Bringing Yoga to Cancer Patients: A Review of the Research

Hundreds of research studies have been conducted in recent years on the therapeutic effects of yoga for people living with cancer. These studies vary greatly in size, method, length, and content. Sifting through this large body of evidence presents a great challenge for those who wish to understand the impact that yoga might have on cancer patients and survivors.

Fortunately, a valuable resource is now available for yoga and healthcare professionals who work with people affected by cancer. A white paper, published in December 2018, provides an overview of recent research on yoga interventions for cancer. Developed by a team of medical writers, oncologists, researchers, and yoga professionals, the paper summarizes the therapeutic benefits of yoga for people living with cancer and offers suggested guidelines for developing safe and effective yoga programs for them.

The authors of the white paper acknowledged that the amount of research on yoga and cancer is vast and that a full literature review was beyond the scope of their project. Instead, they highlighted several studies that suggest “yoga can not only help adult cancer patients and survivors manage symptoms and side effects, but also help them lead longer, healthier lives.”

The white paper opens with a few chilling statistics that illustrate the physical, mental, and financial toll cancer can take:     

• Each day, more than 4,600 Americans are affected by cancer.

• In 2012, there were more than 14.1 million new diagnoses of cancer worldwide.

• Half of men and one-third of women will be diagnosed with cancer.

• In 2014, people living with cancer paid nearly $4 billion out of their own pockets for their cancer treatments.

As more and more lives are impacted by cancer, the need for sound, effective, cost-efficient, and research-backed methods for dealing with the life-changing effects of cancer becomes more and more urgent. From their review of the research, the authors conclude that “health care providers seeking evidence-informed, cost-effective modalities to manage the short- and long-term effects of cancer and its treatment should consider the benefits of cancer-specific yoga interventions.”

The authors aimed to:

1. Call attention to the current research on the therapeutic effects of yoga interventions for cancer patients and survivors.

2. Demonstrate that yoga interventions, when used as a complementary modality, are effective, safe, and can improve health outcomes for people living with cancer.

3. Identify guidelines that will enable healthcare professionals to create safe and effective yoga programs for cancer patients and survivors.

A Look at the Recent Research on Yoga Interventions for Cancer Patients

The authors offered an overview of the current research and highlighted several key studies that suggest the various benefits yoga can provide for cancer patients and survivors. Their survey of medical research incorporated systematic reviews and randomized, controlled trials whenever possible.

The studies highlighted in the white paper suggest that yoga may provide the following benefits for cancer patients and survivors:  

• Improved sleep    

• Reduced fatigue

• Improved mental and emotional health

• Reduced pain, including joint pain, muscle and body aches, and musculoskeletal symptoms

• Increased strength, range of motion, and bone health

• Weight management

• Improved ability to manage lymphedema

Guidelines for Developing Safe, Effective Yoga Programs for Cancer

The authors suggested the following guidelines for designing safe and beneficial yoga programs for cancer patients and survivors:

• Cancer-specific yoga classes should be led by teachers who have completed an oncology-based yoga training program.

An oncology-based yoga training program will provide yoga teachers with a thorough understanding of the disease and its treatments. The training will also enable them to offer their students appropriate practices for managing a variety of side effects, such as scar tissue, bone loss, lymphedema, weight gain, fatigue, sleeplessness, and stress. The knowledge that teachers gain from a cancer-specific training program empowers them to teach with confidence, clarity, and compassion.

• Cancer-specific yoga classes should be offered a minimum of twice a week for 60-75 minutes on an ongoing basis.

The American Cancer Society recommends that cancer survivors engage in at least 150 minutes of moderate exercise per week. The authors emphasize that moderate-intensity is important; gentle and chair yoga may not be vigorous enough to attain the positive effects of moderately intense exercise.

• Cancer-specific yoga classes should consist of physical postures (asana), breathing techniques (pranayama), and meditation.   

A variety of seated, standing, transitional, and supine poses may be incorporated into the class. Students may practice slow, controlled, diaphragmatic, and movement-coordinated breath exercises. Meditation could include body scans, Metta meditation from the Buddhist tradition (loving-kindness), breath awareness, and mindfulness. Teachers should emphasize the ways in which each element of the class addresses common side effects of cancer treatment.

• Cancer-specific yoga classes should be held in a private, climate-controlled, and spacious room.

The ideal temperature for a yoga room is 70-75 degrees Fahrenheit. Warmer rooms may be uncomfortable for participants whose cancer treatments cause hot flashes or increased body temperature. A non-carpeted room is recommended for hygienic reasons. People undergoing treatment may have weakened immune systems and are vulnerable to the bacteria that can be absorbed by carpets. Students will feel safer and more comfortable in rooms that are private and secluded.

• Cancer-specific yoga classes should offer many opportunities for students to modify the poses and practices.

The teacher should offer adaptations and modifications that enable all participants to adapt the various elements of the practice to their own abilities, limitations, desires, and physical and emotional wellbeing.

• Cancer-specific yoga classes should give students access to props such as blocks, bolsters, blankets, and straps.    

The teacher should demonstrate how students with limited flexibility and range of motion could use props such as blocks, bolsters, and blankets to support themselves in each pose. 

• Cancer-specific yoga classes should empower the participants to reclaim a sense of agency about their bodies, health, and lives.

Practicing yoga empowers cancer patients and survivors to alleviate symptoms, reduce side effects, and have a big impact on their own recovery and wellbeing.

How Yoga and Healthcare Professionals Can Help

The authors suggested several ways for medical and yoga professionals to make yoga more accessible to people living with cancer. Professionals working in healthcare could offer a cancer-specific yoga program in their facilities. Yoga teachers and healthcare providers could spread the word about yoga’s therapeutic benefits by sharing the results of research with patients and students. Healthcare and yoga professionals could collaborate to conduct even more research into the benefits of yoga for those affected by cancer.

Yoga professionals could enroll in an oncology-based teacher training program to expand their knowledge and then offer introductory classes for healthcare professionals and mini-classes in cancer treatment centers and hospitals.

Equipped with the kind of knowledge and insight that the white paper provides, yoga and healthcare professionals will be uniquely positioned to offer the benefits of yoga and make a difference in the lives of people living with cancer.

The white paper was funded by yoga4cancer, the Retreat Project, and the Give Back Yoga Foundation.

More yoga practice tips and inspiration from writer Christine Malossi and YogaUOnline – 6 Poses to Counteract the Effects of Sitting.

Study with YogaUOnline and Robin Rothenburg – Restoring Prana: Key Roles of the Diaphragm in Health and Vitality.

Christine Malossi began practicing yoga in 1999. Based in New York City, she offers an alignment-focused, slow Vinyasa practice that cultivates awareness and equanimity. She is currently enrolled in an 800-hour course on the History, Literature, and Philosophy of Yoga (taught by Brenda Feuerstein, designed by the late Georg Feuerstein). Christine is a Registered Yoga Teacher with Yoga Alliance and has additional certifications in Therapeutic Yoga, Restorative Yoga, Accessible Yoga, and Functional Anatomy for Movement and Injuries. She attended the University of Pennsylvania and NYU and also spent many years studying classical ballet. Find her at christinemalossi.com.

References:

Sulik, Gayle, Ph.D. Yoga Interventions for Cancer Patients and Survivors. December 2018.