Restorative Yoga & Breast Cancer: Current Research

 

“You can expect side effects 

including some pretty intense hot flashes for at least six months.”

My doctor shared this information with me as I recently began taking an FDA-approved drug for breast cancer risk reduction. However, she also told me that if I continued my daily gentle and restorative yoga practices, the intensity would lessen and the duration would decrease.

My doctor wasn’t kidding about the intensity!  Running in August, in Florida, was hot enough but running with hot flashes was miserable. I also had trouble falling and staying asleep. Thankfully, within a month and a half of beginning the medication, and continuing my yoga practices, the intense hot flashes ceased. When I ran, I no longer felt like I was burning inside and melting outside. My quality of life definitely improved. Plus, I was able to enjoy undisturbed sleep. Yoga is not decreasing my breast cancer risk, the medication is doing that, but yoga has a positive effect on my physical and mental health... and I am not the only one who has experienced the therapeutic effects of yoga! 

From my personal experience, one may suppose that yoga is “good” for cancer patients and survivors but finding out, through research, is better. In a previous post I discussed yoga research in general. In this post, and in honor of Breast Cancer Awareness Month, I want to highlight a few research studies specifically related to breast cancer and gentle or restorative yoga.

First, it is important to understand that yoga is not a cure for cancer. However, yoga does have a therapeutic effect on the consequences of a cancer diagnosis and the side effects of treatments. The cancer comorbidities and symptoms listed below are what scientists are studying in relation to yoga practice.

 

In fact, research studies have documented the benefits of yoga for cancer comorbidities and symptoms.

What follows is a very small sampling of recent studies and review papers. This evidence-based research explains yoga’s therapeutic efficacy when used in conjunction with conventional medicine.  

REVIEW PAPERS: The purpose of a review paper is to succinctly review recent research in a particular topic. It discusses the findings presented in recent research papers. Then the paper summarizes the current state of knowledge of the topic.

• Low-intensity forms of yoga, specifically gentle hatha and restorative, are feasible, safe, and effective for treating sleep disruption, cancer-related fatigue, cognitive impairment, psycho-social distress, and musculoskeletal symptoms in cancer patients receiving chemotherapy and radiation and cancer survivors.   

Yoga for the Management of Cancer Treatment-Related Toxicities (Full Text Article)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901971/

• This meta-analysis demonstrated that yoga is probably as effective as other exercise modalities in improving the Quality of Life of women with breast cancer.

Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory Meta-Analysis of Randomized Controlled Trial (Full Text Article)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388460/pdf/10.1177_2515690X19828325.pdf
 

• Sedentary breast and ovarian cancer survivors were randomized to practice either restorative yoga (minimal physical exertion) or vigorous yoga (considerable physical exertion). Restorative yoga is a more feasible intervention for this population.

A Feasibility Study of Restorative Yoga Versus Vigorous Yoga Intervention for Sedentary Breast and Ovarian Cancer Survivors (Full Text Article)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470896/


NOTABLE PUBLICATIONS: These are individual, published studies that are notable for scientific, clinical, epidemiological, sociological, and/or policy aspect.

• Participants in Restorative Yoga experienced increases in emotional well-being and less fatigue than those in a control group. This type of intervention should be considered for women undergoing multi-modality treatment for breast cancer.

Restorative yoga for women with breast cancer: findings from a randomized pilot study (Full Text Article)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930083/

• Significant improvements were seen for depression, negative affect, state anxiety, mental health, and overall quality of life.

Restorative yoga for women with ovarian or breast cancer: findings from a pilot study (Abstract)  https://pubmed.ncbi.nlm.nih.gov/18544284/

• Depression scores at follow-up were significantly lower in the yoga group compared to the control group.

A Restorative Yoga Intervention for African-American Breast Cancer Survivors: a Pilot Study (Abstract)
https://pubmed.ncbi.nlm.nih.gov/28411330/

 

Restorative yoga is not a cure. But many breast cancer patients and survivors have found it to be a powerful tool to manage the daily challenges of cancer treatments as well as the side effects and life-long vulnerabilities they create.

To find out more:

Yoga Alliance has curated an online listing of cancer & yoga research studies.

Yoga4cancer has published a review of existing research on the benefits of yoga for cancer patients and survivors and how yoga manages short- and long-term side effects faced by most cancer survivors. It was developed by a team of medical writers, oncologist, researchers and yoga4cancer team. Yoga4Cancer White Paper

National Cancer Institute/Advances in Breast Cancer Research: This page highlights some of the latest research in breast cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.

Online Medical Research Search Engine: PubMed. gov, National Institutes of Health’s National Library of Medicine is comprised of more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

Helpful books:

The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee, MD
Yoga and Breast Cancer by Ingrid Kollak, RN, PhD, & Isabell Utz-Billing, MD
Yoga for Cancer by Tari Prinster, E-RYT 200

 

 

Inhale ... Exhale ...

 

Introduction: Breathing is synonymous with life itself. It is the first thing we do at birth and the last thing we do as we die. Yet, this natural act is often compromised by conditions that affect breathing like colds, asthma, flu, allergies, bad posture and stress. This practice is designed to improve respiratory capacity. We will explore gentle stretches to open the chest, create spinal flexibility and release tension that may be restricting your ability to breathe freely and completely.

