1 2627 95 YOGA FOR THE MANAGEMENT OF CANCER TREATMENT-RELATED TOXICITIES. PURPOSE OF REVIEW: TO (1) EXPLAIN WHAT YOGA IS, (2) SUMMARIZE PUBLISHED LITERATURE ON THE EFFICACY OF YOGA FOR MANAGING CANCER TREATMENT-RELATED TOXICITIES, (3) PROVIDE CLINICAL RECOMMENDATIONS ON THE USE OF YOGA FOR ONCOLOGY PROFESSIONALS, AND (4) SUGGEST PROMISING AREAS FOR FUTURE RESEARCH. RECENT FINDINGS: BASED ON A TOTAL OF 24 PHASE II AND ONE PHASE III CLINICAL TRIALS, LOW-INTENSITY FORMS OF YOGA, SPECIFICALLY GENTLE HATHA AND RESTORATIVE, ARE FEASIBLE, SAFE, AND EFFECTIVE FOR TREATING SLEEP DISRUPTION, CANCER-RELATED FATIGUE, COGNITIVE IMPAIRMENT, PSYCHOSOCIAL DISTRESS, AND MUSCULOSKELETAL SYMPTOMS IN CANCER PATIENTS RECEIVING CHEMOTHERAPY AND RADIATION AND CANCER SURVIVORS. CLINICIANS SHOULD CONSIDER PRESCRIBING YOGA FOR THEIR PATIENTS SUFFERING WITH THESE TOXICITIES BY REFERRING THEM TO QUALIFIED YOGA PROFESSIONALS. MORE DEFINITIVE PHASE III CLINICAL TRIALS ARE NEEDED TO CONFIRM THESE FINDINGS AND TO INVESTIGATE OTHER TYPES, DOSES, AND DELIVERY MODES OF YOGA FOR TREATING CANCER-RELATED TOXICITIES IN PATIENTS AND SURVIVORS. 2018 2 2587 39 YOGA FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS IN WOMEN DIAGNOSED WITH BREAST CANCER. BACKGROUND: BREAST CANCER IS THE CANCER MOST FREQUENTLY DIAGNOSED IN WOMEN WORLDWIDE. EVEN THOUGH SURVIVAL RATES ARE CONTINUALLY INCREASING, BREAST CANCER IS OFTEN ASSOCIATED WITH LONG-TERM PSYCHOLOGICAL DISTRESS, CHRONIC PAIN, FATIGUE AND IMPAIRED QUALITY OF LIFE. YOGA COMPRISES ADVICE FOR AN ETHICAL LIFESTYLE, SPIRITUAL PRACTICE, PHYSICAL ACTIVITY, BREATHING EXERCISES AND MEDITATION. IT IS A COMPLEMENTARY THERAPY THAT IS COMMONLY RECOMMENDED FOR BREAST CANCER-RELATED IMPAIRMENTS AND HAS BEEN SHOWN TO IMPROVE PHYSICAL AND MENTAL HEALTH IN PEOPLE WITH DIFFERENT CANCER TYPES. OBJECTIVES: TO ASSESS EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS AMONG WOMEN WITH A DIAGNOSIS OF BREAST CANCER WHO ARE RECEIVING ACTIVE TREATMENT OR HAVE COMPLETED TREATMENT. SEARCH METHODS: WE SEARCHED THE COCHRANE BREAST CANCER SPECIALISED REGISTER, MEDLINE (VIA PUBMED), EMBASE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL; 2016, ISSUE 1), INDEXING OF INDIAN MEDICAL JOURNALS (INDMED), THE WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (ICTRP) SEARCH PORTAL AND CLINICALTRIALS.GOV ON 29 JANUARY 2016. WE ALSO SEARCHED REFERENCE LISTS OF IDENTIFIED RELEVANT TRIALS OR REVIEWS, AS WELL AS CONFERENCE PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH (ICCMR), THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE (ECIM) AND THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS WERE ELIGIBLE WHEN THEY (1) COMPARED YOGA INTERVENTIONS VERSUS NO THERAPY OR VERSUS ANY OTHER ACTIVE THERAPY IN WOMEN WITH A DIAGNOSIS OF NON-METASTATIC OR METASTATIC BREAST CANCER, AND (2) ASSESSED AT LEAST ONE OF THE PRIMARY OUTCOMES ON PATIENT-REPORTED INSTRUMENTS, INCLUDING HEALTH-RELATED QUALITY OF LIFE, DEPRESSION, ANXIETY, FATIGUE OR SLEEP DISTURBANCES. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY COLLECTED DATA ON METHODS AND RESULTS. WE EXPRESSED OUTCOMES AS STANDARDISED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) AND CONDUCTED RANDOM-EFFECTS MODEL META-ANALYSES. WE ASSESSED POTENTIAL RISK OF PUBLICATION BIAS THROUGH VISUAL ANALYSIS OF FUNNEL PLOT SYMMETRY AND HETEROGENEITY BETWEEN STUDIES BY USING THE CHI(2) TEST AND THE I(2) STATISTIC. WE CONDUCTED SUBGROUP ANALYSES FOR CURRENT TREATMENT STATUS, TIME SINCE DIAGNOSIS, STAGE OF CANCER AND TYPE OF YOGA INTERVENTION. MAIN RESULTS: WE INCLUDED 24 STUDIES WITH A TOTAL OF 2166 PARTICIPANTS, 23 OF WHICH PROVIDED DATA FOR META-ANALYSIS. THIRTEEN STUDIES HAD LOW RISK OF SELECTION BIAS, FIVE STUDIES REPORTED ADEQUATE BLINDING