The study, presented today at the 42nd annual meeting of the American Society of Clinical Oncology by Lorenzo Cohen, Ph.D., associate professor and director of the Integrative Medicine Program at M. D. Anderson, is one of the first to incorporate yoga as part of a treatment plan for cancer patients. It's also the first collaborative research effort representing the partnership between M. D. Anderson and India's largest yoga research institution, Swami Vivekananda Yoga Anusandhana Samsthana (research foundation) in Bangalore, India.
"Cancer and its treatments are associated with considerable distress, impaired quality of life and reduced physical function. This is particularly true for women with breast cancer who receive multi-modality treatment over an extended period of time," Cohen says. "With our studies, we think that we could help ameliorate the treatment-related side effects that accumulate in cancer patients over time.
"The main objective of this study was to examine the feasibility of integrating a daily yoga program into the treatment care plan for women with breast cancer undergoing radiation treatment, and determine if this is something the patients found useful and enjoyable, as well as assessing aspects of their quality of life," he continued.
Sixty-one women with breast cancer undergoing radiation were randomized to participate in the yoga classes twice weekly at, or around, the time of their radiation appointments, or, as the control group, to be offered yoga post-treatment. The patients ranged from Stage 0 to Stage 3 disease; 48 percent had undergone breast-conserving surgery, and 75 percent had received chemotherapy prior to radiation treatment. The yoga program was designed specifically for this patient population - emphasizing breathing and relaxation, and excluding some positions, for example, that would be difficult, given the patients' possible weakened range of motion.
After just one week of yoga and radiation, the patients reported significantly increased physical function, as well as general health, compared to the control group. The study participants also reported marginally better social functioning, significantly lower levels of sleep-related daytime dysfunction, as well as marginally lower levels of fatigue overall. However, no differences in the level of depression or anxiety were found between the two groups.
"It was gratifying to see that we could make a clinically significant difference in these quality of life of these women in such a brief program," says Kavita Chandwani, M.D., yoga instructor and co-investigator responsible for overseeing the trial. "Whether it's yoga or some other type of mind-body program, we believe this study shows how beneficial it is to participate throughout treatment to help with quality of life-based issues."
As a result of these positive findings, a follow-up study, funded by the National Cancer Institute, in breast cancer patients receiving radiation comparing yoga to stretching exercises and standard care is ongoing at M. D. Anderson. Also, from the ASCO highlighted study, Cohen and his team plan to analyze the cortisol levels, a stress hormone collected from saliva samples, and immune function measured from blood samples that were both collected as part of the study.
M. D. Anderson recognizes the growing body of research indicating that relaxation-based interventions can contribute to the well-being of people with cancer. Through the Integrative Medicine Program, complementary therapies are offered through M. D. Anderson's freestanding facility, Place ... of Wellness, and are used in concert with mainstream care to manage symptoms, relieve stress, and enhance quality of life for patients and their caregivers. M. D. Anderson's Integrative Medicine faculty also conduct research in the biological and behavioral effects of mind/body based interventions; the anti-cancer potential of natural compounds; and acupuncture to treat common cancer treatment-related side effects.
Recently, Cohen and his team received a $2.4 million grant from the National Cancer Institute to study the effects of Tibetan yoga in women with breast cancer who are undergoing chemotherapy; the grant is the largest ever to study Tibetan yoga in cancer patients.