Clinical Case Report: Yoga for Fatigue in Five Young Adult Survivors of Childhood Cancer

Abstract

Purpose: Cancer-related fatigue (CRF) is a distressing consequence of cancer and its treatment. CRF impacts many young adult (YA) survivors of childhood cancer, compromising work, social relationships, and daily activities. No satisfactory treatment exists. This pilot study aimed to assess the feasibility, safety, and preliminary efficacy of an 8-week twice/week Iyengar yoga (IY) intervention for treating persistent fatigue in YA survivors of childhood cancer. Methods: Using a single-arm mixed-methods design, adult childhood cancer survivors aged between 18 and 39 years were recruited from a survivorship clinic at a single institution. Quantitative: The primary outcome was fatigue as measured by the Functional Assessment of Chronic Illness Therapy-Fatigue. Secondary outcomes included vitality, social functioning, multidimensional fatigue, mood, and sleep. Weekly self-report monitoring data were collected. Qualitative: Participants also completed a post-intervention interview, major themes evaluated. Results: Five participants enrolled into the study and four completed the intervention. Attendance was 92% and there were no adverse events. Baseline mobility was highly varied, with one YA having had a hemipelvectomy. Quantitative data revealed significantly improved fatigue, social functioning, somatization, and general and emotional manifestations of fatigue following yoga. Qualitative data cross validated, clarified, and expanded upon the quantitative findings. Conclusions: The study suggests that a brief IY intervention is safe for YA survivors of childhood cancer, even for those with physical disabilities. Preliminary efficacy was demonstrated for the primary outcome of fatigue. Qualitative data elucidated additional improvements, such as work-related social functioning, and a sense of calm and relaxation.

Identification of Evidence for Key Positive Psychological Constructs in Pediatric and Adolescent/Young Adult Patients with Cancer: A Scoping Review

“…Vitality among patients with cancer was reported in 38 (13.8%) of included studies, most often as a component of overall quality of life or well-being. Few factors were reported that increased vitality, including marriage, 116 yoga, 117 and stronger overall mental or physical health. 118 , 119 There were conflicting results for whether time since diagnosis improves vitality.…”

“…54,103 Mind-body exercises, like yoga and tai-chi, improved self-acceptance, and, according to patients, this occurred by demonstrating their body's physical capabilities were intact. 33,117 Happiness was studied by 14 (5.1%) included articles. The factors most commonly attributed to increased happiness was the cancer experience and the suffering it caused, 94 the relief of completing treatment, 160 and gratitude for suffering less than expected.…”

Targeting novel mechanisms of pain in sickle cell disease

“…Recently, attention has been focused on perception-based components of pain because of their ability to reduce pain via nonpharmacologic behavioral techniques, such as guided imagery, mindfulness and relaxation training, hypnosis, and cognitive behavioral therapy. [35][36][37] Chronic pain and central sensitization in SCD…”

Yoga for Young Adults With Noncurative Cancer: A Brief Report

“…Yoga can improve disease- and treatment-related side effects in cancer survivors by addressing physical, psychological, and spiritual needs. Although limited, research supports quality of life benefits in YA childhood cancer survivors 5 as well as in adult, noncurative cancer patients. 6 To date, no study has explicitly explored the potential benefits of yoga for YAs with a noncurative cancer diagnosis.…”