Iyengar‐Yoga Compared to Exercise as a Therapeutic Intervention during (Neo)adjuvant Therapy in Women with Stage I–III Breast Cancer: Health‐Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer‐Related Fatigue

Abstract

This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neo)adjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI) (n = 45) or for a physical exercise intervention (PEI) (n = 47). Measurements were obtained before (t 0) and after the intervention (t 1) as well as 3 months after finishing intervention (t 2) using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p < 0.05) but not under YI (t 0 to t 2). Regarding quality of life (EORTC QLQ-C30) a direct effect (t 0 to t 1; p < 0.001) of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p < 0.001) were observed at both t 1 and t 2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t 1 nor for t 2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

Yoga for the Management of Cancer Treatment-Related Toxicities

“…CRF occurs in 25–99% of patients during and after cancer treatments [7, 9, 17, 46–48]. We identified 16 randomized clinical trials that examined the effect of yoga on CRF [21, 26, 39, 41, 43–45, 49, 50•, 51–56, 57•]. Four trials tested the effects of yoga on CRF among cancer patients receiving chemotherapy or radiotherapy [43, 45, 51, 56].…”

“…We identified 16 randomized clinical trials that examined the effect of yoga on CRF [21, 26, 39, 41, 43–45, 49, 50•, 51–56, 57•]. Four trials tested the effects of yoga on CRF among cancer patients receiving chemotherapy or radiotherapy [43, 45, 51, 56]. Ten trials investigated the efficacy of yoga for treating CRF among survivors post-chemotherapy and/or post-radiation therapy [39, 41, 44, 49, 50•, 52–55, 57•].…”

Does yoga decrease cancer-related fatigue in women with breast cancer? Systematic review of randomized controlled trials

“…In 28.57% (n=4) the researchers included a comparison group where participants performed whether stretching exercises, conventional physical exercisesor resistance bands exercises. 17,19,21,25 In 50% of the studies there were no statistically significant differences between experimental and control groups. Table 2 shows methodological quality assessment using the PEDro scale.…”

“…27 On the contrary, in those studies that included a comparison group where participants performed conventional physical exercise (either aerobic or resistance exercise) and stretching, yoga was not superior. 17,22,25 Only in the study of Yagli et al yoga had a greater effect to decrease fatigue in comparison with the conventional physical exercise, which must be interpreted with caution because of the very small sample (20 participants) and, besides, because the authors did not specify the type of exercise in the control group, nor the volume and intensity. 19 In addition, it should be noted that this study was the one that presented the lowest score on the PEDro scale between all of the included.…”

“…Out of the total of 255 initial records, 14 randomized controlled trials were included for review. [14][15][16][17][18][19][20][21][22][23][24][25][26]28 The list of excluded documents (n = 143), together with the exclusion reasons for each, can be found in Annex 1. 28.57 % (n = 4) they were receiving radiotherapy and in 21.43 % (n = 3) of cases they were under chemotherapy.…”