1 2382 107 YOCAS(C)(R) YOGA REDUCES SELF-REPORTED MEMORY DIFFICULTY IN CANCER SURVIVORS IN A NATIONWIDE RANDOMIZED CLINICAL TRIAL: INVESTIGATING RELATIONSHIPS BETWEEN MEMORY AND SLEEP. UNLABELLED: BACKGROUND INTERVENTIONS ARE NEEDED TO ALLEVIATE MEMORY DIFFICULTY IN CANCER SURVIVORS. WE PREVIOUSLY SHOWED IN A PHASE III RANDOMIZED CLINICAL TRIAL THAT YOCAS(C)(R) YOGA-A PROGRAM THAT CONSISTS OF BREATHING EXERCISES, POSTURES, AND MEDITATION-SIGNIFICANTLY IMPROVED SLEEP QUALITY IN CANCER SURVIVORS. THIS STUDY ASSESSED THE EFFECTS OF YOCAS(C)(R) ON MEMORY AND IDENTIFIED RELATIONSHIPS BETWEEN MEMORY AND SLEEP. STUDY DESIGN AND METHODS: SURVIVORS WERE RANDOMIZED TO STANDARD CARE (SC) OR SC WITH YOCAS(C)(R) . 328 PARTICIPANTS WHO PROVIDED DATA ON THE MEMORY DIFFICULTY ITEM OF THE MD ANDERSON SYMPTOM INVENTORY ARE INCLUDED. SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX. GENERAL LINEAR MODELING (GLM) DETERMINED THE GROUP EFFECT OF YOCAS(C)(R) ON MEMORY DIFFICULTY COMPARED WITH SC. GLM ALSO DETERMINED MODERATION OF BASELINE MEMORY DIFFICULTY ON POSTINTERVENTION SLEEP AND VICE VERSA. PATH MODELING ASSESSED THE MEDIATING EFFECTS OF CHANGES IN MEMORY DIFFICULTY ON YOCAS(C)(R) CHANGES IN SLEEP AND VICE VERSA. RESULTS: YOCAS(C)(R) SIGNIFICANTLY REDUCED MEMORY DIFFICULTY AT POSTINTERVENTION COMPARED WITH SC (MEAN CHANGE: YOGA=-0.60; SC=-0.16; P<.05). BASELINE MEMORY DIFFICULTY DID NOT MODERATE THE EFFECTS OF POSTINTERVENTION SLEEP QUALITY IN YOCAS(C)(R) COMPARED WITH SC. BASELINE SLEEP QUALITY DID MODERATE THE EFFECTS OF POSTINTERVENTION MEMORY DIFFICULTY IN YOCAS(C)(R) COMPARED WITH SC (P<.05). CHANGES IN SLEEP QUALITY WAS A SIGNIFICANT MEDIATOR OF REDUCED MEMORY DIFFICULTY IN YOCAS(C)(R) COMPARED WITH SC (P<.05); HOWEVER, CHANGES IN MEMORY DIFFICULTY DID NOT SIGNIFICANTLY MEDIATE IMPROVED SLEEP QUALITY IN YOCAS(C)(R) COMPARED WITH SC. CONCLUSIONS: IN THIS LARGE NATIONWIDE TRIAL, YOCAS(C)(R) YOGA SIGNIFICANTLY REDUCED PATIENT-REPORTED MEMORY DIFFICULTY IN CANCER SURVIVORS. 2016 2 1460 55 INFLUENCE OF YOGA ON CANCER-RELATED FATIGUE AND ON MEDIATIONAL RELATIONSHIPS BETWEEN CHANGES IN SLEEP AND CANCER-RELATED FATIGUE: A NATIONWIDE, MULTICENTER RANDOMIZED CONTROLLED TRIAL OF YOGA IN CANCER SURVIVORS. BACKGROUND: CANCER-RELATED FATIGUE (CRF) OFTEN CO-OCCURS WITH SLEEP DISTURBANCE AND IS ONE OF THE MOST PERVASIVE TOXICITIES RESULTING FROM CANCER AND ITS TREATMENT. WE AND OTHER INVESTIGATORS HAVE PREVIOUSLY REPORTED THAT YOGA THERAPY CAN IMPROVE SLEEP QUALITY IN CANCER PATIENTS AND SURVIVORS. NO NATIONWIDE MULTICENTER PHASE III