Monday, July 17, 2017

Is Yoga Helpful for Breast Cancer?

One of the most important things you can do to help yourself as a breast cancer patient or survivor is to exercise. But when you’re dealing with nasty side effects like severe nausea, fatigue, sleep disturbances and joint pain, exercising can seem like the most difficult thing to get yourself motivated to do. Nevertheless, virtually any kind of physical activity will help, and many doctors are now recommending that breast cancer patients take up yoga as their primary source of physical activity.

From helping ease the shock of your initial diagnosis to getting you stronger post-treatment, yoga offers a gentle form of physical activity, breath work and meditation exercises that can be tailored to your specific needs without taxing your body more than it can handle. Dr. Janice Kiecolt-Glazer, a researcher at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute who completed a study evaluating yoga’s impact on breast cancer survivors in 2014, says “yoga is an excellent option for patients. Part of what it’s helpful for is that in addition to the physical benefits, it appears to reduce fatigue and improve mood. And those are really important, because when women are going through a very stressful time in their lives, an intervention that helps with mood as well as fatigue and inflammation is really a good thing.”

The study included 200 women, some of whom performed hatha yoga, a style of gentle, restorative yoga, for 12 weeks, while the others were assigned to a control group that did not practice yoga. Participants were between two months and three years post-treatment, and three months after completing the classes, patients in the yoga group reported 57 percent less fatigue than their non-yoga counterparts. Inflammation in the body also dropped by 20 percent among those who practiced yoga. One of the most interesting findings, Kiecolt-Glazer says, is that a “dose-response relationship” seems to exist for breast cancer survivors who are using yoga to exercise and relax. This means that the more yoga the women in the study did, the bigger the improvements they saw. “That was partly a proof of concept because it would make sense that if something is good for you, doing it more within reasonable limits should show greater benefits. And that’s what we were able to show,” she says. Why exactly yoga is able to do this is still a “million-dollar question, ” Kiecolt-Glazer says. “We don’t know the particular mechanisms for it, but there’s certainly data from other studies that meditation by itself is useful, that breathing by itself is useful and there’s some mouse data showing that stretching may reduce local inflammation, so our best guess is that all of it probably matters.” Before you start a yoga practice, it’s best to consult your doctor to make sure you’re healthy enough for it. You should also take some time to find a high-quality instructor who has experience working with breast cancer patients.

If you’re dealing with certain side effects, you'll need to take extra care. Neuropathy – a condition in which nerve damage caused by chemotherapy or radiation treatments can cause pain, numbness or tingling in the extremities – can affect your balance. Osteoporosis, a side effect of some treatments, and bone metastasis, when cancer has spread to the bones, can both make your bones brittle, so you need to be careful not to hurt yourself further when doing yoga. An experienced instructor can help you navigate these additional concerns. reports that certain types of more strenuous yoga can put you at higher risk for developing lymphedema, swelling of the arm or trunk that results from a build-up of fluid after lymph nodes have been removed, so some yoga instructors tell patients to wear a compression garment when practicing. Still, a restorative yoga practice is usually a very safe option for most patients, especially when it’s led by an experienced instructor. Carol Krucoff, a yoga therapist with Duke Integrative Medicine and co-author of “Relax into Yoga for Seniors: A Six-Week Program for Strength, Balance, Flexibility, and Pain Relief,” says which poses and breathing techniques you begin with will likely be dictated by “where you are on your cancer journey. If you’re having active treatment, then energy level is going to factor into what would be most useful. And if you have a port,” a device that allows the doctor to infuse chemotherapy or draw blood without having to stick a needle in your arm every time, “that’s going to affect what you can do.”

You’ll need to communicate with your yoga instructor to find ways to work around these obstacles and limitations. That said, Krucoff says “breathing, meditation and relaxation are useful anywhere along the journey, including when people are actually sitting there having their chemo.” She says a teacher of hers encouraged cancer patients to “meditate on the actual chemo substance, not thinking of it as a poison, but thinking of it as a nectar that’s going to help the body reestablish health.” The findings of a 2012 study in The Journal of Alternative and Complementary Medicine seem to corroborate the use of this approach; study participants who used a program of pranayama, or yogic breathing, alongside their chemotherapy treatments experienced an increase in quality of life, a decrease in depression and anxiety, and a reduction in sleep disturbance and fatigue. When you’re ready to move, Krucoff says yoga can offer just the right amount of gentle physical activity. “If you’ve been cleared for activity, there are many exercises – stretching and opening the chest, supported back bend poses – that can be very helpful.” Gently stretching the arms up along a wall and moving slowly until you feel a gentle stretch may be helpful for regaining limb functionality after surgery where scar tissue may develop and limit your range of motion. She also recommends using props or working with a physical therapist or oncologic surgeon to make sure your form is safe with regard to where your incisions were and how they’ve healed. No matter how you approach it, Krucoff says the dividends that yoga practice can pay during treatment for breast cancer are many. “Cancer is a very interesting predicament, because many people feel like they’re fighting themselves and say, ‘I’m going to beat this thing!’ But this thing is also themselves, so there can be this sense of betrayal, so there we go to some of the principles of yoga.

Just learning to love yourself as you are, and make peace with all parts of yourself,” is part and parcel of a yoga practice and a powerful aspect of using it during your cancer journey. Krucoff says establishing a regular breathing practice and using guided imagery can help you come to a more peaceful place. And even if it’s very gentle, yoga is still considered a form of physical activity. For cancer patients here in the Western world who may only think of exercise as striving and sweating and achieving big goals, Krucoff says yoga is the opposite of this and a good way for breast cancer patients to develop a new relationship with a changed body. “The idea in yoga is we move to a point of challenge, where we feel like we’re being challenged, but we do not strain. So we find that balance between effort and surrender. That balance between courage and caution. That balance between doing and undoing.”

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