1 1036 115 EFFECTS OF YOGA IN MANAGING FATIGUE IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE IS WIDELY PREVALENT IN CANCER PATIENTS AND AFFECTS QUALITY OF LIFE IN ADVANCED CANCER PATIENTS. FATIGUE IS CAUSED DUE TO BOTH PSYCHOLOGIC DISTRESS AND PHYSIOLOGICAL SEQUEL FOLLOWING CANCER PROGRESSION AND ITS TREATMENT. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGIC INTERVENTION IN MANAGING FATIGUE IN METASTATIC BREAST CANCER PATIENTS. METHODS: NINETY-ONE PATIENTS WITH METASTATIC BREAST CANCER WERE RANDOMIZED TO RECEIVE INTEGRATED YOGA PROGRAM (N = 46) OR SUPPORTIVE THERAPY AND EDUCATION (N = 45) OVER A 3-MONTH PERIOD. ASSESSMENTS SUCH AS PERCEIVED STRESS, FATIGUE SYMPTOM INVENTORY, DIURNAL SALIVARY CORTISOL, AND NATURAL KILLER CELL COUNTS WERE CARRIED OUT BEFORE AND AFTER INTERVENTION. ANALYSIS WAS DONE USING AN INTENTION-TO-TREAT APPROACH. POSTMEASURES FOR THE ABOVE OUTCOMES WERE ASSESSED USING ANCOVA WITH RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THE RESULTS SUGGEST THAT YOGA REDUCES PERCEIVED STRESS (P = 0.001), FATIGUE FREQUENCY (P < 0.001), FATIGUE SEVERITY (P < 0.001), INTERFERENCE (P < 0.001), AND DIURNAL VARIATION (P < 0.001) WHEN COMPARED TO SUPPORTIVE THERAPY. THERE WAS A POSITIVE CORRELATION OF CHANGE IN FATIGUE SEVERITY WITH 9 A.M. SALIVARY CORTISOL LEVELS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA REDUCES FATIGUE IN ADVANCED BREAST CANCER PATIENTS. 2017 2 851 69 EFFECT OF YOGA ON SLEEP QUALITY AND NEUROENDOCRINE IMMUNE RESPONSE IN METASTATIC BREAST CANCER PATIENTS. BACKGROUND: STUDIES HAVE SHOWN THAT DISTRESS AND ACCOMPANYING NEUROENDOCRINE STRESS RESPONSES AS IMPORTANT PREDICTOR OF SURVIVAL IN ADVANCED BREAST CANCER PATIENTS. SOME PSYCHOTHERAPEUTIC INTERVENTION STUDIES HAVE SHOWN HAVE MODULATION OF NEUROENDOCRINE-IMMUNE RESPONSES IN ADVANCED BREAST CANCER PATIENTS. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGA ON PERCEIVED STRESS, SLEEP, DIURNAL CORTISOL, AND NATURAL KILLER (NK) CELL COUNTS IN PATIENTS WITH METASTATIC CANCER. METHODS: IN THIS STUDY, 91 PATIENTS WITH METASTATIC BREAST CANCER WHO SATISFIED SELECTION CRITERIA AND CONSENTED TO PARTICIPATE WERE RECRUITED AND RANDOMIZED TO RECEIVE "INTEGRATED YOGA BASED STRESS REDUCTION PROGRAM" (N = 45) OR STANDARD "EDUCATION AND SUPPORTIVE THERAPY SESSIONS" (N = 46) OVER A 3 MONTH PERIOD. PSYCHOMETRIC ASSESSMENTS FOR SLEEP QUALITY WERE DONE BEFORE AND AFTER INTERVENTION. BLOOD DRAWS FOR NK CELL COUNTS WERE COLLECTED BEFORE AND AFTER THE INTERVENTION. SALIVA SAMPLES WERE COLLECTED FOR THREE CONSECUTIVE DAYS BEFORE AND AFTER INTERVENTION. DATA WERE ANALYZED USING THE ANALYSIS OF COVARIANCE ON POSTMEASURES USING RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THERE