OF OUTCOME ASSESSMENT AND 15 STUDIES HAD LOW RISK OF ATTRITION BIAS.SEVENTEEN STUDIES THAT COMPARED YOGA VERSUS NO THERAPY PROVIDED MODERATE-QUALITY EVIDENCE SHOWING THAT YOGA IMPROVED HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.22, 95% CI 0.04 TO 0.40; 10 STUDIES, 675 PARTICIPANTS), REDUCED FATIGUE (POOLED SMD -0.48, 95% CI -0.75 TO -0.20; 11 STUDIES, 883 PARTICIPANTS) AND REDUCED SLEEP DISTURBANCES IN THE SHORT TERM (POOLED SMD -0.25, 95% CI -0.40 TO -0.09; SIX STUDIES, 657 PARTICIPANTS). THE FUNNEL PLOT FOR HEALTH-RELATED QUALITY OF LIFE WAS ASYMMETRICAL, FAVOURING NO THERAPY, AND THE FUNNEL PLOT FOR FATIGUE WAS ROUGHLY SYMMETRICAL. THIS HINTS AT OVERALL LOW RISK OF PUBLICATION BIAS. YOGA DID NOT APPEAR TO REDUCE DEPRESSION (POOLED SMD -0.13, 95% CI -0.31 TO 0.05; SEVEN STUDIES, 496 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR ANXIETY (POOLED SMD -0.53, 95% CI -1.10 TO 0.04; SIX STUDIES, 346 PARTICIPANTS; VERY LOW-QUALITY EVIDENCE) IN THE SHORT TERM AND HAD NO MEDIUM-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.10, 95% CI -0.23 TO 0.42; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR FATIGUE (POOLED SMD -0.04, 95% CI -0.36 TO 0.29; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE). INVESTIGATORS REPORTED NO SERIOUS ADVERSE EVENTS.FOUR STUDIES THAT COMPARED YOGA VERSUS PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS PROVIDED MODERATE-QUALITY EVIDENCE INDICATING THAT YOGA CAN REDUCE DEPRESSION (POOLED SMD -2.29, 95% CI -3.97 TO -0.61; FOUR STUDIES, 226 PARTICIPANTS), ANXIETY (POOLED SMD -2.21, 95% CI -3.90 TO -0.52; THREE STUDIES, 195 PARTICIPANTS) AND FATIGUE (POOLED SMD -0.90, 95% CI -1.31 TO -0.50; TWO STUDIES, 106 PARTICIPANTS) IN THE SHORT TERM. VERY LOW-QUALITY EVIDENCE SHOWED NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.81, 95% CI -0.50 TO 2.12; TWO STUDIES, 153 PARTICIPANTS) OR SLEEP DISTURBANCES (POOLED SMD -0.21, 95% CI -0.76 TO 0.34; TWO STUDIES, 119 PARTICIPANTS). NO TRIAL ADEQUATELY REPORTED SAFETY-RELATED DATA.THREE STUDIES THAT COMPARED YOGA VERSUS EXERCISE PRESENTED VERY LOW-QUALITY EVIDENCE SHOWING NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD -0.04, 95% CI -0.30 TO 0.23; THREE STUDIES, 233 PARTICIPANTS) OR FATIGUE (POOLED SMD -0.21, 95% CI -0.66 TO 0.25; THREE STUDIES, 233 PARTICIPANTS); NO TRIAL PROVIDED SAFETY-RELATED DATA. AUTHORS' CONCLUSIONS: MODERATE-QUALITY EVIDENCE SUPPORTS THE RECOMMENDATION OF YOGA AS A SUPPORTIVE INTERVENTION FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE AND REDUCING FATIGUE AND SLEEP DISTURBANCES WHEN COMPARED WITH NO THERAPY, AS WELL AS FOR REDUCING DEPRESSION, ANXIETY AND FATIGUE, WHEN COMPARED WITH PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS. VERY LOW-QUALITY EVIDENCE SUGGESTS THAT YOGA MIGHT BE AS EFFECTIVE AS OTHER EXERCISE INTERVENTIONS AND MIGHT BE USED AS AN ALTERNATIVE TO OTHER EXERCISE PROGRAMMES. 2017 3 1061 23 EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN WOMEN WITH BREAST CANCER RECEIVING CHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA RECEIVE MORE ATTENTION FROM BREAST CANCER PATIENTS, HOWEVER ITS FEASIBILITY AND EFFICACY DURING CHEMOTHERAPY REMAINS CONFLICTING. WE PERFORMED THIS SYSTEMATIC REVIEW TO ASSESS THE EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY. METHODS: A SYSTEMATIC SEARCH WAS CONDUCTED TO RETRIEVE RANDOMIZED CONTROLLED TRIALS (RCTS) WHICH INVESTIGATED THE COMPARATIVE EFFICACY OF YOGA VERSUS COMPARATORS SUCH AS USUAL CARE AMONG BREAST CANCER PATIENTS FOR HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN PUBMED, EMBASE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CNETRAL), NURSING AND ALLIED HEALTH LITERATURE (CINAHL), CHINESE BIOMEDICAL LITERATURE (CBM) DATABASE, CHINA SCIENCE AND