June 21 is the International Day of Yoga. It was declared by the United Nations for the purpose of raising awareness of the benefits of practicing yoga. Yoga is an ancient practice introduced to the United States nearly 60 years ago and whose popularity has grown in recent decades. There are several different traditions of hatha yoga that serve as the foundation for the numerous styles taught here,1 but most emphasize, to varying degrees, physical poses or asanas, breathing techniques, meditation, and yogic philosophy. Yoga is intended to improve and maintain physical, emotional, mental, and spiritual well-being, and the various styles and foci mean that it can be found being offered in retreat centers, yoga studios, gyms, educational institutions, local libraries, and even parks and beaches.
With the establishment of the National Center for Complementary and Alternative Medicine (now the National Center for Complementary and Integrative Health, NCCIH) in 1998 at the National Institutes of Health, practices such as yoga began to be investigated formally by researchers. This type of investigation is important because the National Center for Health Statistic reports that in 2012 10% of Americans used practices like yoga, tai chi, and qi gong.2
With the physical, emotional, cognitive, and existential difficulties that cancer patients face, yoga seems like a fitting remedy. Training is available for regular yoga teachers to tailor their teaching to the needs of cancer patients and well-known programs like Urban Zen incorporate yoga among the integrative therapy components used to address common consequences of illness: pain, anxiety, nausea, insomnia, constipation, and exhaustion.3
A recent review of studies examining yoga therapy during cancer treatment has drawn promising conclusions from this literature.4 Data from nine non-randomized trials and thirteen randomized controlled trials concluded that various types of yoga interventions for adult cancer patients were useful for quality of life, sleep quality, fatigue, and spiritual well-being, as well as psychological outcomes such as depression, distress, and anxiety. Caveats to these conclusions include the fact that the preponderance of this research is conducted in breast cancer patients and those who are not at advanced stages, the dose and type of yoga studied varied, and the training of the yoga instructors was not well characterized by the research reports. The authors noted that physical and biomedical outcomes were less often studied and preliminary findings for side effects like cognitive functioning need to be further investigated.
One larger randomized controlled trial of 200 breast cancer survivors examined yoga’s effects post-treatment. 5 Women in the treatment group participated in 90-minute yoga classes taught by Yoga Alliance-certified instructors twice a week for 12 weeks. Assessments of markers of inflammation were included along with fatigue, vitality, sleep quality and depression. Fatigue and inflammation were affected positively and participating in more yoga practice resulted in stronger effects. A secondary analysis indicated that cognitive problems, thought to be particularly related to inflammation, were also lower in the group that practiced yoga and in those who engaged in more yoga practice.6
This research is promising because of yoga’s uniquely appropriate role for cancer patients and survivors: its gentle movements and focus on breathing and meditation work well for those who are experiencing fatigue and pain. Also, its spiritual focus may resonate also, as cancer can evoke existential themes of control, identity, relationships with others, and meaning.7
1 Subedi, S. (2014). Exploring different types of hatha yoga for patients with cancer. Clinical Journal of Oncology Nursing, 18, 586-590.1 Subedi, S. (2014). Exploring different types of hatha yoga for patients with cancer. Clinical Journal of Oncology Nursing, 18, 586-590.
2 Clarke T. C., Black, L. I., Stussman, B. J., & Nahin, R. L. (2015). Trends in the use of complementary health approaches among adults: United States, 2002–2012. National health statistics reports; no 79. Hyattsville, MD: National Center for Health Statistics.
4 Danhauer, S. C., Addington, E. L., Sohl, S. J., Chaoul, A., & Cohen, L. (2017). Review of yoga therapy during cancer treatment. Supportive Care in Cancer, 25, 1357-1372. doi: 10.1007/s00520-016-3556-9
5 Kiecolt-Glaser, J. K., Bennett, J. M., Andridge, R., Peng, J., Shapiro, C. L., Malarkey, W. B,, Emery, C. F., Layman, R., Mrozek, E. E., Glaser, R. (2014). Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. Journal of Clinical Oncology, 32,1040-1049. doi: 10.1200/JCO.2013.51.8860.
6 Derry, H. M., Jaremka, L. M., Bennett, J. M., Peng, J., Andridge, R., Shapiro, C., & ... Kiecolt‐Glaser, J. K. (2015). Yoga and self‐reported cognitive problems in breast cancer survivors: A randomized controlled trial. Psycho-Oncology, 24, 958-966. doi:10.1002/pon.3707
7 Goldenberg, M., Moyer, A., Schneider, S., Sohl, S., Knapp-Oliver, S. (2014). Psychosocial interventions for cancer patients and outcomes related to religion or spirituality: A systematic review and meta-analysis. World Journal of Psycho-Social Oncology, 3, 1-12.