Yoga Studied to Relieve Fatigue and Stress in Breast Cancer Patients

NCI CAM Annual Report- FY10

Breast cancer survivors confront a number of post-treatment problems. Persistent fatigue, the most common and distressing problem, appears to be related in part to patients’ inflamma­tory responses to various stressors from their disease and its aftermath.

“The best treatment that we know about to remedy this problem is exercise,” noted Janice Kiecolt-Glaser, Ph.D., who holds the S. Robert Davis Chair of Medicine in The Ohio State University College of Medicine. “But the problem is, of course, that if you’re pretty tired and feeling that you don’t have a lot of energy, one of the last things you want to do is exer­cise.” With NCI funding*, she is conducting a clinical trial of a gentle regimen of hatha yoga (which is physically less demanding than other forms of yoga) “that we thought could be quite useful in terms of reducing fatigue, and poten­tially inflammation at the same time.”

Dr. Kiecolt-Glaser and her colleagues have en­rolled approximately 200 women, ages 40 and older, who have been diagnosed with stage I, II, or IIIA breast cancer. The women have all com­pleted cancer treatment within the past year (except for tamoxifen/aromatase inhibitors), and will not start in the study until at least two months after their surgery and comple­tion of adjuvant chemotherapy or radiation (if any). They will be assigned to either a 12-week, twice-weekly hatha yoga intervention or to a delayed “wait list” group who will receive the yoga intervention after a 6-month observa­tion period.

The researchers will measure differences be­tween the two groups at the start (baseline) of the study, at 3 months (at the conclusion of the 12-week yoga intervention), and at 6 months. Also at baseline and 3 months, responses of inflammation-related molecules to a laboratory stressor will be assessed. The primary aim is to determine if the yoga intervention will decrease inflammation, fatigue, and depressive symp­toms relative to the wait-listed group.

They will also determine the extent to which the intervention affects psychological, behav­ioral, and physical functioning; evaluate the relationship between depressive symptoms and the magnitude of the physiological responses elicited by a laboratory stressor, as well as the relationship of both to fatigue; and assess the extent to which the yoga intervention decreases physiological stress responses.

Although they have not yet analyzed data on the two comparison groups of breast cancer pa­tients because the trial is still in progress, “the women in the yoga group have been incredibly enthusiastic about it once they actually get into the program,” Dr. Kiecolt-Glaser noted. “We have small groups that we schedule around the women’s availability. The yoga groups meet twice a week and they’re encouraged strongly to practice at home and we’re getting pretty good compliance in terms of actual home practicing as well.”

If the study results prove positive, yoga could be a good addition to standard medical care for these types of patients, she added. “We believe yoga should be able to offer a lot of other physi­cal benefits in the way that modest exercise does, such as increased flexibility. Yoga could also serve as a ‘gateway’ exercise to other, per­haps more strenuous, kinds of exercise programs for these patients.”