RANDOMIZED CONTROLLED TRIAL (RCT) HAS INVESTIGATED WHETHER YOGA THERAPY IMPROVES CRF OR WHETHER IMPROVEMENTS IN SLEEP MEDIATE THE EFFECT OF YOGA ON CRF. WE EXAMINED THE EFFECT OF A STANDARDIZED, 4-WEEK, YOGA THERAPY PROGRAM (YOGA FOR CANCER SURVIVORS [YOCAS]) ON CRF AND WHETHER YOCAS-INDUCED CHANGES IN SLEEP MEDIATED CHANGES IN CRF AMONG SURVIVORS. STUDY DESIGN AND METHODS: FOUR HUNDRED TEN CANCER SURVIVORS WERE RECRUITED TO A NATIONWIDE MULTICENTER PHASE III RCT COMPARING THE EFFECT OF YOCAS TO STANDARD SURVIVORSHIP CARE ON CRF AND EXAMINING THE MEDIATING EFFECTS OF CHANGES IN SLEEP, STEMMING FROM YOGA, ON CHANGES IN CRF. CRF WAS ASSESSED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY. SLEEP WAS ASSESSED VIA THE PITTSBURGH SLEEP QUALITY INDEX. BETWEEN- AND WITHIN-GROUP INTERVENTION EFFECTS ON CRF WERE ASSESSED BY ANALYSIS OF COVARIANCE AND 2-TAILED T TEST, RESPECTIVELY. PATH ANALYSIS WAS USED TO EVALUATE MEDIATION. RESULTS: YOCAS PARTICIPANTS DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS IN CRF COMPARED WITH PARTICIPANTS IN STANDARD SURVIVORSHIP CARE AT POST-INTERVENTION ( P < .01). IMPROVEMENTS IN OVERALL SLEEP QUALITY AND REDUCTIONS IN DAYTIME DYSFUNCTION (EG, EXCESSIVE NAPPING) RESULTING FROM YOGA SIGNIFICANTLY MEDIATED THE EFFECT OF YOGA ON CRF (22% AND 37%, RESPECTIVELY, BOTH P < .01). CONCLUSIONS: YOCAS IS EFFECTIVE FOR TREATING CRF AMONG CANCER SURVIVORS; 22% TO 37% OF THE IMPROVEMENTS IN CRF FROM YOGA THERAPY RESULT FROM IMPROVEMENTS IN SLEEP QUALITY AND DAYTIME DYSFUNCTION. ONCOLOGISTS SHOULD CONSIDER PRESCRIBING YOGA TO CANCER SURVIVORS FOR TREATING CRF AND SLEEP DISTURBANCE. 2019 3 1052 38 EFFECTS OF YOGA ON CANCER-RELATED FATIGUE AND GLOBAL SIDE-EFFECT BURDEN IN OLDER CANCER SURVIVORS. BACKGROUND: SIXTY PERCENT OF CANCER SURVIVORS ARE 65YEARS OF AGE OR OLDER. CANCER AND ITS TREATMENTS LEAD TO CANCER-RELATED FATIGUE AND MANY OTHER SIDE EFFECTS, IN TURN, CREATING SUBSTANTIAL GLOBAL SIDE-EFFECT BURDEN (TOTAL BURDEN FROM ALL SIDE EFFECTS) WHICH, ULTIMATELY, COMPROMISES FUNCTIONAL INDEPENDENCE AND QUALITY OF LIFE. VARIOUS MODES OF EXERCISE, SUCH AS YOGA, REDUCE CANCER-RELATED FATIGUE AND GLOBAL SIDE-EFFECT BURDEN IN YOUNGER CANCER SURVIVORS, BUT NO STUDIES HAVE SPECIFICALLY EXAMINED THE EFFECTS OF YOGA ON OLDER CANCER SURVIVORS. OBJECTIVES: THE PURPOSE OF THIS STUDY WAS TO ASSESS THE EFFECTS OF A 4-WEEK YOGA INTERVENTION (YOGA FOR CANCER SURVIVORS: YOCAS(C)(R)) ON OVERALL CANCER-RELATED FATIGUE, AND DUE TO ITS MULTIDIMENSIONAL NATURE, THE SUBDOMAINS OF CANCER-RELATED FATIGUE (GENERAL, PHYSICAL, EMOTIONAL, AND