The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy

Abstract

Up to 50 % of breast cancer survivors on aromatase inhibitor therapy report musculoskeletal symptoms such as joint and muscle pain, significantly impacting treatment adherence and discontinuation rates. We conducted a secondary data analysis of a nationwide, multisite, phase II/III randomized, controlled, clinical trial examining the efficacy of yoga for improving musculoskeletal symptoms among breast cancer survivors currently receiving hormone therapy (aromatase inhibitors [AI] or tamoxifen [TAM]). Breast cancer survivors currently receiving AI (N = 95) or TAM (N = 72) with no participation in yoga during the previous 3 months were randomized into 2 arms: (1) standard care monitoring and (2) standard care plus the 4-week yoga intervention (2×/week; 75 min/session) and included in this analysis. The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS©®) program consisting of breathing exercises, 18 gentle Hatha and restorative yoga postures, and meditation. Musculoskeletal symptoms were assessed pre- and post-intervention. At baseline, AI users reported higher levels of general pain, muscle aches, and total physical discomfort than TAM users (all P ≤ 0.05). Among all breast cancer survivors on hormonal therapy, participants in the yoga group demonstrated greater reductions in musculoskeletal symptoms such as general pain, muscle aches and total physical discomfort from pre-to post-intervention than the control group (all P ≤ 0.05). The severity of musculoskeletal symptoms was higher for AI users compared to TAM users. Among breast cancer survivors on hormone therapy, the brief community-based YOCAS©® intervention significantly reduced general pain, muscle aches, and physical discomfort.

Chronic Pain in Breast Cancer Survivors: Nociceptive, Neuropathic, or Central Sensitization Pain?

“…Therefore, aromatase inhibitors are incorporated as part of the standard adjuvant therapy in predominantly postmenopausal women . Despite the fact that aromatase inhibitors improve disease‐free survival by 10% to 40%, up to 50% of BCS report joint pain as a side effect …”

Yoga for the Management of Cancer Treatment-Related Toxicities

“…Only one study examined the efficacy of yoga for improving musculoskeletal symptoms in cancer survivors [72]. Peppone et al found that after 4 weeks of YOCAS©® yoga, which combined gentle hatha and restorative yoga in two 75-min sessions per week, breast cancer survivors on aromatase inhibitor therapy reported significant reductions in musculoskeletal pain, muscle aches, and total physical discomfort compared to the standard cancer survivorship care group [72].…”

“…Peppone et al found that after 4 weeks of YOCAS©® yoga, which combined gentle hatha and restorative yoga in two 75-min sessions per week, breast cancer survivors on aromatase inhibitor therapy reported significant reductions in musculoskeletal pain, muscle aches, and total physical discomfort compared to the standard cancer survivorship care group [72]. These data suggest that gentle hatha and restorative yoga, performed in 75-min sessions at a low to moderate intensity twice per week over a period of 4 weeks may be efficacious for treating musculoskeletal symptoms in cancer survivors.…”

Yoga research review

“…In a randomized controlled trial comparing yoga and usual care, fatigue was reduced [119] and in a similar trial, musculoskeletal pain was reduced [120]. These trials were limited given that the yoga poses were combined with breathing exercises and meditation, as in many of the other randomized controlled trials.…”