Randomized, Controlled Trial of Yoga in Women With Breast Cancer Undergoing Radiotherapy

Abstract

A B S T R A C T PurposePrevious research incorporating yoga (YG) into radiotherapy (XRT) for women with breast cancer finds improved quality of life (QOL). However, shortcomings in this research limit the findings. Patients and MethodsPatients with stages 0 to III breast cancer were recruited before starting XRT and were randomly assigned to YG (n ϭ 53) or stretching (ST; n ϭ 56) three times a week for 6 weeks during XRT or waitlist (WL; n ϭ 54) control. Self-report measures of QOL (Medical Outcomes Study 36-item short-form survey; primary outcomes), fatigue, depression, and sleep quality, and five saliva samples per day for 3 consecutive days were collected at baseline, end of treatment, and 1, 3, and 6 months later. ResultsThe YG group had significantly greater increases in physical component scale scores compared with the WL group at 1 and 3 months after XRT (P ϭ .01 and P ϭ .01). At 1, 3, and 6 months, the YG group had greater increases in physical functioning compared with both ST and WL groups (P Ͻ .05), with ST and WL differences at only 3 months (P Ͻ .02). The group differences were similar for general health reports. By the end of XRT, the YG and ST groups also had a reduction in fatigue (P Ͻ .05). There were no group differences for mental health and sleep quality. Cortisol slope was steepest for the YG group compared with the ST and WL groups at the end (P ϭ .023 and P ϭ .008) and 1 month after XRT (P ϭ .05 and P ϭ .04). ConclusionYG improved QOL and physiological changes associated with XRT beyond the benefits of simple ST exercises, and these benefits appear to have long-term durability.

Depression in cancer: The many biobehavioral pathways driving tumor progression

“…Similarly, an additional yoga program to usual treatment (e.g., surgery followed by adjuvant radiotherapy or chemotherapy) provided significant improvements in depressive symptoms' severity on the Beck's Depression Inventory as compared to supportive therapy in a RCT involving patients with stage II and III breast cancer 189 . However, other RCTs did not confirm these data 190 . For instance, a 8-week yoga exercise program with twice-per-week sessions was effective in reducing fatigue in patients with non-metastatic breast cancer undergoing adjuvant chemotherapy but did not reduce depressive symptoms 191 .…”

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.…”

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

“…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.…”

“…[17][18][19][20][21] In the remaining three studies the yoga styles employed were Vyasa yoga, Anusara yoga23 and restorative yoga. [22][23][24] In most of the randomized controlled trials included in this review (71.43%, n=10) yoga was compared to a control group in which participants did not perform any exercise (i.e., waitlists or conventional health care). In 28.57% (n=4) the researchers included a comparison group where participants performed whether stretching exercises, conventional physical exercisesor resistance bands exercises.…”

“…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.…”