TECHNOLOGY JOURNAL (CSTJ) DATABASE, CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), AND WANGFANG DATABASE FROM INCEPTION TO DECEMBER 2018. THE LATEST SEARCH WAS UPDATED ON SEPTEMBER 2020. ALL ANALYSES WERE COMPLETED USING REVMAN VERSION 5.3. RESULTS: SEVEN TRIALS INVOLVING 693 BREAST CANCER PATIENTS MET INCLUSION CRITERIA. META-ANALYSIS INDICATED A SHORT-TERM IMPROVEMENT IN FATIGUE [STANDARD MEAN DIFFERENCE (SMD), -0.62; 95% CONFIDENCE INTERVAL (CI), -1.17 TO -0.07], SLEEP DISTURBANCE (SMD, -0.34; 95% CI, -0.55 TO -0.12), DEPRESSION (SMD, -0.50; 95% CI, -0.70 TO -0.31) ANXIETY (SMD, -0.50; 95% CI, -0.70 TO -0.31), AND HEALTH-RELATED QUALITY OF LIFE (QOL) (SMD, 0.72; 95% CI, -0.12 TO 1.56) IN THE YOGA GROUP; HOWEVER BENEFICIAL MEDIUM- AND LONG-TERM EFFECTS IN FATIGUE, SLEEP DISTURBANCE WERE NOT IDENTIFIED. MOREOVER, QUALITATIVE ANALYSES SUGGESTED THAT YOGA WAS NOT ASSOCIATED WITH DECREASED ADVERSE EVENTS (AES) COMPARED WITH CONTROL GROUPS. CONCLUSIONS: YOGA MAY BENEFIT TO REDUCE FATIGUE, DEPRESSION AND ANXIETY, IMPROVE SLEEP DISTURBANCE, AND IMPROVE QOL IN BREAST CANCER PATIENTS RECEIVING CHEMOTHERAPY IN THE SHORT-TERM; HOWEVER, MEDIUM- AND LONG-TERM EFFECTS SHOULD BE FURTHER ESTABLISHED OWING TO LIMITATIONS. 2021 4 2657 34 YOGA IN ADDITION TO STANDARD CARE FOR PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES. BACKGROUND: HAEMATOLOGICAL MALIGNANCIES ARE MALIGNANT NEOPLASMS OF THE MYELOID OR LYMPHATIC CELL LINES INCLUDING LEUKAEMIA, LYMPHOMA AND MYELOMA. IN ORDER TO MANAGE PHYSICAL AND PSYCHOLOGICAL ASPECTS OF THE DISEASE AND ITS TREATMENT, COMPLEMENTARY THERAPIES LIKE YOGA ARE COMING INCREASINGLY INTO FOCUS. HOWEVER, THE EFFECTIVENESS OF YOGA PRACTICE FOR PEOPLE SUFFERING FROM HAEMATOLOGICAL MALIGNANCIES REMAINS UNCLEAR. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA PRACTICE IN ADDITION TO STANDARD CANCER TREATMENT FOR PEOPLE WITH HAEMATOLOGICAL MALIGNANCIES. SEARCH METHODS: OUR SEARCH STRATEGY INCLUDED THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE (1950 TO 4TH FEBRUARY 2014), DATABASES OF ONGOING TRIALS (CONTROLLED-TRIALS.COM; CLINICALTRIALS.GOV), CONFERENCE PROCEEDINGS OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY, THE AMERICAN SOCIETY OF HEMATOLOGY, THE EUROPEAN HAEMATOLOGY ASSOCIATION, THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE, AND GLOBAL ADVANCES IN HEALTH AND MEDICINE. WE HANDSEARCHED REFERENCES OF THESE STUDIES FROM IDENTIFIED TRIALS AND RELEVANT REVIEW ARTICLES. TWO REVIEW AUTHORS INDEPENDENTLY SCREENED THE SEARCH RESULTS. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) OF YOGA IN ADDITION TO STANDARD CARE FOR HAEMATOLOGICAL MALIGNANCIES COMPARED WITH STANDARD CARE ONLY. WE DID NOT RESTRICT THIS TO ANY SPECIFIC STYLE OF YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY EXTRACTED DATA FOR ELIGIBLE STUDIES AND ASSESSED THE RISK OF BIAS ACCORDING TO PREDEFINED CRITERIA. WE EVALUATED DISTRESS, FATIGUE, ANXIETY, DEPRESSION AND QUALITY OF SLEEP. FURTHER OUTCOMES WE PLANNED TO ASSESS WERE HEALTH-RELATED QUALITY OF LIFE (HRQOL), OVERALL SURVIVAL (OS) AND ADVERSE EVENTS (AE), BUT DATA ON THESE WERE NOT AVAILABLE. MAIN RESULTS: OUR SEARCH STRATEGIES LED TO 149 POTENTIALLY RELEVANT REFERENCES, BUT ONLY A SINGLE SMALL STUDY MET OUR INCLUSION CRITERIA. THE INCLUDED STUDY WAS PUBLISHED AS A FULL TEXT ARTICLE AND INVESTIGATED THE FEASIBILITY AND EFFECT OF TIBETAN YOGA ADDITIONAL TO STANDARD CARE (N = 20; 1 PERSON DROPPED OUT BEFORE ATTENDING ANY CLASSES AND NO DATA WERE COLLECTED) COMPARED TO STANDARD CARE ONLY (N = 19). THE STUDY INCLUDED PEOPLE WITH ALL STAGES OF HODGKIN AND NON-HODGKIN'S LYMPHOMA, WITH AND WITHOUT CURRENT CANCER TREATMENT. THE MEAN AGE WAS 51 YEARS.WE JUDGED THE OVERALL RISK OF BIAS AS HIGH AS WE