Yoga is a combination of physical, mental, and spiritual
practices that originated in India thousands of years ago. Yoga began as a Hindu philosophy
advocating and prescribing a course of physical and mental disciplines for attaining liberation from the material world and union of the self with a “Supreme Being." That said, yoga is ultimately secular.
There are many types of yoga. Any combination of methods or disciplines that include a series of postures and breathing exercises practiced to achieve control of the body and mind, tranquillity, equanimity, etc. could all classify as "yoga."
In the traditional sense of Patanjali's Yoga Sutras, yoga is described as “the cessation of the perturbations of the mind.” In the Yoga Sutras, Patanjali indicates that the ultimate goal of yoga is a state of permanent peace in which someone can experience one's true self. Saying, "Absolute freedom occurs when the lucidity of material nature and spirit are in pure equilibrium."
Apart from these spiritual elements—the physical postures, breathing and mindfulness of yoga have potent health benefits that western medical doctors have been researching for decades. Two recent studies published in the Journal of Clinical Oncology have confirmed specific—and universal—health benefits of yoga by studying women with breast cancer.
A March 3 study from The University of Texas found that yoga helped women undergoing radiation therapy reduce fatigue, improve mental outlook, and regulate the stress hormone cortisol.
Another study published in January 2014 from Ohio State University found that yoga helped women who had just completed cancer treatment reduce inflammation, increase energy, and improve mood. The researchers believe the health benefits of yoga are applicable to the broad population.
Yoga Reduces Fatigue, Improves General Health and Regulates Cortisol
The preliminary findings of the MD Anderson Cancer Center study from University of Texas were first reported in 2011 by Lorenzo Cohen, Ph.D., professor and director of the Integrative Medicine Program. His research is part of an ongoing effort to scientifically validate mind-body interventions in cancer patients and was conducted in collaboration with India's largest yoga research institution, Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India.
Cohen and his colleagues found that while simple stretching exercises counteracted fatigue, patients who participated in yoga exercises that incorporated controlled breathing, meditation
and relaxation techniques experienced improved ability to engage in their daily activities, better general health and better regulation of the stress hormone cortisol.
"Combining mind and body practices that are part of yoga clearly have tremendous potential to help patients manage the psychosocial and physical difficulties associated with treatment and life after cancer, beyond the benefits of simple stretching," said Cohen.
To conduct the study, 191 women with breast cancer (stage 0-3) were randomized to one of three groups: 1) yoga; 2) simple stretching; or 3) no instruction in yoga or stretching. Participants in the yoga and stretching groups attended sessions specifically tailored to breast cancer patients for one-hour, three days a week throughout their six weeks of radiation treatment.
Women who practiced yoga had the steepest decline in their cortisol levels across the day, indicating that yoga had the ability to help regulate this stress hormone. According to Cohen this is particularly important because higher stress hormone levels throughout the day—known as a blunted circadian cortisol rhythm—have been linked to worse breast cancer outcomes. Although these findings focused on patients with cancer, it is likely that the cortisol regulating benefits of yoga are universal.
Yoga Increases Vitality, Improves Mood, and Reduces Inflammation
Another study from Ohio State University also found that practicing yoga for as little as three months can reduce fatigue and lower inflammation in breast cancer survivors. The more the women in the study practiced yoga, the better their results. The January 2014 study was titled “Yoga’s Impact on Inflammation, Mood, and Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial.”
The research team focused on breast cancer survivors because the rigors of treatment can be so taxing on patients. "Though many studies have suggested that yoga has numerous benefits, this is the largest known randomized controlled trial that includes biological measures," said Janice Kiecolt-Glaser, professor of psychiatry and psychology at The Ohio State University and lead author of the study.
The participants of the Ohio study had completed all breast cancer treatments before the start of the study. Only yoga novices were recruited for the randomized, controlled clinical trial. At the six-month point of the study—three months after the formal yoga practice had ended—results showed that on average, fatigue was 57 percent lower in women who had practiced yoga compared to the non-yoga group, and their inflammation was reduced by up to 20 percent.
Participants practiced yoga in small groups twice a week for 12 weeks. Women making up the control group were wait-listed to receive the same yoga sessions once the trial was over. During the study, they were instructed to go about their normal routines and not to do yoga.
"This showed that modest yoga practice over a period of several months could have substantial benefits for breast cancer survivors," said Janice Kiecolt-Glaser. "We also think the results could easily generalize to other groups of people who have issues with fatigue and inflammation."
"One of the problems they face is a real reduction in cardiorespiratory fitness. The treatment is so debilitating and they are so tired, and the less you do physically, the less you're able to do. It's a downward spiral," Kiecolt-Glaser said. "That's one reason we think there are higher levels of inflammation in cancer survivors, meaning that an intervention that reduces inflammation could potentially be very beneficial."
Chronic inflammation is linked to numerous health problems, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer's disease, as well as the frailty and functional decline that can accompany aging. To gauge the participants' inflammation levels, the scientists measured the activation of three proteins in the blood that are markers of inflammation—called pro-inflammatory cytokines.
Participants ranged in age from 27 to 76 and were two months to three years past the latest surgical or radiation treatment. Kiecolt-Glaser and colleagues deliberately selected women of a variety of ages, stages of cancer (between 0 and 3A) and treatment methods so the results could be generalized to a broad population of cancer survivors, she said.
Each yoga group included between four and 20 women who practiced the same poses during 90-minute sessions twice a week. Researchers encouraged the women to practice at home, as well; participants logged their total weekly practice time.
"We were really surprised by the data because some more recent studies on exercise have suggested that exercise interventions may not necessarily lower inflammation unless people are substantially overweight or have metabolic problems," Kiecolt-Glaser said. "In this group, the women didn't lose weight, but we saw really marked reductions in inflammation. So this was a particularly striking finding biologically."
A secondary analysis showed that more frequent yoga practice produced larger changes in fatigue, vitality and depressive symptoms as well as between an average 4 to 6 percent reduction in two of the three pro-inflammatory cytokines. The yoga group also reported significantly improved sleep compared to the control group.
Conclusion: Yoga Improves Quality of Life
According to Lorenzo Cohen, research shows that developing a yoga practice also helps patients after completing cancer treatment. Cohen said, "The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult." Cohen also found that patients who did yoga were more likely to find 'life meaning' from their cancer experience than the other groups.
Dr. Cohen is also conducting research to demonstrate that lifestyle changes can influence cancer outcomes. Ongoing studies are examining lifestyle changes in the areas of diet/nutrition, physical activity, stress management and social connectiviy to change the risk of developing cancer and influencing outcomes in those with cancer.
Janice Kiecolt-Glaser said, "Yoga has many parts to it—meditation, breathing, stretching and strengthening. We think the breathing and meditation components were really important in terms of some of the changes we were seeing,"
Kiecolt-Glaser concluded, "We think improved sleep could be part of the mechanism of what we were seeing. When women were sleeping better, inflammation could have been lowered by that. Reducing fatigue enables women to engage in other activities over time. So yoga may have offered a variety of benefits in addition to the yoga exercises themselves."
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