Yoga and Mindfulness as Complementary Therapies for Breast Cancer

This post was written by H&W instructor Susannah Haarmann, PT, WCS, CLT, who authored and instructs the course, Rehabilitation for the Breast Oncology Patient.

It is holistic and forward thinking for medical practitioners, such as physical and occupational therapists, to consider the interconnectedness of mind and body when creating an effective treatment plan. Today, it is generally accepted that stress weakens the immune system and, the American Medical Association reports that “80% of all diseases are stress related,” (1). Prolonged physical and emotional distress triggers the neuroendocrine system to secrete stress hormones which affect the immune system, specifically, decreasing T-cell production and lowering basal and interferon augmented NK cell activity (NKCA). Knowing this unlocks huge potential for cancer patients who wish to actively boost their immune system during treatment; one of these proven techniques is called mindfulness-based stress reduction (MBSR). A study performed by Witek-Janusek et al, demonstrated a significant increase in NKCA levels in breast cancer patients after just one month of participating in a MBSR program; this is significant because elevated NKCA levels correlate with a decreased incidence of lymph node metastasis and improved survival rates in women with breast cancer (6).

MBSR may be compared to meditation and in the west we are seeing an increased acceptance of patients and practitioners looking to eastern philosophy as an adjunct treatment to western medicine. In fact, yoga is one of the most commonly sought after complementary treatments for breast-cancer related impairments among survivors today (4). Yoga, as a practice, blends mindfulness and movement. Physical exercise and mindfulness practices have both independently been shown to have a positive effect on cancer outcomes (3,6), therefore, it makes sense that patients are seeking yoga during treatment and supports why yoga is beneficial for physical and occupational therapists to include in their tool box of effective interventions.

In 2012, the first available systematic review on yoga for breast cancer survivors was published which performed a meta-analysis of twelve random control trials (RCTs) (2). The outcomes reported the following short-term effects: moderate improvements in overall well-being, small differences in quality of life (functional, social and spiritual), and large changes in perceived stress, anxiety, depression and psychological distress. At the moment, there is no evidence for longer term effects due to the limited amount of RCTs with long-term follow-up. In summary, the authors of the article stated that “the clearly positive effects of yoga on psychological health in breast cancer patients should warrant its use in this patient population. Yoga might be particularly recommended as an intervention to improve psychological health during active breast cancer treatment.” Although physical and occupational therapists objectives are geared towards improved physical outcomes with objective gains, we as practitioners value the importance of a quality of life measures when determining the effectiveness of treatment and can attest to the correlation between lessened psychological distress and alleviated symptom burden (2).

Susannah Haarmann’s course, “Rehabilitation for the Breast Cancer Patient,” will touch on yoga as a solution for the physical side effects of breast cancer such as peripheral neuropathy, osteoporosis, lymphatic cording and chest mobility after surgery to name a few. Participants may choose to participate in short, didactic yoga sessions interspersed throughout the course to address these topics. Bring your yoga mats and be prepared to breathe!

Resources:

1.Chapman, J. Y, YCat YOGA Therapy: Yoga for People with Cancer and Chronic Illness Teacher Training Manual, Yogaville, Buckingham, VA, 2011. 2.Cramer, H., Lange, S., Klose, P., Paul, A., Dobos, G., Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer, 2012; 12: 412.
3.Denmark-Wahnefried, W., Campbell, K., Hayes,S. Weight management and its role in breast cancer rehabilitation. Cancer, 118 (8). 2277-2287.
4.Fouladbakhsh, J., Stommel, M., Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population. Oncol Nurs Forum, 2010, 37: E7-E15.
5.Rock, C. et al, Nutrition and Physical activity guidelines for cancer survivors. Clinical Journal of Cancer, 2012.
6.Witek-Janusek, L., Albuquerque, K., Chroniak, K., et al. ‘Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav Immun. 2008. 22(6): 969-981.