FOUND A HIGH RISK FOR PERFORMANCE, DETECTION AND ATTRITION BIAS. ADDITIONALLY, POTENTIAL OUTCOME REPORTING BIAS COULD NOT BE COMPLETELY RULED OUT. FOLLOWING THE RECOMMENDATIONS OF GRADE, WE JUDGED THE OVERALL QUALITY OF THE BODY OF EVIDENCE FOR ALL PREDEFINED OUTCOMES AS 'VERY LOW', DUE TO THE METHODICAL LIMITATIONS AND THE VERY SMALL SAMPLE SIZE.THE INFLUENCE OF YOGA ON HRQOL AND OS WAS NOT REPORTED. THERE IS NO EVIDENCE THAT YOGA IN ADDITION TO STANDARD CARE COMPARED WITH STANDARD CARE ONLY CAN IMPROVE DISTRESS IN PEOPLE WITH HAEMATOLOGICAL MALIGNANCIES (MEAN DIFFERENCE (MD) -0.30, 95% CONFIDENCE INTERVAL (CI) -5.55 TO 4.95; P = 0.91). SIMILARLY, THERE IS NO EVIDENCE OF A DIFFERENCE BETWEEN EITHER GROUP FOR FATIGUE (MD 0.00, 95% CI -0.94 TO 0.94; P = 1.00), ANXIETY (MD 0.30, 95% CI -5.01 TO 5.61; P = 0.91) OR DEPRESSION (MD -0.70, 95% CI -3.21 TO 1.81; P = 0.58).THERE IS VERY LOW QUALITY EVIDENCE THAT YOGA IMPROVES THE OVERALL QUALITY OF SLEEP (MD -2.30, 95% CI -3.78 TO -0.82; P = 0.002). THE YOGA GROUPS' TOTAL SCORE FOR THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) WAS 5.8 (+/- 2.3 SD) AND BETTER THAN THE TOTAL SCORE (8.1 (+/- 2.4 SD)) OF THE CONTROL GROUP. A PSQI TOTAL SCORE OF 0 TO 5 INDICATES GOOD SLEEP WHEREAS PSQI TOTAL SCORE 6 TO 21 POINTS TOWARDS SIGNIFICANT SLEEP DISTURBANCES. THE OCCURRENCE OF AES WAS NOT REPORTED. AUTHORS' CONCLUSIONS: THE CURRENTLY AVAILABLE DATA PROVIDE LITTLE INFORMATION ABOUT THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR PEOPLE SUFFERING FROM HAEMATOLOGICAL MALIGNANCIES. THE FINDING THAT YOGA MAY BE BENEFICIAL FOR THE PATIENTS' QUALITY OF SLEEP IS BASED ON A VERY SMALL BODY OF EVIDENCE. THEREFORE, THE ROLE OF YOGA AS AN ADDITIONAL THERAPY FOR HAEMATOLOGICAL MALIGNANCIES REMAINS UNCLEAR. FURTHER HIGH-QUALITY RANDOMISED CONTROLLED TRIALS WITH LARGER NUMBERS OF PARTICIPANTS ARE NEEDED TO MAKE A DEFINITIVE STATEMENT. 2014 5 1907 38 REVIEW OF YOGA THERAPY DURING CANCER TREATMENT. PURPOSE: REVIEWS OF YOGA RESEARCH THAT DISTINGUISH RESULTS OF TRIALS CONDUCTED DURING (VERSUS AFTER) CANCER TREATMENT ARE NEEDED TO GUIDE FUTURE RESEARCH AND CLINICAL PRACTICE. WE THEREFORE CONDUCTED A REVIEW OF NON-RANDOMIZED STUDIES AND RANDOMIZED CONTROLLED TRIALS OF YOGA INTERVENTIONS FOR CHILDREN AND ADULTS UNDERGOING TREATMENT FOR ANY CANCER TYPE. METHODS: STUDIES WERE IDENTIFIED VIA RESEARCH DATABASES AND REFERENCE LISTS. INCLUSION CRITERIA WERE THE FOLLOWING: (1) CHILDREN OR ADULTS UNDERGOING CANCER TREATMENT, (2) INTERVENTION STATED AS YOGA OR COMPONENT OF YOGA, AND (3) PUBLICATION IN ENGLISH IN PEER-REVIEWED JOURNALS THROUGH OCTOBER 2015. EXCLUSION CRITERIA WERE THE FOLLOWING: (1) SAMPLES RECEIVING HORMONE THERAPY ONLY, (2) INTERVENTIONS INVOLVING MEDITATION ONLY, AND (3) YOGA DELIVERED WITHIN BROADER CANCER RECOVERY OR MINDFULNESS-BASED STRESS REDUCTION PROGRAMS. RESULTS: RESULTS OF NON-RANDOMIZED (ADULT N = 8, PEDIATRIC N = 4) AND RANDOMIZED CONTROLLED TRIALS (ADULT N = 13, PEDIATRIC N = 0) CONDUCTED DURING CANCER TREATMENT ARE SUMMARIZED SEPARATELY BY AGE GROUP. FINDINGS MOST CONSISTENTLY SUPPORT IMPROVEMENT IN PSYCHOLOGICAL OUTCOMES (E.G., DEPRESSION, DISTRESS, ANXIETY). SEVERAL STUDIES ALSO FOUND THAT YOGA ENHANCED QUALITY OF LIFE, THOUGH FURTHER INVESTIGATION IS NEEDED TO CLARIFY DOMAIN-SPECIFIC EFFICACY (E.G., PHYSICAL, SOCIAL, CANCER-SPECIFIC). REGARDING PHYSICAL AND BIOMEDICAL OUTCOMES, EVIDENCE INCREASINGLY SUGGESTS THAT YOGA AMELIORATES SLEEP AND FATIGUE; ADDITIONAL RESEARCH IS NEEDED TO ADVANCE PRELIMINARY FINDINGS FOR OTHER TREATMENT SEQUELAE AND STRESS/IMMUNITY BIOMARKERS. CONCLUSIONS: AMONG ADULTS UNDERGOING CANCER TREATMENT, EVIDENCE SUPPORTS RECOMMENDING YOGA FOR IMPROVING PSYCHOLOGICAL OUTCOMES, WITH POTENTIAL FOR ALSO IMPROVING PHYSICAL SYMPTOMS. EVIDENCE IS INSUFFICIENT TO EVALUATE THE EFFICACY OF YOGA IN PEDIATRIC ONCOLOGY. WE DESCRIBE SUGGESTIONS FOR STRENGTHENING YOGA RESEARCH METHODOLOGY TO INFORM CLINICAL PRACTICE GUIDELINES. 