MENTAL) AND GLOBAL SIDE-EFFECT BURDEN IN OLDER CANCER SURVIVORS. MATERIALS AND METHODS: WE CONDUCTED A SECONDARY ANALYSIS ON DATA FROM A MULTICENTER PHASE III RANDOMIZED CONTROLLED CLINICAL TRIAL WITH 2 ARMS (STANDARD CARE AND STANDARD CARE PLUS A 4-WEEK YOCAS(C)(R) INTERVENTION). THE SAMPLE FOR THIS SECONDARY ANALYSIS WAS 97 OLDER CANCER SURVIVORS (>/=60YEARS OF AGE), BETWEEN 2MONTHS AND 2YEARS POST-TREATMENT, WHO PARTICIPATED IN THE ORIGINAL TRIAL. RESULTS: PARTICIPANTS IN THE YOCAS(C)(R) INTERVENTION ARM REPORTED SIGNIFICANTLY LOWER CANCER-RELATED FATIGUE, PHYSICAL FATIGUE, MENTAL FATIGUE, AND GLOBAL SIDE-EFFECT BURDEN THAN PARTICIPANTS IN THE STANDARD CARE ARM FOLLOWING THE 4-WEEK INTERVENTION PERIOD (P<0.05). CONCLUSIONS: YOCAS(C)(R) IS AN EFFECTIVE STANDARDIZED YOGA INTERVENTION FOR REDUCING CANCER-RELATED FATIGUE, PHYSICAL FATIGUE, MENTAL FATIGUE, AND GLOBAL SIDE-EFFECT BURDEN AMONG OLDER CANCER SURVIVORS. 2015 4 1650 48 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: THIRTY PERCENT TO 90% OF CANCER SURVIVORS REPORT IMPAIRED SLEEP QUALITY POST-TREATMENT, WHICH CAN BE SEVERE ENOUGH TO INCREASE MORBIDITY AND MORTALITY. LIFESTYLE INTERVENTIONS, SUCH AS EXERCISE, ARE RECOMMENDED IN CONJUNCTION WITH DRUGS AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF IMPAIRED SLEEP. PRELIMINARY EVIDENCE INDICATES THAT YOGA-A MIND-BODY PRACTICE AND FORM OF EXERCISE-MAY IMPROVE SLEEP AMONG CANCER SURVIVORS. THE PRIMARY AIM OF THIS RANDOMIZED, CONTROLLED CLINICAL TRIAL WAS TO DETERMINE THE EFFICACY OF A STANDARDIZED YOGA INTERVENTION COMPARED WITH STANDARD CARE FOR IMPROVING GLOBAL SLEEP QUALITY (PRIMARY OUTCOME) AMONG POST-TREATMENT CANCER SURVIVORS. PATIENTS AND METHODS: IN ALL, 410 SURVIVORS SUFFERING FROM MODERATE OR GREATER SLEEP DISRUPTION BETWEEN 2 AND 24 MONTHS AFTER SURGERY, CHEMOTHERAPY, AND/OR RADIATION THERAPY WERE RANDOMLY ASSIGNED TO STANDARD CARE OR STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION. THE YOGA INTERVENTION USED THE YOGA FOR CANCER SURVIVORS (YOCAS) PROGRAM CONSISTING OF PRANAYAMA (BREATHING EXERCISES), 16 GENTLE HATHA AND RESTORATIVE YOGA ASANAS (POSTURES), AND MEDITATION. PARTICIPANTS ATTENDED TWO 75-MINUTE SESSIONS PER WEEK. SLEEP QUALITY WAS ASSESSED BY USING THE PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY PRE- AND POSTINTERVENTION. RESULTS: IN ALL, 410 SURVIVORS WERE ACCRUED (96% FEMALE; MEAN AGE, 54 YEARS; 75% HAD BREAST CANCER). YOGA PARTICIPANTS DEMONSTRATED GREATER IMPROVEMENTS IN GLOBAL SLEEP QUALITY AND, SECONDARILY, SUBJECTIVE SLEEP