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)}. In a randomized preference trial, yoga was similar to cognitive-behavioral therapy for reducing late-life worry and anxiety, and no preference or selection effects were found ^(61) (62). 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 physician. 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.

MSK offers yoga courses for our patients and caregivers, and as part of a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.