2017 6 1331 24 HOME-BASED YOGA PROGRAM FOR THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA DURING CHEMOTHERAPY: A FEASIBILITY STUDY. BACKGROUND: YOGA IS PROVEN BENEFICIAL IN IMPROVING QUALITY OF LIFE AMONG BREAST CANCER SURVIVORS RECEIVING CHEMOTHERAPY, BUT ITS EFFECTIVENESS IN LYMPHOMA PATIENTS NEEDS TO BE EXPLORED. AS CHEMOTHERAPY-INDUCED NEUTROPENIA IS VERY COMMON AMONG LYMPHOMA PATIENTS, THEY ARE MUCH PRONE TO INFECTIONS FROM THE ENVIRONMENT. FURTHERMORE, TRAINED YOGA INSTRUCTORS ARE NOT AVAILABLE IN EVERY SETTING, SO THERE IS A NEED TO DEVELOP HOME-BASED YOGA PROGRAM MODULES FOR LYMPHOMA PATIENTS RECEIVING CHEMOTHERAPY. AIM: THE AIM OF THE STUDY WAS TO EXPLORE THE FEASIBILITY AND SAFETY OF YOGIC EXERCISES AMONG LYMPHOMA PATIENTS DURING CHEMOTHERAPY. SUBJECTS AND METHODS: AN INTERVENTIONAL, SINGLE-ARM PREPOST DESIGN STUDY WAS CONDUCTED AT A TERTIARY HEALTH-CARE CENTER. PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA (18-65 YEARS) WITH EASTERN COOPERATIVE ONCOLOGY GROUP PERFORMANCE STATUS FROM 0 TO 2, PLANNED TO RECEIVE CHEMOTHERAPY WERE ADMINISTERED A HOME-BASED YOGA PROGRAM OVER A PERIOD OF 2 MONTHS FROM THE START OF CHEMOTHERAPY. THE PRIMARY OUTCOME VARIABLES WERE RETENTION RATE, ACCEPTANCE RATE, SAFETY, AND ADHERENCE. HEALTH-RELATED QUALITY OF LIFE (HRQOL), FATIGUE LEVEL, OVERALL SLEEP QUALITY, DEPRESSION, ANXIETY LEVEL, AND PAIN WERE ALSO ASSESSED. STATISTICAL ANALYSIS: DESCRIPTIVE STATISTICS WAS USED TO SEE THE FEASIBILITY AND ADHERENCE. THE PAIRED T-TEST WAS USED TO COMPARE VARIOUS PRE AND POSTINTERVENTION OUTCOME MEASURES. RESULTS: FOURTEEN PATIENTS (MEDIAN AGE: 36 YEARS, RANGE13-65 YEARS) OF MALIGNANT LYMPHOMA WERE ENROLLED IN THE STUDY. MALE-TO-FEMALE RATIO WAS 9:5. NON-HODGKIN'S LYMPHOMA PATIENTS CONSTITUTED 64%. THE RECRUITMENT RATE WAS 93%. FAVORABLE RETENTION (100%), ACCEPTABILITY (97%), ADHERENCE (78.6%), AND NO SERIOUS ADVERSE EVENTS FOLLOWING YOGA PRACTICE WERE REPORTED. IMPROVEMENT WAS ALSO FOUND IN HRQOL, FATIGUE, SLEEP, DEPRESSION, AND ANXIETY. HOWEVER, IT NEEDS FURTHER VALIDATION IN A RANDOMIZED STUDY. CONCLUSION: HOME-BASED YOGA PROGRAM IS SAFE AND FEASIBLE AMONG THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA RECEIVING CHEMOTHERAPY. 2018 7 2623 30 YOGA FOR SYMPTOM MANAGEMENT IN ONCOLOGY: A REVIEW OF THE EVIDENCE BASE AND FUTURE DIRECTIONS FOR RESEARCH. BECAUSE YOGA IS INCREASINGLY RECOGNIZED AS A COMPLEMENTARY APPROACH TO CANCER SYMPTOM MANAGEMENT, PATIENTS/SURVIVORS AND PROVIDERS NEED TO UNDERSTAND ITS POTENTIAL BENEFITS AND LIMITATIONS BOTH DURING AND AFTER TREATMENT. THE AUTHORS REVIEWED RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA CONDUCTED AT THESE POINTS IN THE CANCER CONTINUUM (N = 29; N = 13 DURING TREATMENT, N = 12 POST-TREATMENT, AND N = 4 WITH MIXED SAMPLES). FINDINGS BOTH DURING AND AFTER TREATMENT DEMONSTRATED THE EFFICACY OF YOGA TO IMPROVE OVERALL QUALITY OF LIFE (QOL), WITH IMPROVEMENT IN SUBDOMAINS OF QOL VARYING ACROSS STUDIES. FATIGUE WAS THE MOST COMMONLY MEASURED OUTCOME, AND MOST RCTS CONDUCTED DURING OR AFTER CANCER TREATMENT REPORTED IMPROVEMENTS IN FATIGUE. RESULTS ALSO SUGGESTED THAT YOGA CAN IMPROVE STRESS/DISTRESS DURING TREATMENT AND POST-TREATMENT DISTURBANCES IN SLEEP AND COGNITION. SEVERAL RCTS PROVIDED EVIDENCE THAT YOGA MAY IMPROVE BIOMARKERS OF STRESS, INFLAMMATION, AND IMMUNE FUNCTION. OUTCOMES WITH LIMITED OR MIXED FINDINGS (EG, ANXIETY, DEPRESSION, PAIN, CANCER-SPECIFIC SYMPTOMS, SUCH AS LYMPHEDEMA) AND POSITIVE PSYCHOLOGICAL OUTCOMES (SUCH AS BENEFIT-FINDING AND LIFE SATISFACTION) WARRANT