QUALITY, DAYTIME DYSFUNCTION, WAKE AFTER SLEEP ONSET, SLEEP EFFICIENCY, AND MEDICATION USE AT POSTINTERVENTION (ALL 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 9 2508 44 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 10 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 11 2605 31 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: RESULTS OF A PILOT STUDY. APPROXIMATELY ONE-THIRD OF BREAST CANCER SURVIVORS EXPERIENCES PERSISTENT FATIGUE FOR MONTHS OR YEARS AFTER SUCCESSFUL TREATMENT COMPLETION. THERE IS A LACK OF EVIDENCE-BASED TREATMENTS FOR CANCER-RELATED FATIGUE, PARTICULARLY AMONG CANCER SURVIVORS. THIS SINGLE-ARM PILOT STUDY EVALUATED THE FEASIBILITY AND PRELIMINARY EFFICACY OF A YOGA INTERVENTION FOR FATIGUED BREAST CANCER SURVIVORS BASED ON THE IYENGAR TRADITION. IYENGAR YOGA PRESCRIBES SPECIFIC POSES FOR INDIVIDUALS WITH SPECIFIC MEDICAL PROBLEMS AND CONDITIONS; THIS TRIAL EMPHASIZED POSTURES BELIEVED TO BE EFFECTIVE FOR REDUCING FATIGUE AMONG BREAST CANCER SURVIVORS, INCLUDING INVERSIONS AND BACKBENDS PERFORMED WITH THE SUPPORT OF PROPS. TWELVE WOMEN WERE ENROLLED IN THE TRIAL, AND 11 COMPLETED THE FULL 12-WEEK COURSE OF TREATMENT. THERE WAS A SIGNIFICANT IMPROVEMENT IN FATIGUE SCORES FROM PRE- TO POST-INTERVENTION THAT WAS MAINTAINED AT THE 3-MONTH POST-INTERVENTION FOLLOWUP. SIGNIFICANT IMPROVEMENTS WERE ALSO OBSERVED IN MEASURES OF PHYSICAL FUNCTION, DEPRESSED MOOD, AND QUALITY OF LIFE. THESE RESULTS SUPPORT THE ACCEPTABILITY OF THIS INTERVENTION AND SUGGEST THAT IT MAY HAVE BENEFICIAL EFFECTS ON PERSISTENT POST-TREATMENT FATIGUE. HOWEVER, RESULTS REQUIRE REPLICATION IN A LARGER RANDOMIZED CONTROLLED TRIAL. 2011 12 428 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 13 1865 40 RANDOMIZED PILOT TRIAL OF YOGA VERSUS STRENGTHENING EXERCISES IN BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE. PURPOSE: FATIGUE IS ONE OF THE MOST COMMON AND BOTHERSOME REFRACTORY SYMPTOMS EXPERIENCED BY CANCER SURVIVORS. MINDFUL EXERCISE INTERVENTIONS SUCH AS YOGA IMPROVE CANCER-RELATED FATIGUE; HOWEVER, STUDIES OF YOGA HAVE INCLUDED HETEROGENEOUS SURVIVORSHIP POPULATIONS, AND THE EFFECT OF YOGA ON FATIGUED SURVIVORS REMAINS UNCLEAR. METHODS: WE RANDOMLY ASSIGNED 34 EARLY-STAGE BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE (>/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016 14 2230 41 THE IMPACT OF YOGA ON FATIGUE IN CANCER SURVIVORSHIP: A META-ANALYSIS. BACKGROUND: MIND-BODY APPROACHES, PARTICULARLY YOGA, ARE USED BY CANCER SURVIVORS TO COPE WITH TREATMENT-RELATED SYMPTOMS. CONSISTENCY