WAS A SIGNIFICANT DECREASE IN SCALES OF SYMPTOM DISTRESS (P < 0.001), SLEEP PARAMETERS (P = 0.02), AND IMPROVEMENT IN QUALITY OF SLEEP (P = 0.001) AND INSOMNIA RATING SCALE SLEEP SCORE (P = 0.001) FOLLOWING INTERVENTION. THERE WAS A DECREASE IN MORNING WAKING CORTISOL IN YOGA GROUP (P = 0.003) ALONE FOLLOWING INTERVENTION. THERE WAS A SIGNIFICANT IMPROVEMENT IN NK CELL PERCENT (P = 0.03) FOLLOWING INTERVENTION IN YOGA GROUP COMPARED TO CONTROL GROUP. CONCLUSION: THE RESULTS SUGGEST MODULATION OF NEUROENDOCRINE RESPONSES AND IMPROVEMENT IN SLEEP IN PATIENTS WITH ADVANCED BREAST CANCER FOLLOWING YOGA INTERVENTION. 2017 3 962 50 EFFECTS OF A YOGA PROGRAM ON CORTISOL RHYTHM AND MOOD STATES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY: A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: OBJECTIVES. THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY AT A CANCER CENTER. METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS ARE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO RADIOTHERAPY TREATMENT. ASSESSMENTS INCLUDE DIURNAL SALIVARY CORTISOL LEVELS 3 DAYS BEFORE AND AFTER RADIOTHERAPY AND SELF-RATINGS OF ANXIETY, DEPRESSION, AND STRESS COLLECTED BEFORE AND AFTER 6 WEEKS OF RADIOTHERAPY. RESULTS: ANALYSIS OF COVARIANCE REVEALS SIGNIFICANT DECREASES IN ANXIETY (P < .001), DEPRESSION (P = .002), PERCEIVED STRESS (P < .001), 6 A.M. SALIVARY CORTISOL (P = .009), AND POOLED MEAN CORTISOL (P = .03) IN THE YOGA GROUP COMPARED WITH CONTROLS. THERE IS A SIGNIFICANT POSITIVE CORRELATION BETWEEN MORNING SALIVARY CORTISOL LEVEL AND ANXIETY AND DEPRESSION. CONCLUSION: YOGA MIGHT HAVE A ROLE IN MANAGING SELF-REPORTED PSYCHOLOGICAL DISTRESS AND MODULATING CIRCADIAN PATTERNS OF STRESS HORMONES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. 2009 4 2096 45 THE EFFECT OF YOGA EXERCISE ON IMPROVING DEPRESSION, ANXIETY, AND FATIGUE IN WOMEN WITH BREAST CANCER: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: DEPRESSION, ANXIETY, AND FATIGUE ARE AMONG THE MOST SIGNIFICANT PROBLEMS THAT INFLUENCE THE QUALITY OF LIFE OF PATIENTS WITH BREAST CANCER WHO RECEIVE ADJUVANT CHEMOTHERAPY. ALTHOUGH EVIDENCE HAS SHOWN YOGA TO DECREASE ANXIETY, DEPRESSION, AND FATIGUE IN PATIENTS WITH CANCER, FEW STUDIES ON THE EFFECTS OF YOGA HAVE TARGETED PATIENTS WITH BREAST CANCER. YOGA INTERVENTIONS SHOULD BE TESTED TO PROMOTE THE PSYCHOLOGICAL AND PHYSICAL HEALTH OF WOMEN WITH BREAST CANCER. PURPOSE: THIS STUDY EXAMINES THE EFFECTIVENESS OF AN 8-WEEK YOGA EXERCISE PROGRAM IN PROMOTING THE PSYCHOLOGICAL AND PHYSICAL HEALTH OF WOMEN WITH BREAST CANCER UNDERGOING ADJUVANT CHEMOTHERAPY IN TERMS OF DEPRESSION, ANXIETY, AND