FURTHER STUDY. IMPORTANT FUTURE DIRECTIONS FOR YOGA RESEARCH IN ONCOLOGY INCLUDE: ENROLLING PARTICIPANTS WITH CANCER TYPES OTHER THAN BREAST, STANDARDIZING SELF-REPORT ASSESSMENTS, INCREASING THE USE OF ACTIVE CONTROL GROUPS AND OBJECTIVE MEASURES, AND ADDRESSING THE HETEROGENEITY OF YOGA INTERVENTIONS, WHICH VARY IN TYPE, KEY COMPONENTS (MOVEMENT, MEDITATION, BREATHING), DOSE, AND DELIVERY MODE. 2019 8 2557 29 YOGA FOR CHRONIC CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY PAIN: A PILOT, RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A YOGA INTERVENTION FOR CANCER SURVIVORS WITH CHRONIC CIPN PAIN, AS WELL AS THE IMPACT OF THE INTERVENTION ON PATIENT-REPORTED OUTCOMES. METHODS: CANCER SURVIVORS WITH CHRONIC CIPN PAIN WERE RECRUITED FROM THE BREAST, GASTROINTESTINAL, AND GYNECOLOGICAL ONCOLOGY CENTERS AT DANA-FARBER CANCER INSTITUTE. PARTICIPANTS WERE RANDOMIZED (2:1) TO RECEIVE AN 8-WEEK YOGA INTERVENTION OR USUAL CARE. AFTER 21/50 OF PARTICIPANTS WERE ENROLLED, THE COVID-19 PANDEMIC REQUIRED THE YOGA INTERVENTION TO BE DELIVERED VIRTUALLY (I.E., ZOOM). PRE- AND POST-INTERVENTION, PARTICIPANTS SELF-REPORTED CIPN AND CO-OCCURRING SYMPTOM SEVERITY. ADHERENCE TO THE INTERVENTION WAS DEFINED AS PRACTICING >/= 12 YOGA SESSIONS OVER THE 8-WEEK INTERVENTION PERIOD. CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN GROUPS WERE COMPARED USING WILCOXON'S RANK-SUM TESTS. RESULTS: PARTICIPANTS (N = 28 YOGA, N = 16 CONTROL) WERE MAINLY FEMALE (96%) AND DIAGNOSED WITH STAGE III/IV DISEASE (66%). OVERALL, 19/28 (67.8%) OF YOGA GROUP PARTICIPANTS WERE ADHERENT TO THE YOGA PROTOCOL. YOGA GROUP PARTICIPANTS EXPERIENCED SIGNIFICANT WITHIN-GROUP IMPROVEMENTS IN ALL PATIENT-REPORTED OUTCOMES, INCLUDING WORST CIPN PAIN (MEDIAN CHANGE = - 1.7, P < 0.0001) AND SENSORY CIPN (MEDIAN CHANGE = - 14.8, P < 0.0001), BUT ONLY IMPROVEMENTS IN FATIGUE (P = 0.05) AND DEPRESSION (P = 0.04) WERE SIGNIFICANT COMPARED TO THE CONTROL. THERE WERE NO DIFFERENCES (P > 0.05) IN CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN IN-PERSON (N = 6) OR VIRTUAL (N = 15) YOGA GROUP PARTICIPANTS. CONCLUSIONS: YOGA IS A FEASIBLE NON-PHARMACOLOGICAL MODALITY FOR CANCER SURVIVORS WITH CIPN, BUT MORE INFORMATION IS NEEDED REGARDING ITS IMPACT ON CIPN AND OTHER SYMPTOMS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT03824860 IMPLICATIONS FOR CANCER SURVIVORS: ONCOLOGY CLINICIANS MAY CONSIDER REFERRING CANCER SURVIVORS TO YOGA FOR CHRONIC CIPN PAIN, BUT YOGA CANNOT BE CURRENTLY RECOMMENDED AS AN EFFICACIOUS TREATMENT. 2021 9 2684 28 YOGA IN THE PEDIATRIC ONCOLOGY POPULATION: A REVIEW OF THE LITERATURE. BACKGROUND: THE PURPOSE OF THIS REVIEW WAS TO EVALUATE THE CURRENT BODY OF LITERATURE ON YOGA IN THE PEDIATRIC ONCOLOGY POPULATION. CONSIDERING THE INCREASING NUMBER OF STUDIES ON YOGA INDICATING IMPROVEMENTS IN HEALTH-RELATED QUALITY OF LIFE (HRQL) AMONG THE ADULT ONCOLOGY POPULATION, IT IS IMPORTANT TO EXPLORE WHETHER SIMILAR BENEFITS HAVE BEEN FOUND IN PEDIATRIC ONCOLOGY PATIENTS. METHODS: CINAHL, OVID MEDLINE, PSYCINFO, PUBMED, AND SCOPUS WERE SEARCHED FROM THE YEARS 2010 THROUGH 2020 FOR STUDIES ASSESSING THE USE OF YOGA IN CHILDREN AND ADOLESCENTS AFFECTED BY CANCER. CONSIDERING THE BENEFITS OF YOGA ON HRQL IN THE ADULT ONCOLOGY POPULATION, THE AIM OF THIS REVIEW WAS TO EVALUATE THE CURRENT BODY OF LITERATURE ON YOGA IN THE PEDIATRIC CANCER POPULATION. RESULTS: EIGHT STUDIES, ALL NONRANDOMIZED WITH SINGLE-ARM DESIGNS, WERE REVIEWED. FIVE OF THE STUDIES WERE DESIGNED AS FEASIBILITY STUDIES AND WHILE RECRUITMENT RATES RANGED FROM 34% TO 55%, RETENTION RATES WERE APPROXIMATELY 70%. QUALITATIVE FEEDBACK FROM PARTICIPANTS WAS VERY POSITIVE AND THEMES RELATED TO BOTH PHYSICAL AND PSYCHOLOGICAL BENEFITS. CERTAIN MEASURES OF HRQL (I.E., ANXIETY, PAIN, AND PHYSICAL FUNCTIONING) WERE FOUND TO BE SIGNIFICANTLY IMPROVED FOLLOWING A YOGA INTERVENTION. DISCUSSION: ALTHOUGH NO RANDOMIZED CLINICAL TRIALS HAVE BEEN CONDUCTED TO DATE ON THIS IMPORTANT TOPIC, THE STUDIES REVIEWED SHOWED THAT DELIVERING YOGA TO THIS POPULATION IS FEASIBLE AND SAFE. ADDITIONALLY, PRELIMINARY FINDINGS ON THE IMPACT OF YOGA FOR SOME OF THE COMMON SYMPTOMS AND TREATMENT-RELATED SIDE EFFECTS EXPERIENCED BY CHILDREN AND ADOLESCENTS AFFECTED BY CANCER ARE PROMISING. 