OF YOGA-RELATED EFFECTS ON TREATMENT-RELATED SYMPTOMS ARE NOT KNOWN. THIS META-ANALYSIS WAS DESIGNED TO EXAMINE EFFECTS OF YOGA ON PRE- TO POSTINTERVENTION IMPROVEMENTS IN FATIGUE AMONG CANCER PATIENTS. METHODS: PUBMED AND PSYCINFO WERE SEARCHED FOR PEER-REVIEWED ARTICLES OF YOGA RANDOMIZED CONTROLLED TRIALS INCLUDING CANCER SURVIVORS AND REPORTING AT LEAST ONE FATIGUE MEASURE. TWENTY-NINE STUDIES MET INCLUSION CRITERIA (N = 1828 PATIENTS). EFFECT SIZES (HEDGE'S G) WERE CALCULATED FOR FATIGUE, DEPRESSION, AND QUALITY OF LIFE. PATIENT-RELATED AND INTERVENTION-RELATED CHARACTERISTICS WERE TESTED AS MODERATORS OF OUTCOMES. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: YOGA PRACTICE WAS ASSOCIATED WITH A SMALL, STATISTICALLY SIGNIFICANT DECREASE IN FATIGUE (G = 0.45, P = .013). YOGA TYPE WAS A STATISTICALLY SIGNIFICANT MODERATOR OF THIS RELATIONSHIP (P = .02). YOGA WAS ASSOCIATED WITH A MODERATE DECREASE IN DEPRESSION (G = 0.72, P = .007) BUT WAS NOT ASSOCIATED WITH STATISTICALLY SIGNIFICANT CHANGES IN QUALITY OF LIFE (P = .48). SESSION LENGTH WAS A STATISTICALLY SIGNIFICANT MODERATOR OF THE RELATIONSHIP BETWEEN YOGA AND DEPRESSION (P = .004). NEITHER TIMING OF TREATMENT (DURING TREATMENT VS POSTTREATMENT) NOR CLINICAL CHARACTERISTICS WERE STATISTICALLY SIGNIFICANT MODERATORS OF THE EFFECTS OF YOGA ON OUTCOMES. THE EFFECT OF YOGA ON FATIGUE AND DEPRESSION WAS LARGER WHEN THE COMPARATOR WAS A "WAITLIST" OR "USUAL CARE" THAN WHEN THE CONTROL GROUP WAS ANOTHER ACTIVE TREATMENT (P = .036). CONCLUSIONS: RESULTS SUGGEST YOGA MAY BE BENEFICIAL AS A COMPONENT OF TREATMENT FOR BOTH FATIGUE AND DEPRESSION IN CANCER SURVIVORS. 2020 15 877 40 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 16 1556 36 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 17 1106 31 EFFECTS OF YOGA, AEROBIC, AND STRETCHING AND TONING EXERCISES ON COGNITION IN ADULT CANCER SURVIVORS: PROTOCOL OF THE STAY FIT PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER SURVIVORS EXPERIENCE COMPROMISED QUALITY OF LIFE DUE TO IMPAIRED COGNITIVE FUNCTION AS A RESULT OF CANCER DIAGNOSIS AND TREATMENT. ALTHOUGH EXERCISE HAS PROVEN TO BE EFFECTIVE IN IMPROVING COGNITIVE FUNCTION ACROSS THE LIFESPAN, INTERVENTIONS COMPREHENSIVELY TESTING THE EFFECTIVENESS FOR CANCER SURVIVORS ARE LIMITED. THE STAY FIT TRIAL IS A THREE-ARMED PILOT RANDOMIZED CONTROLLED TRIAL DESIGNED TO COMPARE THE EFFECTS OF A 12-WEEK YOGA, AEROBIC WALKING, AND STRETCH AND TONE INTERVENTION ON COGNITIVE FUNCTION AMONG ADULT CANCER SURVIVORS. METHODS: THIS PILOT STUDY AIMS TO