Gather your props: Chair; bolster (or a firm pillow or cushion); 2 blankets; towel.

Warm Up: Breath Stretches – Repeat each three times.

Move … flow with your natural, peaceful breathing pattern … inhaling … exhaling.

** Feel free to make any adjustments.  Build/stack the props up to your body rather than straining to bring your body down to the props.  Take a few moments to make adjustments as you come into each pose so that you are comfortable, able to release your weight into the props, and relax. **

Easy Breath Pose
Props: 1 blanket & 1 towel

Sit with the folded blanket (folded to approximately 8-10 inches wide, 3 inches high, and 3 feet long) lined up vertically behind you. Place the towel within easy reach. Slowly release down onto the blanket, so that your spine is supported by the blanket and your hips are resting on the mat. Bend your knees, press into your feet, lift your hips and scoot your tailbone towards your heels, releasing your lower back. You can keep your legs bent or extended long down the mat. Place the folded towel under your head and neck so that your forehead is slightly higher than your chin.

Strengthening the Diaphragm[i]

Now bring your hands to the bottom of your rib cage, placing your thumbs on the back and your fingers on the front. Press your thumbs firmly into the rib cage but allow your fingers to simply rest on the front of the ribs.
Begin to direct and expand your breath into your ribs, expanding your ribs against the pressure of your hands. With each inhalation the fingers of the hands move away from each other, with each exhalation, they come closer together as your rib cage moves like an accordion.

Continue breathing, providing resistance with your hands so that your diaphragm and intercostal muscles receive a gentle workout. Scan your chest, neck, back, and face. Are those areas tense and tight? If so, mindfully release tension on each exhale.
Continue for 10 breaths then return to your normal, natural breathing pattern. How does your breathing feel now?

Reclining Quarter Moon Pose (2 – 5 minutes per side): This pose stretches the intercostal muscles, the muscles that lift the ribs during inhalation and then draw the ribs down on exhalation. 

Props: bolster; 2 blankets

Place a bolster horizontally across the mat.  Place a rectangular folded blanket below the bolster on the right edge of the mat; place a square folded blanket above the bolster.

Sit with your right hip next to the long side of the bolster. Elongate and extend the right side of your torso over the bolster so that your ribs are supported. Slide the right arm under the square folded blanket and draw the blanket under your head and neck. Reach your left arm overhead, bend your elbow and rest your left arm on your head. Extend your left leg out in front and scissor the right leg backward. Place the rectangular folded blanket under the left knee.

Bring your awareness to your ribs as you feel your breath moving in … out.

To come out of the pose: Bring your left hand onto the floor in front of your chest and bend your knees towards your chest. On an exhale, using your hands and arms, press yourself up to sitting. 

Repeat on your other side.

Heart Opening Pose (5 - 10 minutes): This pose opens up your back and chest and counteracts all the hunching forward you likely do throughout the day. 

Props: bolster; folded blanket; a rolled blanket (or a firm pillow or a cushion).

Place a folded blanket at the top of your mat (this will support your head and neck). Place a bolster horizontally across the mat below it, (this will support your shoulder blades and mid-back). Finally place a rolled blanket (or firm pillow or cushion) below it, horizontally . This will support your knees. 

Lie over the bolster with your arms extended in a T shape. Rest your head and neck on the folded blanket. If the bolster feels too high, place another blanket under your head and neck. 

As you relax, imagine your body softening and spreading. Breathing in, know that you are breathing in. Breathing out, know that you are breathing out. In. Out.

To come out of the pose: Bend your knees and use your feet to push the rolled blanket/firm pillow/cushion away. Then, keeping your knees bent, roll to your favorite side. On an exhale, using your hands and arms, press yourself up to sitting. 

Chair Forward Fold (3 minutes per side) – Sixty percent of your lungs are in your back body. This pose opens up your back body allowing you to focus on how your back moves with the breath. 

Props: Chair; 1 or 2 blankets. 

Place the chair at the top of your mat with the seat facing you. Place a square folded blanket on the seat of the chair.

Sit in front of the chair with one leg straight out in front of you under the chair. Bend the knee of the other leg, with your foot folded towards your pelvis. On an exhale, fold forward, your forearms resting on the chair seat, elbows bent. Rest your forehead on your forearms. Adjust the chair as needed for comfort. You may also want another folded blanket under your hips for comfort. 

Let the weight of your head rest completely. Breathe into your back as you let it softly round.

Switch the straight leg and the bent leg after 3 minutes. 

Legs on a Chair (7 – 10 minutes): This pose is a gentle inversion. Inversion poses have many benefits including helping to drain excess fluid and congestion from the lungs. 

Props: Chair; 1 or 2 blankets. 

The setup is the same as Chair Forward Fold. 

Ease onto your back with your knees bent, calves resting on the seat of the chair. Adjust a folded blanket under your head for comfort. 

Let each breath be slow and steady, moving deeply and gently into your lungs and back out. Enjoy the sensation of fatigue draining from your legs; your back and shoulders opening; and your mind quieting. 

Forget the world for the next several minutes; allow yourself the important task of doing nothing. Breathing … in…out.

[1] Farhi, D. (1996). Breathing book - vitality and good health through essential breath work. Henry Holt & Company.