2021 10 2440 20 YOGA AND QUALITY-OF-LIFE IMPROVEMENT IN PATIENTS WITH BREAST CANCER: A LITERATURE REVIEW. OBJECTIVE: WOMEN UNDERGOING TREATMENT FOR BREAST CANCER OFTEN TURN TO COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM), INCLUDING YOGA, FOR IMPROVEMENT OF MOOD, QUALITY OF LIFE (QOL), SLEEP, AND TREATMENT-RELATED SIDE EFFECTS. THE EXTANT LITERATURE WAS REVIEWED TO EXAMINE THE CLINICAL EFFECTS OF YOGA PRACTICE ON QOL FOR PATIENTS WITH BREAST CANCER. QOL WAS DEFINED AS PHYSICAL WELL-BEING, SOCIAL FUNCTIONING, EMOTIONAL HEALTH, AND FUNCTION-AL ADAPTATION. METHODS: SEVEN DATABASES, INCLUDING PUBMED, OVID MEDLINE, CINAHL, EMBASE, PSYCINFO, COCHRANE LIBRARY, AND WEB OF SCIENCE WERE USED TO SEARCH FOR STUDIES OF PATIENTS WITH BREAST CANCER THAT INCLUDED A YOGA INTERVENTION AND QOL ASSESSMENT. ATTENTION WAS PAID TO ASSESSING STUDY POPULATION, OUTCOME VARIABLES, THE TYPE OF YOGA INTERVENTION USED, AND METHODOLOGICAL STRENGTHS AND LIMITATIONS. RESULTS: SEVENTY-ONE ARTICLES WERE IDENTIFIED THAT FIT THE SEARCH CRITERIA. ALTHOUGH THE LITERATURE PROVIDED EVIDENCE OF QOL BENEFITS OF YOGA FOR PATIENTS WITH BREAST CANCER, NO SPECIFIC ASPECT OF YOGA WAS IDENTIFIED AS BEING MOST ADVANTAGEOUS. CONCLUSION: ALTHOUGH PARTICIPATION IN YOGA PROGRAMS APPEARED TO BENEFIT PATIENTS WITH BREAST CANCER, GREATER METHODOLOGICAL RIGOR IS REQUIRED TO UNDERSTAND THE MECHANISMS THAT CONTRIBUTE TO THEIR EFFECTIVENESS. 2012 11 1865 25 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 12 2129 25 THE EFFECTIVENESS OF YOGA ON CANCER-RELATED FATIGUE: A SYSTEMATIC REVIEW AND META-ANALYSIS. PROBLEM IDENTIFICATION: THE AIM OF THIS ARTICLE IS TO EVALUATE THE EFFECTIVENESS OF YOGA ON CANCER-RELATED FATIGUE (CRF) IN PATIENTS UNDERGOING CHEMOTHERAPY AND/OR RADIATION THERAPY. LITERATURE SEARCH: RELEVANT ENGLISH AND CHINESE ARTICLES WERE RETRIEVED FROM MEDICAL DATABASES AND INCLUDED IN THIS ANALYSIS. STANDARDIZED CRITICAL APPRAISAL INSTRUMENTS FROM THE JOANNA BRIGGS INSTITUTE WERE ADOPTED FOR THE QUALITY ASSESSMENT. DATA EVALUATION: 16 RANDOMIZED CONTROLLED TRIALS MET THE INCLUSION CRITERIA. SYNTHESIS: YOGA INTERVENTIONS HAD A POSITIVE EFFECT IN REDUCING CRF AMONG PATIENTS UNDERGOING CHEMOTHERAPY AND/OR RADIATION THERAPY, BUT THE ADHERENCE TO YOGA WAS LOW. MIXED TYPES OF YOGA, IN ADDITION TO SUPERVISED AND SELF-PRACTICING STRATEGIES, WERE ASSOCIATED WITH INCREASED PATIENT ADHERENCE AND IMPROVED CRF. IMPLICATIONS FOR PRACTICE: YOGA APPEARS TO BE A SAFE AND EFFECTIVE EXERCISE FOR THE MANAGEMENT OF CRF DURING CHEMOTHERAPY AND/OR RADIATION THERAPY; HOWEVER, ADDITIONAL HIGH-QUALITY STUDIES ARE NEEDED TO DEFINE AN OPTIMAL YOGA INTERVENTION STRATEGY. 