RECRUIT 75 ADULT CANCER SURVIVORS WHO WILL COMPLETE ASSESSMENTS OF COGNITIVE FUNCTION, CARDIOVASCULAR FITNESS, PHYSICAL ACTIVITY, AND PSYCHOSOCIAL MEASURES AT BASELINE AND AFTER THE 12-WEEK INTERVENTION. THE AIMS OF STAY FIT ARE (1) TO ASSESS THE EFFICACY OF YOGA TO IMPROVE COGNITIVE FUNCTION AMONG CANCER SURVIVORS, COMPARED TO AEROBIC EXERCISE AND AN ACTIVE CONTROL GROUP; (2) TO EXAMINE CHANGES IN CARDIOVASCULAR FITNESS AS A RESULT OF THE INTERVENTIONS; AND (3) TO ASSESS CHANGES IN QUALITY OF LIFE AMONG OUR POPULATION AS A RESULT OF THE EXERCISE INTERVENTIONS. DISCUSSION: THE STAY FIT TRIAL WILL TEST THE EFFECTIVENESS OF YOGA, AEROBIC EXERCISE, AND STRETCHING AND TONING EXERCISES IN IMPROVING COGNITIVE FUNCTION AND FITNESS AMONG ADULT CANCER SURVIVORS. THE RESULTS OF THIS PILOT STUDY WILL ENABLE US TO UNDERSTAND THE MOST EFFECTIVE PHYSICAL ACTIVITY MODALITY TO IMPROVE COGNITIVE FUNCTION IN THIS POPULATION AND POTENTIALLY COMBAT CANCER-RELATED COGNITIVE IMPAIRMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03650322 . REGISTERED ON 28 AUGUST 2018. 2020 18 1564 45 LONGITUDINAL IMPACT OF YOGA ON CHEMOTHERAPY-RELATED COGNITIVE IMPAIRMENT AND QUALITY OF LIFE IN WOMEN WITH EARLY STAGE BREAST CANCER: A CASE SERIES. PURPOSE: ADJUVANT CHEMOTHERAPY FOR WOMEN WITH BREAST CANCER HAS SIGNIFICANTLY IMPROVED THE CURE RATE; HOWEVER, IT HAS BEEN ASSOCIATED WITH CHEMOTHERAPY-RELATED COGNITIVE IMPACT (CRCI). THE LITERATURE PROVIDES PRELIMINARY SUPPORT FOR THE FEASIBILITY AND EFFICACY OF YOGA INTERVENTIONS FOR THE GENERAL CANCER POPULATION, HOWEVER, CONTROLLED TRIALS ARE SCARCE AND NO STUDIES HAVE EXAMINED THE EFFECT OF YOGA ON COGNITION FOR WOMEN WITH BREAST CANCER DURING CHEMOTHERAPY. THIS CASE SERIES AIMS TO IDENTIFY THE IMPACT OF YOGA ON MEASURES OF COGNITION, FUNCTIONAL OUTCOMES, AND QUALITY OF LIFE (QOL) FOR BREAST CANCER SURVIVORS (BCS). METHODS: FOUR WOMEN WITH A DIAGNOSIS OF EARLY-STAGE BREAST CANCER PRIOR TO CHEMOTHERAPY TREATMENT WERE ADMINISTERED THE FOLLOWING PHYSIOLOGIC MEASURES AT BASELINE, 6, AND 12 WEEKS DURING CHEMOTHERAPY, AND AT ONE AND THREE MONTHS AFTER THE CONCLUSION OF THE STUDY: FUNCTIONAL REACH TEST (BALANCE) AND SIT AND REACH TEST (FLEXIBILITY), AND QOL, POMS (MOOD) AND FACT-B (QOL), AT BASELINE. PRIMARY OUTCOMES OF COGNITION WERE MEASURED WITH THE PERCEIVED COGNITION QUESTIONNAIRE (PCQ) AND COGSTATE, A COMPUTERIZED MEASUREMENT OF COGNITION. WOMEN ATTENDED AN IYENGAR-INSPIRED YOGA PROGRAM TWICE A WEEK FOR 12 WEEKS. QUALITATIVE QUESTIONNAIRES WERE ADMINISTERED AFTER THE COMPLETION OF THE STUDY TO DETERMINE