FATIGUE. METHODS: A SAMPLE OF 60 WOMEN WITH NONMETASTATIC BREAST CANCER WAS RECRUITED. PARTICIPANTS WERE RANDOMLY ASSIGNED INTO EITHER THE EXPERIMENTAL GROUP (N = 30) OR THE CONTROL GROUP (N = 30). A 60-MINUTE, TWICE-PER-WEEK YOGA EXERCISE WAS IMPLEMENTED FOR 8 WEEKS AS THE INTERVENTION FOR THE PARTICIPANTS IN THE EXPERIMENTAL GROUP. THE CONTROL GROUP RECEIVED STANDARD CARE ONLY. RESULTS: ANALYSIS USING THE JOHNSON-NEYMAN PROCEDURE FOUND THAT THE YOGA EXERCISE REDUCED OVERALL FATIGUE AND THE INTERFERENCE OF FATIGUE IN EVERYDAY LIFE FOR THE EXPERIMENTAL GROUP PARTICIPANTS. SIGNIFICANT REDUCTIONS WERE OBTAINED AFTER 4 WEEKS OF INTERVENTION PARTICIPATION FOR THOSE EXPERIMENTAL GROUP PATIENTS WITH RELATIVELY LOW STARTING BASELINE VALUES (BASELINE ITEM MEAN VALUE < 3.31 AND 3.22, RESPECTIVELY) AND AFTER 8 WEEKS FOR MOST PATIENTS (APPROXIMATELY 75%) WITH MODERATE STARTING BASELINE VALUES (BASELINE ITEM MEAN VALUE < 7.30 AND 5.34, RESPECTIVELY). THE 8-WEEK INTERVENTION DID NOT SIGNIFICANTLY IMPROVE THE LEVELS OF DEPRESSION (F = 1.29, P > .05) OR ANXIETY (F = 2.7, P > .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: THE 8-WEEK YOGA EXERCISE PROGRAM DEVELOPED IN THIS STUDY EFFECTIVELY REDUCED FATIGUE IN PATIENTS WITH BREAST CANCER BUT DID NOT REDUCE DEPRESSION OR ANXIETY. ONCOLOGY NURSES SHOULD STRENGTHEN THEIR CLINICAL HEALTH EDUCATION AND APPLY YOGA TO REDUCE THE FATIGUE EXPERIENCED BY PATIENTS WITH BREAST CANCER WHO UNDERGO ADJUVANT CHEMOTHERAPY. 2014 5 1461 53 INFLUENCE OF YOGA ON MOOD STATES, DISTRESS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN EARLY STAGE BREAST CANCER PATIENTS UNDERGOING SURGERY. CONTEXT: BREAST CANCER PATIENTS AWAITING SURGERY EXPERIENCE HEIGHTENED DISTRESS THAT COULD AFFECT POSTOPERATIVE OUTCOMES. AIMS: THE AIM OF OUR STUDY WAS TO EVALUATE THE EFFECTS OF YOGA INTERVENTION ON MOOD STATES, TREATMENT-RELATED SYMPTOMS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN BREAST CANCER PATIENTS UNDERGOING SURGERY. SETTINGS AND DESIGN: NINETY-EIGHT RECENTLY DIAGNOSED STAGE II AND III BREAST CANCER PATIENTS WERE RECRUITED FOR A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF A YOGA PROGRAM WITH SUPPORTIVE THERAPY PLUS EXERCISE REHABILITATION ON POSTOPERATIVE OUTCOMES FOLLOWING SURGERY. MATERIALS AND METHODS: SUBJECTS WERE ASSESSED PRIOR TO SURGERY AND FOUR WEEKS THEREAFTER. PSYCHOMETRIC INSTRUMENTS WERE USED TO ASSESS SELF-REPORTED ANXIETY, DEPRESSION, TREATMENT-RELATED DISTRESS AND QUALITY OF LIFE. BLOOD SAMPLES WERE COLLECTED FOR ENUMERATION OF T LYMPHOCYTE SUBSETS (CD4 %, CD8 % AND NATURAL KILLER (NK) CELL % COUNTS) AND SERUM IMMUNOGLOBULINS (IGG, IGA AND IGM). STATISTICAL ANALYSIS USED: WE USED ANALYSIS OF