For Patients & Caregivers
What Is It
How It Works
Studies have shown that yoga can be helpful for patients with irritable bowel syndrome, asthma, diabetes, migraine headaches, depression, and anxiety. It is also practiced for weight maintenance. Cancer survivors including those recently diagnosed reported better sleep, less stress, and improved mood and quality of life with the practice of yoga. Among less active cancer survivors, a restorative yoga practice may be easier to maintain, and also have benefits. Regular practice also increases benefits.
The American Society of Clinical Oncology (ASCO) and Society of Integrative Oncology (SIO) recommend yoga for anxiety, stress reduction, depression, mood disturbance, and improved quality of life in cancer patients.
Many clinical studies indicate that yoga can reduce anxiety.
Some studies have linked yoga to reduced depression and positive mood.
Small studies show that yoga may help problems such as shortness of breath and anxiety in patients with chronic obstructive pulmonary disease (COPD) and lung cancer. More research is needed.
Many studies indicate that yoga can help reduce fatigue in both cancer patients and survivors
Small studies show that yoga may be effective in cancer patients who have hot flashes and related symptoms.
Yoga was shown in some studies to relieve pain.
Post-traumatic stress disorder
Several yoga programs for survivors of war and natural disasters show it may be possible to use this practice in certain populations with post-traumatic stress disorder.
Sleep quality and sleep medication use
A large study of a specific yoga program showed improved sleep quality and less sleep medication use in cancer survivors with sleep problems.
Several studies support use of yoga for reducing stress.
Is It Safe
- Side effects from yoga are rare. However, blood clots, nerve damage, torn ligaments and difficulty breathing have been reported.
- Musculoskeletal effects including osteoarthritis, chronic back, neck or shoulder pain, tendon shortening or sciatica were associated with hand-, shoulder- and head stands; and following yoga self-study without supervision.
- Pregnant women and individuals with hypertension or glaucoma should use caution when practicing certain yoga postures.
Who Can Provide this Service
Where Can I Get Treatment
For Healthcare Professionals
Yoga was first described in the Vedic texts of India and has been practiced over several centuries. It is an integral part of Ayurveda, the traditional healing system that originated in India. Major components of yoga include regulated breathing (pranayama), moving through various postures (asansas), meditation (dhyana), and optimal coping principles (swadhyaya) (1) to cultivate physical and emotional health, and spiritual growth, with self-realization as a core intention. Many styles of yoga encompass some or all of these components. In the United States, most practices focus on postures, meditation, and breath control (2).
Yoga is helpful in reducing symptoms of carpal tunnel syndrome (3), irritable bowel syndrome (4), asthma (5), and drug-resistant epilepsy (6). It also has shown benefit for weight maintenance (7), diabetes (8), migraines (9), low back pain (10) (48), depression (11) (12) (49), and anxiety (4) (11) (13) (14) (15) (16). Long-term yoga practice was reported to have beneficial effects on inflammation in adults with metabolic syndrome and high-normal blood pressure (50). Other evaluations suggest yoga is beneficial in those with arthritis (46) and post-traumatic stress disorder (14) (17) (18) (47). Yoga may improve symptoms and quality of life in patients with paroxysmal atrial fibrillation (16); and as an adjunct to pulmonary rehabilitation, contributes to improvements in dyspnea for COPD patients (1). For adolescents and young adults with difficult disease states, clinicians have also noted that yoga can return a sense of control to one’s experience (4) (19).
The American Society of Clinical Oncology (ASCO) (52) and Society of Integrative Oncology (SIO) (53) recommend yoga for anxiety, stress reduction, depression, mood disturbance, and improved quality of life in cancer patients. It is widely available in many cancer centers across the country, and patients now use this modality at all disease stages to relieve various symptoms (20) (21) (22) (55). The ability of yoga to reduce stress, increase sense of well-being, improve quality of life, and impart more restful sleep in both newly diagnosed and long-term cancer survivors is well documented (2) (23) (24) (25) (26) (27) (28) with the potential for reduced need for sleep medications (28) (29). Yoga practice during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time (51). It was also reported to reduce fatigue in patients with different types of cancer (56), as well as in cancer survivors (57). Furthermore, studies in breast cancer survivors indicate that yoga improves social functioning and mood, reduces stress levels (30) (31), and can help to address a range of psychological symptoms (32). In survivors with persistent fatigue and induced or exacerbated menopausal symptoms, yoga reduced fatigue, joint pain, and number of hot flashes while increasing vigor, with benefits persisting at 3-month follow-up (22) (33). Yoga can improve quality of life in breast cancer patients undergoing radiation therapy (34). Preliminary studies in other cancers have also shown that yoga can increase forced expiratory volume in non-small cell lung cancer patients (35) and improve sleep quality in lymphoma survivors (29). Among sedentary cancer survivors, patient adherence was greater with restorative yoga compared with vigorous yoga (54).
Adverse effects associated with improper yoga practices have been reported. However, appropriate and long-term yoga practices to relieve symptoms can have additional downstream benefits, such as genetic and physiologic changes (35), as well as the ability to adhere to exercise programs or make other lifestyle changes (1). Cancer patients interested in beginning yoga should first consult their physicians. In addition, it is advisable to learn proper technique from certified instructors who have experience working with cancer patients, because survivors may have special limitations due to surgery, chemotherapy, or radiotherapy.
Mechanism of Action
Because components of yoga practice include postural alignment and engagement of the extremities, yoga raises somatic self-awareness, educating the user of states in which the body experiences balance and calm, and identifying symptoms that may be problematic (3). The engagement of the mind, attention to comfort, and deep relaxed abdominal breathing reduces gastrointestinal symptoms by disrupting chronic patterns of functional disability and maladaptive coping strategies often experienced with irritable bowel syndrome (4).
Some studies have shown that the meditative component of yoga increases blood flow to the brain, releases endogenous dopamine, and reduces respiratory rate (6). The changes in breathing patterns that accompany various yoga practices may also alter airway hyper-responsiveness (5). Yoga postures and controlled breathing interact with both the somatic nervous system and endocrine mechanisms, thereby affecting insulin kinetics (8). Neuroplastic mechanisms for its antidepressant effects include elevated serum brain-derived neurotrophic factor (BDNF) levels (36). Yoga relieves stress and anxiety by increasing levels of the neurotransmitter gamma amino-butyric acid (GABA) (13) and improving hypothalamic-pituitary-adrenal (HPA) axis functioning (25). Improvements in fatigue, sleep disturbance, anxiety, and quality of life are also attributed to increased parasympathetic and decreased sympathetic activities, stimulation of the vagus nerve, and reduction in allostatic load which optimizes homeostasis in stress response systems (14), thereby replacing the flight-or-fight response with the relaxation response (19). By eliciting the relaxation response, long-term practice has been shown to promote mitochondrial resiliency via ATPase and insulin function upregulation and downregulation of NF-kB-dependent pathways (35).
- Rare, due to improper practice: Hematoma (12) (37) (58), nerve damage (38), aggravation of glaucoma (39) (40), embolism (41), ligament rupture (42), spontaneous pneumothorax (43) (44) and bilateral ulnar artery thrombosis (59).
- Musculoskeletal effects including osteoarthritis, chronic back, neck or shoulder pain, tendon shortening or sciatica were associated with hand-, shoulder- and head stands; and following yoga self-study without supervision (60).
Practitioners and Treatments
Yoga classes are offered at hospitals, cancer clinics and community centers.
Cancer patients interested in beginning yoga should first consult their physicians. Because of limitations due to surgery, chemotherapy and radiotherapy, it is also advisable to learn the proper technique from certified instructors who have experience working with cancer patients.