How Yoga Can Improve Cancer Survivor Well-being

A structured yoga practice could help cancer survivors improve their mood, anxiety, fatigue, and sleep problems according to a new study. The results were presented at the American Society of Clinical Oncology (ASCO) Annual Meeting. 

Improving distress improves quality of life for cancer survivors

According to the American Cancer Society, there will be more than 22 million cancer survivors in the United States by 2035. Cancer survivors are people living through a cancer diagnosis and treatment and after active treatment ends. 

After experiencing cancer, distress is common. Up to 95% of people with cancer report sleep problems, like insomnia, and more than half have problems with mood, anxiety, and/or fatigue. Finding ways to improve this distress, especially without medication or additional treatments, is important for improving the quality of life of cancer survivors. 

Testing the impact of gentle and restorative yoga on distress 

Yoga is an ancient mind-body practice. It incorporates movement, posing, breathing, and meditation. ASCO guidelines, which help cancer doctors know which treatments have the most evidence behind them, recommend yoga as a part of its integrative oncology guideline to help with stress, mood, sleep, fatigue, and quality of life. 

This study tested how a structured yoga program of gentle and restorative yoga worked to treat the distress of cancer survivors. The program was called Yoga for Cancer Survivors or YOCAS. YOCAS lasts for 4 weeks and combines 18 gentle hatha and restorative yoga poses with breathing exercises and mindfulness.

“There is no single gold standard behavioral treatment available to survivors for treating overall mood disturbance, anxiety, fatigue, and insomnia. By demonstrating that YOCAS intervention improves all four of these cancer-related side effects and showing how improvements in overall mood disturbance, anxiety, and fatigue influence yoga’s effect on insomnia, this trial helps fill that gap,” said Yuri Choi, PhD, MSN, RN, the lead study author and a Research Assistant Professor at the University of Rochester Medical Center. 

Testing a yoga program with a randomized trial

There were 410 people enrolled in the clinical trial. The average age of the participants was 54, 96% were women, and 75% were breast cancer survivors. Half of the participants were enrolled in standard survivorship care and half in standard survivorship care plus YOCAS. The survivorship care that participants received typically included: 

• Any necessary maintenance therapy
• Follow-up visits
• Side effect monitoring

As part of the YOCAS program, participants took two 75-minute guided yoga sessions. They also completed low- to moderate-intensity gentle hatha and restorative yoga at home for at least 3 times a week. The participants did yoga for an average of 180 minutes each week. 

The participants assessed their mood with a questionnaire called the Profile of Mood States. Their sleep was also evaluated with the Insomnia Severity Index. 

How yoga impacted participants’ mood

When compared to the standard of care group, cancer survivors reported: 

• Improvements in their overall mood, scoring on average more than 5 points lower on the Profile of Mood State
• Improvements in anxiety
• Improvements in fatigue

As for sleep, researchers found that participants’ sleep improved, too, thanks to the improvements in mood, anxiety, and fatigue. 

“This large, randomized study shows that structured yoga may help relieve some of the most consistently reported and hard-to-treat issues in cancer survivorship, leading to decreased insomnia. It’s an important advance because it offers survivors, who are likely already managing multiple medications, a non-pharmaceutical solution for reducing four different side effects at once,” said ASCO expert and associate professor in breast radiation oncology Fumiko Chino, MD. 

Source: 

• YOCAS yoga, mood disturbance, and insomnia: A URCC NCORP RB nationwide, phase III, randomized, controlled trial with cancer survivors
• Yoga May Help Cancer Survivors Sleep Better and Reduce Anxiety, Fatigue