COVARIANCE TO COMPARE INTERVENTIONS POSTOPERATIVELY. RESULTS: SIXTY-NINE PATIENTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA N = 33, CONTROL N = 36). THE RESULTS SUGGEST A SIGNIFICANT DECREASE IN THE STATE (P = 0.04) AND TRAIT (P = 0.004) OF ANXIETY, DEPRESSION (P = 0.01), SYMPTOM SEVERITY (P = 0.01), DISTRESS (P < 0.01) AND IMPROVEMENT IN QUALITY OF LIFE (P = 0.01) IN THE YOGA GROUP AS COMPARED TO THE CONTROLS. THERE WAS ALSO A SIGNIFICANTLY LESSER DECREASE IN CD 56% (P = 0.02) AND LOWER LEVELS OF SERUM IGA (P = 0.001) IN THE YOGA GROUP AS COMPARED TO CONTROLS FOLLOWING SURGERY. CONCLUSIONS: THE RESULTS SUGGEST POSSIBLE BENEFITS FOR YOGA IN REDUCING POSTOPERATIVE DISTRESS AND PREVENTING IMMUNE SUPPRESSION FOLLOWING SURGERY. 2008 6 974 60 EFFECTS OF AN INTEGRATED YOGA PROGRAM ON SELF-REPORTED DEPRESSION SCORES IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT: A RANDOMIZED CONTROLLED TRIAL. AIM: TO COMPARE THE EFFECTS OF YOGA PROGRAM WITH SUPPORTIVE THERAPY ON SELF-REPORTED SYMPTOMS OF DEPRESSION IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT. PATIENTS AND METHODS: NINETY-EIGHT BREAST CANCER PATIENTS WITH STAGE II AND III DISEASE FROM A CANCER CENTER WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 45) AND SUPPORTIVE THERAPY (N = 53) OVER A 24-WEEK PERIOD DURING WHICH THEY UNDERWENT SURGERY FOLLOWED BY ADJUVANT RADIOTHERAPY (RT) OR CHEMOTHERAPY (CT) OR BOTH. THE STUDY STOPPAGE CRITERIA WAS PROGRESSIVE DISEASE RENDERING THE PATIENT BEDRIDDEN OR ANY PHYSICAL MUSCULOSKELETAL INJURY RESULTING FROM INTERVENTION OR LESS THAN 60% ATTENDANCE TO YOGA INTERVENTION. SUBJECTS UNDERWENT YOGA INTERVENTION FOR 60 MIN DAILY WITH CONTROL GROUP UNDERGOING SUPPORTIVE THERAPY DURING THEIR HOSPITAL VISITS. BECK'S DEPRESSION INVENTORY (BDI) AND SYMPTOM CHECKLIST WERE ASSESSED AT BASELINE, AFTER SURGERY, BEFORE, DURING, AND AFTER RT AND SIX CYCLES OF CT. WE USED ANALYSIS OF COVARIANCE (INTENT-TO-TREAT) TO STUDY THE EFFECTS OF INTERVENTION ON DEPRESSION SCORES AND PEARSON CORRELATION ANALYSES TO EVALUATE THE BIVARIATE RELATIONSHIPS. RESULTS: A TOTAL OF 69 PARTICIPANTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA, N = 33, AND CONTROLS, N = 36). THERE WAS 29% ATTRITION IN THIS STUDY. THE RESULTS SUGGEST AN OVERALL DECREASE IN SELF-REPORTED DEPRESSION WITH TIME IN BOTH THE GROUPS. THERE WAS A SIGNIFICANT DECREASE IN DEPRESSION SCORES IN THE YOGA GROUP AS COMPARED TO CONTROLS FOLLOWING SURGERY, RT, AND CT (P < 0.01). THERE WAS A POSITIVE CORRELATION (P < 0.001) BETWEEN DEPRESSION SCORES WITH SYMPTOM SEVERITY AND DISTRESS DURING SURGERY, RT, AND CT. CONCLUSION: THE RESULTS SUGGEST POSSIBLE ANTIDEPRESSANT EFFECTS WITH YOGA INTERVENTION IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT. 2015 7 428 35 CAN YOGA HAVE ANY EFFECT ON SHOULDER AND ARM PAIN AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER? A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL. OBJECTIVE: TO EXAMINE THE EFFECTS OF YOGA ON SHOULDER AND ARM PAIN, QUALITY OF LIFE (QOL), DEPRESSION, AND PHYSICAL PERFORMANCE IN PATIENTS WITH BREAST CANCER. METHODS: THIS PROSPECTIVE, RANDOMIZED STUDY INCLUDED 42 PATIENTS. THE PATIENTS IN GROUP 1 UNDERWENT A 10-WEEK HATHA YOGA EXERCISE PROGRAM. THE PATIENTS IN GROUP 2 WERE INCLUDED IN A 10-WEEK FOLLOW-UP PROGRAM. OUR PRIMARY ENDPOINT WAS ARM AND SHOULDER PAIN INTENSITY. RESULTS: THE GROUP RECEIVING YOGA SHOWED A SIGNIFICANT IMPROVEMENT IN THEIR PAIN SEVERITY FROM BASELINE TO POST-TREATMENT, AND THESE BENEFITS WERE MAINTAINED AT 2.5 MONTHS POST-TREATMENT. WHEN COMPARED TO THE CONTROL GROUP, THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS WITH RESPECT TO THE PARAMETERS ASSESSED AT THE END OF WEEK 10. CONCLUSION: YOGA WAS AN EFFECTIVE AND SAFE EXERCISE FOR ALLEVIATING SHOULDER AND ARM PAIN, WHICH IS A COMPLICATION WITH A HIGH PREVALENCE IN PATIENTS WITH BREAST CANCER. 2018 8 2604 49 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 9 877 35 EFFECT OF YOGA THERAPY ON SYMPTOMS OF ANXIETY IN CANCER PATIENTS. BACKGROUND: MANY CANCER PATIENTS SUFFER FROM SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE. SUPPORTIVE TREATMENTS ARE INCREASINGLY USED TO ALLEVIATE DISTRESS IN CANCER. IN THIS STUDY, THE EFFECTS OF YOGA ON THESE SYMPTOMS ARE EXAMINED. METHODS: WE PERFORMED A RANDOMIZED CONTROLLED STUDY ON CANCER PATIENTS WITH MIXED DIAGNOSES COMPARING YOGA THERAPY WITH A WAITING LIST CONTROL GROUP. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERAL ANXIETY DISORDER (GAD-7) SCALE, DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANISATION FOR RESEARCH AND TREATMENT OF CANCER FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS CARRIED OUT IN WEEKLY SESSIONS OF 60 MIN EACH FOR 8 WEEKS. THE PROGRAM PROVIDED RESTRAINED BODY AND BREATHING EXERCISES AS WELL AS MEDITATION. THE CONTROL GROUP DID NOT RECEIVE ANY YOGA THERAPY WHILE ON THE WAITING LIST. RESULTS: A TOTAL OF 70 SUBJECTS PARTICIPATED IN THE STUDY. ANXIETY WAS SIGNIFICANTLY REDUCED BY THE YOGA THERAPY IN THE INTERVENTION GROUP COMPARED TO THE CONTROL GROUP (P = 0.005). HOWEVER, YOGA THERAPY DID NOT SHOW ANY SIGNIFICANT EFFECTS ON DEPRESSION (P = 0.21) AND FATIGUE (P = 0.11) COMPARED TO THE CONTROL GROUP. CONCLUSION: YOGA THERAPY MAY BE USED TO ALLEVIATE ANXIETY SYMPTOMS IN CANCER PATIENTS AND SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2018 10 1556 40 LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER PATIENTS 6 MONTHS AFTER THE END OF YOGA THERAPY. BACKGROUND: SYMPTOMS OF ANXIETY, DEPRESSION, AND CANCER-RELATED FATIGUE ARE COMMONLY ASSOCIATED WITH CANCER. CANCER PATIENTS INCREASINGLY USE COMPLEMENTARY AND ALTERNATIVE TREATMENTS, SUCH AS YOGA, TO COPE WITH PSYCHOLOGICAL AND PHYSICAL IMPAIRMENTS. IN THE PRESENT ARTICLE, LONG-TERM CHANGES OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER ARE EXAMINED 6 MONTHS AFTER A YOGA INTERVENTION. METHOD: WE USED AN OBSERVATIONAL DESIGN BASED ON A RANDOMIZED CONTROLLED STUDY IN CANCER PATIENTS WITH MIXED DIAGNOSES TO EVALUATE LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE 6 MONTHS AFTER THE END OF YOGA THERAPY. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERALIZED ANXIETY DISORDER SCALE (GAD-7), DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE-FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS PROVIDED IN YOGA CLASSES OF 60 MINUTES EACH ONCE A WEEK FOR 8 WEEKS IN TOTAL. THE EXERCISES PROVIDED CONTAINED BOTH BODY AND BREATHING ACTIVITIES AS WELL AS MEDITATION. RESULTS: A TOTAL OF 58 PATIENTS PARTICIPATED IN THE STUDY. SIX MONTHS AFTER THE END OF YOGA THERAPY, SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE WERE SIGNIFICANTLY REDUCED COMPARED WITH BASELINE. HOWEVER, SYMPTOMS OF ANXIETY AND FATIGUE SLIGHTLY INCREASED DURING THE FOLLOW-UP PERIOD, WHEREAS SYMPTOMS OF DEPRESSION REMAINED STABLE. CONCLUSION: OUR RESULTS ARE PROMISING AND SUPPORT THE INTEGRATION OF YOGA INTERVENTIONS IN SUPPORTIVE CANCER TREATMENT CONCEPTS BUT SHOULD BE CONFIRMED BY RANDOMIZED CONTROLLED TRIALS. LONG-TERM EFFECTS OF YOGA THERAPY ON CANCER PATIENTS SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2019 11 2508 43 YOGA BREATHING FOR CANCER CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: MANY DEBILITATING SYMPTOMS ARISE FROM CANCER AND ITS TREATMENT THAT ARE OFTEN UNRELIEVED BY ESTABLISHED METHODS. PRANAYAMA, A SERIES OF YOGIC BREATHING TECHNIQUES, MAY IMPROVE CANCER-RELATED SYMPTOMS AND QUALITY OF LIFE, BUT IT HAS NOT BEEN STUDIED FOR THIS PURPOSE. OBJECTIVES: A PILOT STUDY WAS PERFORMED TO EVALUATE FEASIBILITY AND TO TEST THE EFFECTS OF PRANAYAMA ON CANCER-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. DESIGN: THIS WAS A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING PRANAYAMA TO USUAL CARE. SETTING: THE STUDY WAS CONDUCTED AT A UNIVERSITY MEDICAL CENTER. SUBJECTS: PATIENTS RECEIVING CANCER CHEMOTHERAPY WERE RANDOMIZED TO RECEIVE PRANAYAMA IMMEDIATELY OR AFTER A WAITING PERIOD (CONTROL GROUP). INTERVENTIONS: THE PRANAYAMA INTERVENTION CONSISTED OF FOUR BREATHING TECHNIQUES TAUGHT IN WEEKLY CLASSES AND PRACTICED AT HOME. THE