Yoga for Patients with Early Breast Cancer and its Impact on Quality of Life – a Randomized Controlled Trial

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Breast cancer is the most common malignancy in women worldwide. It accounts for 14 % of all cancer diagnoses in Europe 1. In the industrialized countries of the northern hemisphere, between one in eight and one in ten women will be diagnosed with breast cancer in their lifetime 2, 3. Due to the enormous advances in adjuvant and palliative treatment, it has, in many cases, become a controllable chronic disease 4.

Health-related quality of life (QoL) is very important for patients. QoL is defined as self-perceived well-being related to, or affected by the presence of disease or treatment 5. As a multifactorial construct, it includes perceptions, both positive and negative, of many different dimensions such as physical, emotional, social and cognitive functional status. It also includes the negative aspects of symptoms caused by disease and/or its treatment 6. Breast cancer is one of the oncologic diseases in which QoL has been studied most 7. Recent studies have suggested that QoL in the months after diagnosis and breast cancer surgery may be a predictor of psychological well-being later on 8.

Within the population of cancer patients, there is a growing interest in complementary therapies. Compared to other oncologic entities, e.g. gynecological cancer, women with breast cancer frequently make use of complementary therapies 9. The overall rate has been reported to be as high as 75 % 10, 11, 12.

As a mind–body discipline, yoga is claimed to offer physical, mental and spiritual benefits 13. Studies have shown beneficial physical and psychological effects in different cancer patients 13, 14, 15, 16. Studies of yoga programs for breast cancer patients showed improvements in physical well-being, social function, emotional health and functional adaption 17. Yoga programs can reduce distressing symptoms in patients undergoing treatment for breast cancer 18, 19. After hatha yoga, constraints on physical activity were reduced and fitness was found to be improved in breast cancer survivors 20. Yoga has also been shown to be beneficial in reducing chemotherapy-induced side effects compared with other supportive therapies 21. Women with breast cancer showed a cognitive improvement after participating in yoga programs 22, 23. They reported less fatigue when undergoing breast cancer treatment 24, 25, 26.

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Studies of yoga programs for breast cancer patients found improvements in emotional outcomes and in quality of life 23, 25, 27, 28. Anxiety and depression was reduced with yoga interventions compared with supportive therapy following surgery, radiation therapy and chemotherapy 18, 29. Several authors have described an increase in positive affect and a decrease in negative affect in patients with breast cancer who participated in yoga programs 22, 25.

Women who were prescribed a 6-week daily yoga program reported improved confidence in social settings relative to controls who had only a brief supportive therapy 22. Moadel et al. described that participants in a yoga group did not report a significant change in social well-being but the 12-week waiting-list control group noted a significant decrease in support 30.

The aim of our study was to test the hypothesis that newly diagnosed patients with early breast cancer could benefit from yoga in the early postoperative period. This benefit would be expressed primarily by a higher QoL and secondarily by an improvement in physical activity. Furthermore, we hypothesized that QoL is influenced by sociodemographic factors and the type of surgery.


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About the Author: Tung Chi