PERCEIVED BENEFITS AND CHALLENGES OF THE YOGA PROGRAM. RESULTS: FOUR WOMEN WITH STAGE II BREAST CANCER RANGED IN AGE FROM 44-65 YEARS. COGSTATE COMPUTERIZED TESTING SHOWED CHANGES IN VARYING DOMAINS OF COGNITION THROUGH TREATMENT AND FOLLOW-UP. IMPROVED BALANCE, FLEXIBILITY, AND QOL WERE ALSO NOTED OVER TIME. NO ADVERSE EVENTS WERE OBSERVED. ANALYSIS OF QUALITATIVE DATA REVEALED THE YOGA CLASSES WERE HELPFUL AND SUBJECTS CONTINUED THE PRACTICE ELEMENTS OF YOGA INCLUDING RELAXATION, BREATHING, AND STRETCHING. THE MOST CHALLENGING ASPECT OF THE STUDY WAS PHYSICAL LIMITATIONS DUE TO VARIOUS MEDICAL COMPLICATIONS AND INCLUDED FATIGUE, DECREASED RANGE OF MOTION, AND PAIN. CONCLUSION: THIS CASE SERIES SUGGESTS THAT YOGA MAY IMPACT VARIOUS ASPECTS OF COGNITION DURING AND AFTER CHEMOTHERAPY ADMINISTRATION AS NOTED THROUGH QUANTITATIVE MEASURES. WOMEN DESCRIBE YOGA AS IMPROVING VARIOUS DOMAINS OF QOL THROUGH THE TREATMENT TRAJECTORY. THIS MIND-BODY INTERVENTION MAY STAVE OFF CRCI; HOWEVER, FURTHER INVESTIGATION IS NEEDED FOR ADDITIONAL RANDOMIZED CONTROLLED TRIALS ON THE EFFECTS OF YOGA ON COGNITION FOR WOMEN WITH BREAST CANCER UNDERGOING ADJUVANT CHEMOTHERAPY TREATMENT. 2012 19 2156 34 THE EFFECTS OF THE BALI YOGA PROGRAM FOR BREAST CANCER PATIENTS ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING: RESULTS OF A PARTIALLY RANDOMIZED AND BLINDED CONTROLLED TRIAL. COMPLEMENTARY AND ALTERNATIVE MEDICINE HAS BEEN SHOWN TO BE BENEFICIAL IN REDUCING CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING. HOWEVER, CONCLUSIVE RESULTS ARE LACKING IN ORDER TO CONFIRM ITS USEFULNESS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE WHETHER A STANDARDIZED YOGA INTERVENTION COULD REDUCE THESE ADVERSE SYMPTOMS. THIS WAS A PARTIALLY RANDOMIZED AND BLINDED CONTROLLED TRIAL COMPARING A STANDARDIZED YOGA INTERVENTION WITH STANDARD CARE. ELIGIBLE PATIENTS WERE ADULTS DIAGNOSED WITH STAGES I TO III BREAST CANCER RECEIVING CHEMOTHERAPY. PATIENTS RANDOMIZED TO THE EXPERIMENTAL GROUP PARTICIPATED IN AN 8-WEEK YOGA PROGRAM. THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN THE EXPERIMENTAL AND CONTROL GROUPS ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING AFTER 8 WEEKS. RESULTS SUGGEST THE YOGA PROGRAM IS NOT BENEFICIAL IN MANAGING THESE ADVERSE SYMPTOMS. HOWEVER, CONSIDERING PRELIMINARY EVIDENCE SUGGESTING YOGA'S BENEFICIAL IMPACT IN CANCER SYMPTOM MANAGEMENT, METHODOLOGICAL LIMITATIONS SHOULD BE EXPLORED AND ADDITIONAL STUDIES SHOULD BE CONDUCTED. 2017 20 1036 35 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