TREATMENT GROUP RECEIVED PRANAYAMA DURING TWO CONSECUTIVE CYCLES OF CHEMOTHERAPY. THE CONTROL GROUP RECEIVED USUAL CARE DURING THEIR FIRST CYCLE, AND RECEIVED PRANAYAMA DURING THEIR SECOND CYCLE OF CHEMOTHERAPY. OUTCOME MEASURES: FEASIBILITY, CANCER-ASSOCIATED SYMPTOMS (FATIGUE, SLEEP DISTURBANCE, ANXIETY, DEPRESSION, STRESS), AND QUALITY OF LIFE WERE THE OUTCOMES. RESULTS: CLASS ATTENDANCE WAS NEARLY 100% IN BOTH GROUPS. SIXTEEN (16) PARTICIPANTS WERE INCLUDED IN THE FINAL INTENT-TO-TREAT ANALYSES. THE REPEATED-MEASURES ANALYSES DEMONSTRATED THAT ANY INCREASE IN PRANAYAMA DOSE, WITH DOSE MEASURED IN THE NUMBER OF HOURS PRACTICED IN CLASS OR AT HOME, RESULTED IN IMPROVED SYMPTOM AND QUALITY-OF-LIFE SCORES. SEVERAL OF THESE ASSOCIATIONS--SLEEP DISTURBANCE (P=0.04), ANXIETY (P=0.04), AND MENTAL QUALITY OF LIFE (P=0.05)--REACHED OR APPROACHED STATISTICAL SIGNIFICANCE. CONCLUSIONS: YOGA BREATHING WAS A FEASIBLE INTERVENTION AMONG PATIENTS WITH CANCER RECEIVING CHEMOTHERAPY. PRANAYAMA MAY IMPROVE SLEEP DISTURBANCE, ANXIETY, AND MENTAL QUALITY OF LIFE. A DOSE-RESPONSE RELATIONSHIP WAS FOUND BETWEEN PRANAYAMA USE AND IMPROVEMENTS IN CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER STUDY. 2012 12 1087 53 EFFECTS OF YOGA ON SYMPTOM MANAGEMENT IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY ON DISTRESSFUL SYMPTOMS IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. MATERIALS AND METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO THEIR RADIOTHERAPY TREATMENT. INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60 MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY ONCE IN 10 DAYS DURING THE COURSE OF THEIR ADJUVANT RADIOTHERAPY. ASSESSMENTS INCLUDED ROTTERDAM SYMPTOM CHECK LIST AND EUROPEAN ORGANIZATION FOR RESEARCH IN THE TREATMENT OF CANCER-QUALITY OF LIFE (EORTC QOL C30) SYMPTOM SCALE. ASSESSMENTS WERE DONE AT BASELINE AND AFTER 6 WEEKS OF RADIOTHERAPY TREATMENT. RESULTS: A GLM REPEATED-MEASURES ANOVA SHOWED A SIGNIFICANT DECREASE IN PSYCHOLOGICAL DISTRESS (P = 0.01), FATIGUE (P = 0.007), INSOMNIA (P = 0.001), AND APPETITE LOSS (P = 0.002) OVER TIME IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS SIGNIFICANT IMPROVEMENT IN THE ACTIVITY LEVEL (P = 0.02) IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A SIGNIFICANT POSITIVE CORRELATION BETWEEN PHYSICAL AND PSYCHOLOGICAL DISTRESS AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, APPETITE LOSS, AND CONSTIPATION. THERE WAS A SIGNIFICANT NEGATIVE CORRELATION BETWEEN THE ACTIVITY LEVEL AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, AND APPETITE LOSS. CONCLUSION: THE RESULTS SUGGEST BENEFICIAL EFFECTS WITH YOGA INTERVENTION IN MANAGING CANCER-AND TREATMENT-RELATED SYMPTOMS IN BREAST CANCER PATIENTS. 