Influence of yoga on mood states, distress, quality of life and immune outcomes in early stage breast cancer patients undergoing surgery

Abstract

Context:Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes.Aims:The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery.Settings and Design:Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery.Materials and Methods:Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK) cell % counts) and serum immunoglobulins (IgG, IgA and IgM).Statistical Analysis Used:We used analysis of covariance to compare interventions postoperatively.Results:Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36). The results suggest a significant decrease in the state (P = 0.04) and trait (P = 0.004) of anxiety, depression (P = 0.01), symptom severity (P = 0.01), distress (P < 0.01) and improvement in quality of life (P = 0.01) in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% (P = 0.02) and lower levels of serum IgA (P = 0.001) in the yoga group as compared to controls following surgery.Conclusions:The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

Review of yoga therapy during cancer treatment

“…In studies with sufficient information to compare, attrition was greater among yoga participants in two studies [37, 47], among control participants in three studies [38, 48-49, 51-52, 54-56], and approximately equal across groups in four studies [41-43, 58]. Two trials reported 100% completion [39, 57].…”

“…Treatment-related side effects, including sleep, fatigue, pain, appetite loss, nausea and vomiting, sequelae-related distress, and toxicity, improved among yoga participants in several studies [39, 41, 48-49, 52, 54, 57]. One study documented better post-operative outcomes, including decreased drain retention, earlier suture removal, and shorter hospitalization, among yoga vs. control participants [51]. …”

“…Compared to controls, yoga participants had lower 6:00 am and mean pooled levels of salivary cortisol [54-56] and a steeper cortisol slope [58], which may predict improved survival [59-60]. In the other two studies investigating physiologic results, yoga participants demonstrated a favorable immune response (i.e., serum immunoglobulins and lymphocytes, TNF-alpha) [51-52] and decreased DNA damage [38, 51-52]. …”

Yoga into Cancer Care

“…After examination of the titles and the abstracts, 138 studies met the inclusion criteria - 28 single armed trials [Table 1][32333435363738394041424344454647484950515253545556575859] and 110 randomized and nonrandomized controlled trials: 18 from 1996 to 2008 [Table 2],[606162636465666768697071727374757677] 34 from 2009 to 2012 [Table 3],[78798081828384858687888990919293949596979899100101102103104105106107108109110111] and 58 from 2013 to 2016 [Table 4]. [112113114115116117118119…”

“…In addition, the effect of yoga was reported on the telomere length, telomerase activity, T-cell subsets, signaling pathways of inflammatory transcription genes, cytokines, nuclear factor kappa B, and cAMP response element binding protein. [77131] In the vast majority of the studies, the yoga intervention was found to be beneficial and yielded positive effect on all the measures.…”