Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors

Abstract

Background Sixty percent of cancer survivors are 65 years of age or older. Cancer and its treatments lead to cancer-related fatigue and many other side effects, in turn, creating substantial global side-effect burden (total burden from all side effects) which, ultimately, compromises functional independence and quality of life. Various modes of exercise, such as yoga, reduce cancer-related fatigue and global side-effect burden in younger cancer survivors, but no studies have specifically examined the effects of yoga on older cancer survivors. Objectives The purpose of this study was to assess the effects of a 4-week yoga intervention (Yoga for Cancer Survivors: YOCAS©®) on overall cancer-related fatigue, and due to its multidimensional nature, the subdomains of cancer-related fatigue (general, physical, emotional, and mental) and global side-effect burden in older cancer survivors. Materials and Methods We conducted a secondary analysis on data from a multicenter phase III randomized controlled clinical trial with 2 arms (standard care and standard care plus a 4-week YOCAS©® intervention). The sample for this secondary analysis was 97 older cancer survivors (≥ 60 years of age), between 2 months and 2 years post-treatment, who participated in the original trial. Results Participants in the YOCAS©® intervention arm reported significantly lower cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden than participants in the standard care arm following the 4-week intervention period (p<0.05). Conclusions YOCAS©® is an effective standardized yoga intervention for reducing cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden among older cancer survivors.

Cancer-Related Fatigue, Version 2.2015

“…Complementary therapies, such as massage therapy, 96,97,100 yoga, 101–105 muscle relaxation, and stress reduction based on mindfulness, 106–108 have been evaluated alone or in combination with CBT approaches. The data suggest that these therapies may be effective in reducing fatigue in patients with cancer.…”

Yoga for the Management of Cancer Treatment-Related Toxicities

“…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•]. Two studies recruited both cancer patients and survivors [21, 26].…”

“…Interventions ranged in length from four weeks to six months. Eight studies showed that yoga significantly reduced CRF post-intervention and/or during 1-, 3-, or 6-month follow-ups comparing to the non-yoga intervention control groups where participants followed their standard cancer care only [41, 44, 49, 52, 57•] or received a health education intervention [39, 45, 50•]. Another two studies compared yoga to conventional strengthening exercises [51, 53] and found both groups significantly improved in multiple domains of fatigue.…”

Advances in caring for the older cancer patient: a report from the 2015 conference of the International Society of Geriatric Oncology

“…Ronald Maggiore (Health Science University, Oregon, USA) explained how treatment is being tailored to the circumstances of individual patients through a combined oncogeriatric approach, assessment of life expectancy, and optimization of agents and drug dose using tools to predict chemotherapy-associated toxicity 14 . Long-term survivors face complex problems and require the support, among others, of therapists expert in speech, swallowing, hearing and nutrition.…”

“…The G8 screening tool described above contains questions about nutrition, weight loss and body mass index (BMI) 10 . And data from the MiniNutritional Assessment are among the clinical factors included by Extermann et al 14 in the CRASH score that predicts toxicity from cancer therapy. Superimposed on sarcopenia, the hypercatabolic state induced in advanced cancer by inflammatory mediators causes depletion of fat and muscle reserves that is resistant to conventional nutritional interventions.…”