Tuesday, June 15, 2010

Yoga – Not Just for Skinny, Pretty Women Anymore?

This post is dedicated to a close friend of mine, a budding scientist with an aversion to yoga.

The benefits of yoga for cancer patients were plastered throughout the popular press recently, in anticipation of a presentation by Dr. Karen Mustian from the University of Rochester Medical Center at this year’s meeting of the American Society for Clinical Oncology in Chicago. This study enrolled 410 cancer survivors (96% female, 75% had breast cancer) suffering from moderate or worse sleep disturbance. The participants were randomized to standard monitoring versus a 4 week yoga intervention. Participants in the yoga program had improvements in sleep quality, fatigue, and various measures of Quality of Life compared with the control arm (no intervention). The benefit was significant enough to be covered by mainstream media outlets like CNN as well as web-based media like Breastcancer.org. ASCO president Douglas Blayney, MD, stated that the results are “readily applicable” for a huge patient population.

But wait. As we scientists often ask, do the results support the conclusions?

I think the answer is a resounding “Maybe.”

There is mounting evidence that cancer survivors benefit from participating in yoga programs. Although this study is the largest thus far reported, it is certainly not the first to show a benefit to yoga. Back in 2003 a study presented at the ASCO meeting showed that participation in a yoga intervention improved the Quality of Life of women newly diagnosed with breast cancer.

But is it yoga, per se, that helps? So far none of the studies have compared participation in yoga with any other exercise program. This study, for example, published in 2001, demonstrated that a home-based walking exercise program improved fatigue and other Quality of Life measures in women being treated for breast cancer. The studies cited on this page of the American Cancer Society’s website demonstrate a benefit to using a treadmill or an outpatient wellness program involving aerobic exercise, strength training, flexibility and relaxation. So maybe it’s exercise in general, and not specifically yoga, that helps cancer survivors live better.

Are the results of the yoga study “readily applicable” to a huge patient population, as suggested by Dr. Blayney? Again, I think the answer is “Maybe.” It depends on how you define “a huge patient population.” Dr. Mustian’s study is certainly applicable to the very large number of women diagnosed with breast cancer every year, but her study involved essentially only women with breast cancer. Given the variety of ways various cancers are treated, it may be premature to conclude that because yoga helped these women, that it would make a difference for young adults being treated with intensive chemotherapy for leukemia.

So what can we conclude? I think it is safe to conclude that some degree of exercise is beneficial for cancer patients, probably regardless of where they are in the course of their therapy. But before we can state that yoga is the best form of exercise, the right study has to be performed: patients need to be randomized to various forms of exercise, and research participants need to include men as well. Perhaps for a relatively inflexible man like me, the frustration of not being able to do “downward dog” will make yoga a poor choice, while the feeling of accomplishment associated with being able to last 5 more minutes on the treadmill will make that form of exercise a much better choice. Only a well-designed experiment can tell us for sure.

Related Posts:
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Cancer and Self-Image


Yoga Teacher Training said...

Yoga is very beneficial in chronic diseases like cancer. Yoga has proved that it can cure various problems just by breathing.

Melissa Silversmith said...

Yoga is definitely not just for skinny women. In fact Yoga is one of the most effective weight loss exercise for those who have been trying to loss extra pounds.

cynthia bailey said...

Hello David,
I love the last photo, that gave me a real chuckle.

I also love yoga and for me it doesn't have the be the best exercise, it just has to be useful, which I think it is. My husband has also started taking yoga classes and he has regained much of the flexibility he had when he was younger. We study a type of yoga that is a hybrid between tai chi and yoga so the slow repetitive movements enhance the strengthening and flexibility benefits. I'm always up for multi-tasking!

Earlier in the year I was curious to know if any western scientific studies had been done to look at potential health benefits from yoga and did a literature review. I posted this on the link below. The studies weren't perfect, but I think there's reason to believe that yoga might help me and my patients maintain/regain the ability to get in and out our bath tubs for more years of our lives. This is surprisingly hard for many elderly people who otherwise seem functionally mobile. Many other forms of fitness would undoubtedly help as well, but in my experience functional flexibility in the hips is often overlooked by other fitness regimens. There's also the 'chill' vibe in a yoga class.... well I like it anyway.

Warm Regards,
Cynthia Bailey MD

Dreaming again said...

I have myasthenia gravis and lupus. A few weeks ago, i began a summer class of yoga.
I expected it to help with pain in the way that exercise and physical therapy helps with pain.

I've not had a day in 15 years that I've gone without pain and I'd rank it in the 5 to 7 on a good day.

I went to my first class, excited to be learning something new. I participated, a bit surprised at how well accepted my plus size frame was accepted both by the studio and the students.

I did the class and when I stood up after 'the final resting pose' I felt something absolutely amazing, astonishing. I could not feel a single bit of pain. Not an ache, not a twinge, nothing. morphine had not worked that well!

this pain free state lasted 3 hours. I was taking darvocet on a daily basis trying to stay a step ahead of the pain. I took it at least twice, 4 times on a bad day (but script is for 6 times a day).

By the 3rd week, I went to class on a thursday, I realized that at bedtime, I was still pain free. i took my darvocet to my bedside table in case i woke up in pain. I slept solid that night. No pain interferring with sleep. It was 5 pm before I needed to take anything!

The last 2 weeks, I have averaged 4 darvocets a WEEK.

I'm sold. My sleep has vastly improved, my pain levels are distinctly different, my overall wellbeing has dramatically changed for the better.

If I, an overweight myasthenic with lupus can do yoga ...anyone can!

Dr. Anders Cohen, brooklyn, NY said...

Yoga definitely is not for fitness alone. It enhances one's self and inner being. So if you are depressed, yoga is the best for you.

abouthealthiness said...

In essence yoga train you to relax, so that it affects blood circulation in the body, especially hands and kaki.Yoga also helps oxygen to enter the cell. Pose a twist, such as whether to carry blood to the organs in and drain out after the pose was finished. Pose headstand, handstand, and shoulderstand help bring blood from the legs and pelvis to the heart and from there pumped to the lungs, so get fresh oxygen. Yoga also increases levels of hemoglobin and red blood cells that carries oxygen to tissues.

pain management Walnut Creek CA said...

Yoga needs to be practiced on a regular basis by people of all ages to stay healthy...

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