Yoga for Patients with Early Breast Cancer and its Impact on Quality of Life - a Randomized Controlled Trial

Abstract

Introduction !Breast cancer is the most common malignancy in women worldwide. It accounts for 14 % of all cancer diagnoses in Europe [1]. In the industrialized countries of the northern hemisphere, between one in eight and one in ten women will be diagnosed with breast cancer in their lifetime [2,3]. Due to the enormous advances in adjuvant and palliative treatment, it has, in many cases, become a controllable chronic disease [4]. Abstract !The aim of this prospective, randomized, controlled trial was to investigate the impact of yoga on newly diagnosed patients with early breast cancer in the immediate postoperative phase. 93 women newly diagnosed with early breast cancer were randomized into an intervention group (IG) and a control group (waiting group, WG). The IG started yoga immediately after the operation. The WG started yoga 5 weeks after surgery. Both groups attended yoga classes twice weekly for 5 weeks. Quality of life (QoL) was evaluated using the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires before the intervention, immediately after the operation and after 3 months. After 3 months the patients were asked whether yoga improved their physical activity and whether they wished to continue with yoga. The overall QoL (p = 0.002) and the functional status (p = 0.005) increased significantly in the IG, while physical symptoms decreased over time in both groups. 86 % of patients in the IG and only 59 % of patients in the WG (p = 0.04) confirmed a positive change in their physical activity through yoga. More women in the IG intended to continue with yoga (p = 0.03). Early initiation of yoga as a supportive treatment in cancer had a positive impact on QoL. Teaching yoga allowed patients to practice yoga by themselves, enhanced the patientsʼ QoL and was found to improve physical activity. Zusammenfassung

Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

“…The use of yoga for depression and mood disturbance was downgraded from grade A to grade B because of 4 new published studies demonstrating conflicting results . The use of yoga for improving QOL changed from grade C to grade B, because 2 additional trials demonstrated beneficial effects . Finally, new trials on the use of yoga and hypnosis for fatigue upgraded previous recommendations from grade I to grade C.…”

“…Yoga is recommended for improving QOL in patients with breast cancer (grade B). This recommendation is based on 12 RCTs, completed between 2006 and 2015, which tested a variety of yoga programs (see Supporting Information Table 4) . QOL was the primary outcome for 6 of those 12 trials .…”

Post-operative exercises after breast cancer surgery: Results of a RCT evaluating standard care versus standard care plus additional yoga exercise

“…Reviews and metaanalyses evaluating the effect of yoga in randomised controlled trials (RCT) in women with breast cancer conclude there is moderate to good evidence that yoga may be a useful practice during recovery from treatment [11][12][13]. Despite an emerging number of large RCTs measuring the effectiveness of yoga on fatigue [14,15], sleep quality [16], QoL [17], and during radiotherapy [18], there is scope for more investigation into its physical benefits, in particular its role following breast cancer surgery.…”

Immunological and Quality-of-Life Profiles in Women with Breast Cancer: Complementary versus Conventional Care

“…Noteworthy, personality traits (extraversion vs. introversion) have been identified to show different gene expression profiles related to proinflammatory signaling [27]. It is also known that stress-release programs, ethical caring, choir singing, and psychotherapy have beneficial effects on women with breast cancer [28,29,30,31], and an important stress-reducing aspect of anthroposophic care is the individually composed therapy consisting of holistic care including natural products, Iscador, diets, art therapy, rhythmic therapy, therapeutic massage, and hydrotherapy [3,4]. A deeper psychoneuroimmunological understanding of these effects induced by intervention programs are needed [32].…”