investigated whether yoga therapy can improve the sleep quality of breast cancer patients. Of the studies conducted, reduced fatigue and better sleep were noted, however more research is needed to better understand these connections.
Yoga and Depression
Several investigations tested the link between yoga therapy and depression, and found a consistently strong correlation between participating in a yoga program and fewer depressive symptoms among breast cancer patients. This supports the premise that yoga may be of benefit before, during, and after cancer treatment in helping to alleviate depressed mood.
Yoga and Anxiety
Of the five studies in which yoga or MBSR were used to alleviate anxiety of breast cancer patients, 3 examined global anxiety ratings, while the remaining 2 parsed anxiety into state and trait categories. Regardless of how anxiety was measured, yoga and MBSR were consistently found to be associated with lowered levels of anxiety, with larger reductions being linked to more frequent yoga practice.
Yoga and Social and Emotional Functioning
Several studies explicitly examined whether yoga benefits social and emotional functioning. Of those reviewed, 5 reported significantly better social and emotional functioning following a yoga intervention when compared to a control group. This suggests that interventions of this kind may enable patients to cope better with their diagnosis and treatment, and seek social and medical support, which may, in turn, help to decrease feelings of social isolation and depression.
Yoga and Alterations in DNA Damage
Radiation therapy is designed to cause damage to the DNA of tumor tissue leading to cell death and tumor reduction. An unfortunate side effect of this approach is that other areas of the body may also experience DNA damage as a result. Very preliminary research finds that the lowest levels of DNA damage were found among senior yoga practitioners, suggesting that regular yoga practice may serve to buffer the harsh effects of radiation. Previous studies suggest that yoga may be associated with lower levels of metabolic and oxidative stress, and thus potentially beneficial in cellular reparation. As such, yoga may prove to be beneficial for prevention and rehabilitation of radiation-related effects.
Use of Yoga Therapy for Breast Cancer Patients
There are a number of important factors to consider when determining the timing and course of yoga for those with breast cancer. In light of its beneficial impact on stress, mood, and quality of life, it is important to begin yoga practice as early as possible to maximize its benefit. Evidence also suggests that longer yoga programs, with multiple sessions per week, tend to yield the greatest benefits, and that intervention should continue even after cancer treatment to maximize yoga’s physical and psychological gains.
Breathing exercises, meditation, and other forms of relaxation therapy may be of considerable use during radiation therapy, and at other points of diagnosis and treatment where stress is likely to be greatest. Studies find that the initial 12 months following the completion of treatment may be the most difficult for beginning and maintaining recovery, due to a reduced quality of life, and symptoms of depression and anxiety.
Frequent participation in yoga groups may be especially impactful for those experiencing negative or depressed mood, a decreased quality of life, high levels of stress, and relationship difficulties.
It is important to match individuals with an appropriate style of yoga and a well-qualified and experienced instructor. During and after cancer treatment, gentle and restorative approaches, yoga therapy, and practices that incorporate breathing, meditation, and suitable postures with modifications appear most impactful.
As always, we have a great deal more to learn regarding the benefits of yoga in general, and for breast cancer patients in particular. Please consult with your physician to see which options are most suited to your individual needs, and seek out a skilled and knowledgeable yoga therapist or instructor.
Originally published at YogaU Online
Galliford M, Robinson S, Bridge P, Carmichael M (2017). Salute to the sun: A new dawn in yoga therapy for breast cancer. Journal of Medical Radiation Sciences. doi: 10.1002/jmrs.218