2009 13 2553 30 YOGA FOR CHILDREN AND ADOLESCENTS AFTER COMPLETING CANCER TREATMENT. SURVIVORS OF CHILDHOOD CANCER MAY EXPERIENCE PERSISTENT SYMPTOMS, INCLUDING FATIGUE, SLEEP DISTURBANCE, AND BALANCE IMPAIRMENT. YOGA IS A COMPLEMENTARY THERAPY THAT IMPROVES FATIGUE, SLEEP, AND QUALITY OF LIFE IN ADULT CANCER SURVIVORS. USING A ONE GROUP, REPEATED MEASURES DESIGN, WE EVALUATED THE FEASIBILITY OF A YOGA PROGRAM AND ASSESSED IF CANCER SURVIVOR PARTICIPANTS AGES 10 TO 17 YEARS (N = 13) HAD SIGNIFICANTLY LESS FATIGUE AND ANXIETY, AND BETTER BALANCE AND SLEEP, AFTER A 6-WEEK YOGA INTERVENTION COMPARED WITH A 6-WEEK PRE-INTERVENTION WAIT PERIOD. STUDY RECRUITMENT WAS CHALLENGING WITH A 32% ENROLLMENT RATE; YOGA ATTENDANCE WAS 90%. NONE OF THE SCORES FOR ANXIETY, FATIGUE, SLEEP, AND BALANCE HAD SIGNIFICANT CHANGES DURING THE WAIT PERIOD. AFTER THE 6-WEEK YOGA PROGRAM, CHILDREN (N = 7) HAD A SIGNIFICANT DECREASE IN ANXIETY SCORE (P = .04) WHILE ADOLESCENT SCORES (N = 7) SHOWED A DECREASING TREND (P = .10). SCORES FOR FATIGUE, SLEEP, AND BALANCE REMAINED STABLE POST-INTERVENTION. FATIGUE AND BALANCE SCORES WERE BELOW NORMS FOR HEALTH CHILDREN/ADOLESCENTS WHILE SLEEP AND ANXIETY SCORES WERE SIMILAR TO HEALTHY PEERS. 2016 14 2442 43 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 15 2529 41 YOGA EFFECTIVELY REDUCES FATIGUE AND SYMPTOMS OF DEPRESSION IN PATIENTS WITH DIFFERENT TYPES OF CANCER. PURPOSE: EXAMINE THE EFFECTS OF AN 8-WEEK YOGA THERAPY ON FATIGUE IN PATIENTS WITH DIFFERENT TYPES OF CANCER. METHODS: A TOTAL OF 173 CANCER PATIENTS SUFFERING FROM MILD TO SEVERE FATIGUE WERE RANDOMLY ALLOCATED TO YOGA INTERVENTION (N = 84) (IG) VERSUS WAITLIST CONTROL GROUP (CG) (N = 88). YOGA THERAPY CONSISTED OF EIGHT WEEKLY SESSIONS WITH 60 MIN EACH. THE PRIMARY OUTCOME WAS SELF-REPORTED FATIGUE SYMPTOMS. SECONDARY OUTCOMES WERE SYMPTOMS OF DEPRESSION AND QUALITY OF LIFE (QOL). DATA WERE ASSESSED USING QUESTIONNAIRES BEFORE (T0) AND AFTER YOGA THERAPY FOR IG VERSUS WAITING PERIOD FOR CG (T1). RESULTS: A STRONGER REDUCTION OF GENERAL FATIGUE (P = .033), PHYSICAL FATIGUE (P = .048), AND DEPRESSION (P < .001) AS WELL AS A STRONGER INCREASE IN QOL (P = .002) WAS FOUND FOR PATIENTS WHO ATTENDED 7 OR 8 SESSIONS COMPARED WITH CONTROLS. WITHIN THE YOGA GROUP, BOTH HIGHER ATTENDANCE RATE AND LOWER T0-FATIGUE WERE SIGNIFICANT PREDICTORS OF LOWER T1-FATIGUE (P 0.05). COMPARISON OF THE 2 GROUPS REVEALED NO DIFFERENCES. CONCLUSION: YOGA MAY HAVE BENEFICIAL EFFECTS ON QOL IN PATIENTS WITH BREAST CANCER BUT DOES NOT HAVE A SIGNIFICANT EFFECT ON PA. THERE IS A NEED FOR FURTHER STUDIES TO MAKE A DEFINITIVE STATEMENT. 2021