Vivekananda Yoga Program for Patients With Advanced Lung Cancer and Their Family Caregivers

Abstract

BACKGROUND Although yoga practice may improve quality of life (QOL) in cancer patients, feasibility in patients with lung cancer is largely unknown. Moreover, previous research has excluded patients’ family caregivers. Because caregivers are vulnerable to caregiver burden, a dyadic approach targeting QOL in both patient and caregiver may be particularly beneficial. Thus, the purpose of this study was to establish the feasibility of a couple-based Vivekananda Yoga (VKC) intervention in lung cancer patients and caregivers. Vivekananda Yoga may be suitable for a dyadic approach and address the multifaceted needs (e.g., emotional, physical, spiritual, and social) common among families coping with lung cancer. METHOD In this single-arm feasibility trial, patients with lung cancer undergoing radiotherapy and their caregivers participated in a 15-session VKC program focused on the interconnectedness of the dyad. The program consisted of four main components: 1) joint loosening with breath synchronization; 2) postures (asanas) and a deep relaxation technique; 3) breath energization (pranayama) with sound resonance; and 4) meditation. We assessed pre/post-intervention levels of fatigue (BFI), sleep disturbances (PSQI), psychological distress (BSI), overall mental and physical QOL (SF-36), spirituality (FACT-Sp) and relational closeness. We also tracked feasibility data, and participants completed program evaluations. RESULTS We approached 28 eligible dyads of which 15 (53%) consented and 9 (60%) completed the intervention. No adverse events were reported. Patients (mean age: 73 years, 63% female, all stage III) and caregivers (mean age: 62 years, 38% female, 63% spouses) completed a mean of 10 sessions (range: 4–14) and 95.5% of them rated the program as very useful. Paired t-tests revealed a significant increase in patients’ mental health (d=.84, P=.04) and a significant decrease in caregivers’ sleep disturbances (d=1.44, P=.02). Although not statistically significant, for patients, effect sizes for change scores were medium for benefit finding and small for distress (d=.65 and .37, respectively). For caregivers, medium effects were found for improvement in physical functioning (d=.50). CONCLUSION This novel supportive care program appears to be safe, feasible, acceptable, and subjectively useful for lung cancer patients and their caregivers and lends support for further study in a larger randomized controlled trial.

Review of yoga therapy during cancer treatment

“…Statistically and/or clinically significant improvements in mental health included anxiety, depression, mood, negative affect, relaxation and overall mental health [22, 27-29], which were further corroborated by qualitative feedback [22, 24, 28]. Additional qualitative findings included improvements in cognition, benefit finding, spiritual well-being, social support, self-efficacy and coping [21-24, 28].…”

“…Particularly high adherence rates were achieved in studies that included family caregivers [27-28] or a group discussion component [21, 26]. Five studies also described adherence to home practice, which varied widely.…”

“…For example, in a case study of four women, home adherence was bimodal, with two participants at 80% adherence and two participants under 50% [24]. Studies measuring home practice by number of occurrences reported means between 2-3, range 0-9 [26-28], while another study described home practice as an average of 21 minutes per day [21]. In the five studies that assessed satisfaction with yoga, mean satisfaction ratings were high (i.e., >=9/10), and the majority rated yoga as useful or helpful [21-22, 26-28].…”

“…Additional qualitative findings included improvements in cognition, benefit finding, spiritual well-being, social support, self-efficacy and coping [21-24, 28]. …”

The Role of Yoga in the Complementary Treatment of Cancer

“…Reduction of depression has also been noted in other cancers [68]. Interestingly, emotional benefits have also been seen in cancer caregivers with yoga therapy [69].…”