By John M. de Castro, Ph.D.
“When you say yoga, some people think of standing on their heads, but it’s the non-physical aspects of yoga, such as breathing, that are fundamental to healing.” – Jnani Chapman
About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. Breast cancer diagnosis, however, is not a death sentence. It is encouraging that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.
But treatments for breast cancer can be difficult on the patient markedly reducing their mental and physical quality of life. Chemotherapy or radiotherapy can produce increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image. With the loss of a breast or breasts, scars, hair shedding, complexion changes and weight gain or loss many young women feel ashamed or afraid that others will reject or feel sorry for them. As a result, breast cancer survivors frequently suffer from anxiety, depression, mood disturbance, Post-Traumatic Stress Disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission.
Unfortunately, most of these residual problems often go untreated. So, safe and effective treatments for the effects of radiotherapy on breast cancer patients are needed. Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual psychological symptoms and improve cognitive function. Yoga has also been shown to be helpful with the residual symptoms. In today’s Research News article “Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy.” See:
or see summary below or view the full text of the study at:
Ratcliff and colleagues recruited women diagnosed with breast cancer and scheduled to undergo radiotherapy for 6-weeks. They were randomly assigned to receive either yoga practice, stretching, or to a wait list while receiving treatment as usual. The yoga group and the stretching group practiced 3 times per week for 60 minutes during the 6-weeks of radiotherapy. Measurements were taken before treatment during the last week of radiotherapy and 1, 3, and 6 months later of health related quality of life, depression, sleep disturbance, posttraumatic stress symptoms, benefits finding, and salivary cortisol levels.
They found that the greater the distress prior to treatment the greater the effect of yoga practice.
Women who were high in sleep disturbance and depression prior to treatment showed the greatest improvement in mental health related quality of life with the effect getting stronger 3 and 6 months following treatment. This suggests that yoga practice has the greatest impact when the women are particularly distressed before treatment and the effects are lasting. They also found that yoga practice led to increased benefits finding, that is to increased acceptance of life’s imperfections, change in priorities, and development of a sense of purpose in life as a result of having been diagnosed with cancer. This increased benefits finding at 3-months led to improvements in physical health related quality of life at 6-months.
These results are interesting and demonstrate that yoga practice can be of benefit to women with breast cancer undergoing radiotherapy, improving their mental and physical health related quality of life. Yoga practice appears to be most beneficial to women who have the most problems with sleep and depression before treatment and the benefits appear to be lasting. So yoga practice helps the most those who need it the most. Yoga practice appears to work, in part, by improving the patient’s ability to find benefits in being diagnosed with cancer.
So, improve quality of life during and after radiotherapy with yoga.
“Yoga is known as a great way to ease stress and boost the body’s immune system. But it can be another way to fight chemo-related nausea and vomiting. And that’s not all. The gentle stretching and movement of yoga might give you more energy and help you sleep better.” – Amanda Gardner
CMCS – Center for Mindfulness and Contemplative Studies
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Ratcliff, C. G., Milbury, K., Chandwani, K. D., Chaoul, A., Perkins, G., Nagarathna, R., … Cohen, L. (2016). Examining Mediators and Moderators of Yoga for Women With Breast Cancer Undergoing Radiotherapy. Integrative Cancer Therapies, 15(3), 250–262. http://doi.org/10.1177/1534735415624141
This study examines moderators and mediators of a yoga intervention targeting quality-of-life (QOL) outcomes in women with breast cancer receiving radiotherapy.
Women undergoing 6 weeks of radiotherapy were randomized to a yoga (YG; n = 53) or stretching (ST; n = 56) intervention or a waitlist control group (WL; n = 54). Depressive symptoms and sleep disturbances were measured at baseline. Mediator (posttraumatic stress symptoms, benefit finding, and cortisol slope) and outcome (36-item Short Form [SF]-36 mental and physical component scales [MCS and PCS]) variables were assessed at baseline, end-of-treatment, and 1-, 3-, and 6-months posttreatment.
Baseline depressive symptoms (P = .03) and sleep disturbances (P < .01) moderated the Group × Time effect on MCS, but not PCS. Women with high baseline depressive symptoms in YG reported marginally higher 3-month MCS than their counterparts in WL (P = .11). Women with high baseline sleep disturbances in YG reported higher 3-months MCS than their counterparts in WL (P < .01) and higher 6-month MCS than their counterparts in ST (P = .01). YG led to greater benefit finding than ST and WL across the follow-up (P = .01). Three-month benefit finding partially mediated the effect of YG on 6-month PCS. Posttraumatic stress symptoms and cortisol slope did not mediate treatment effect on QOL.
Yoga may provide the greatest mental-health–related QOL benefits for those experiencing pre-radiotherapy sleep disturbance and depressive symptoms. Yoga may improve physical-health–related QOL by increasing ability to find benefit in the cancer experience.