2021 13 2552 27 YOGA FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY AND FALL RISK: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS A COMMON, DEBILITATING SIDE EFFECT THAT WORSENS QUALITY OF LIFE AND INCREASES THE RISK OF FALLS IN CANCER SURVIVORS. EVIDENCE OF YOGA'S SAFETY AND EFFICACY IN TREATING CIPN IS LACKING. METHODS: IN A RANDOMIZED CONTROLLED STUDY, WE ASSIGNED BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE-TO-SEVERE CIPN PAIN, NUMBNESS, OR TINGLING WITH A SCORE OF 4 OR GREATER (0-10 NUMERIC RATING SCALE [NRS]) FOR AT LEAST 3 MONTHS AFTER CHEMOTHERAPY TO 8 WEEKS OF USUAL CARE OR YOGA FOCUSED ON BREATHWORK AND MUSCULOSKELETAL CONDITIONING. PRIMARY ENDPOINT WAS TREATMENT ARM DIFFERENCES FOR NRS, AND SECONDARY ENDPOINTS WERE FUNCTIONAL ASSESSMENT OF CANCER THERAPY/GYNECOLOGIC ONCOLOGY GROUP-NEUROTOXICITY SUBSCALE (FACT/GOG-NTX), AND FUNCTIONAL REACH TEST AFTER WEEK 8. WE TESTED TREATMENT ARM DIFFERENCES FOR EACH OUTCOME MEASURE USING LINEAR MIXED MODELS WITH TREATMENT-BY-TIME INTERACTIONS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: WE RANDOMLY ASSIGNED 41 PARTICIPANTS INTO YOGA (N = 21) OR USUAL CARE (N = 20). AT WEEK 8, MEAN NRS PAIN DECREASED BY 1.95 POINTS (95% CONFIDENCE INTERVAL [CI] = -3.20 TO -0.70) IN YOGA VS 0.65 (95% CI = -1.81 TO 0.51) IN USUAL CARE (P = .14). FACT/GOG-NTX IMPROVED BY 4.25 (95% CI = 2.29 TO 6.20) IN YOGA VS 1.36 (95% CI = -0.47 TO 3.19) IN USUAL CARE (P = .035). FUNCTIONAL REACH, AN OBJECTIVE FUNCTIONAL MEASURE PREDICTING THE RISK OF FALLS, IMPROVED BY 7.14 CM (95% CI = 3.68 TO 10.59) IN YOGA AND DECREASED BY 1.65 CM (95% CI = -5.00 TO 1.72) IN USUAL CARE (P = .001). FOUR GRADE 1 ADVERSE EVENTS WERE OBSERVED IN THE YOGA ARM. CONCLUSION: AMONG BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH MODERATE-TO-SEVERE CIPN, YOGA WAS SAFE AND SHOWED PROMISING EFFICACY IN IMPROVING CIPN SYMPTOMS. 2020 14 1503 28 INVESTIGATING THE PERCEIVED FEASIBILITY OF INTEGRATIVE MEDICINE IN A CONVENTIONAL ONCOLOGY SETTING: YOGA THERAPY AS A TREATMENT FOR BREAST CANCER SURVIVORS. BACKGROUND: A MAJORITY OF CANCER SURVIVORS EXPERIENCE DEBILITATING EFFECT(S) RELATED TO THEIR CANCER DIAGNOSIS AND TREATMENTS ACROSS PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND SPIRITUAL DOMAINS. TIMELY AND INNOVATIVE SOLUTIONS ARE NEEDED TO ADDRESS THE ADVERSE TREATMENT-RELATED EFFECTS AND OFTEN DISJOINTED SERVICES THAT BREAST CANCER PATIENTS FACE. RECENT STUDIES SUGGEST THAT THE MAJORITY OF BREAST CANCER SURVIVORS ARE USING COMPLEMENTARY AND ALTERNATIVE MEDICINE AT SOME POINT ALONG THEIR CANCER TRAJECTORY. IN RECENT YEARS, SCIENTISTS AND CLINICIANS HAVE EXAMINED THE EFFECTS OF YOGA THERAPY AMONG CANCER PATIENTS AND SURVIVORS. THE CURRENT STUDY EXAMINED THE PERCEIVED FEASIBILITY OF IMPLEMENTING YOGA THERAPY AS A TREATMENT SERVICE FOR BREAST CANCER PATIENTS AT A LARGE URBAN CANCER CENTER IN CANADA. METHODS: A MIXED-METHODS APPROACH THAT INCLUDED FOCUS GROUPS AND SELF-REPORTED SURVEYS WITH HEALTH CARE PROVIDERS (HCPS) AND BREAST CANCER PATIENTS WAS USED IN THIS RESEARCH. RESULTS: OVERALL, RESULTS INDICATED THAT BREAST CANCER PATIENTS AND HCPS WERE SUPPORTIVE AND EAGER FOR THE IMPLEMENTATION OF A YOGA THERAPY PROGRAM. SIX THEMES EMERGED FROM THE ANALYSIS OF THE FOCUS GROUP AND THE SURVEY DATA: (1) THE AVAILABILITY OF RESOURCES AND ACCESSIBILITY OF YOGA THERAPY, (2) THE CREDIBILITY AND TRANSPARENCY OF YOGA THERAPY, (3) THE UNDERSTANDING OF YOGA THERAPY, (4) AN EDUCATIONAL COMPONENT, (5) THE THERAPEUTIC CONTEXT, AND (6) THE INTEGRATION OF YOGA THERAPY. SPECIFIC FACILITATORS AND BARRIERS BECAME EVIDENT WITHIN THESE THEMES. CONCLUSIONS: ALTHOUGH ENTHUSIASM FOR THE IMPLEMENTATION OF AN INTEGRATIVE YOGA THERAPY PROGRAM WAS APPARENT AMONG BOTH BREAST CANCER SURVIVORS AND HCPS, BARRIERS WERE ALSO IDENTIFIED. THE FINDINGS OF THIS STUDY ARE CURRENTLY BEING USED TO INFORM A LARGE-SCALE PROGRAM OF RESEARCH AIMED AT DEVELOPING INTEGRATIVE TREATMENT SERVICES FOR BREAST CANCER PATIENTS, BEGINNING WITH YOGA THERAPY. 2013 15 1650 33 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 0.05). CONCLUSIONS: THE RESULTS INDICATE THAT RELAXATION TRAINING ACCORDING TO THE YOGA IN DAILY LIFE SYSTEM COULD BE A USEFUL CLINICAL PHYSIOTHERAPY INTERVENTION FOR PATIENTS WHO HAVE BREAST CANCER AND WHO ARE EXPERIENCING LOW SELF-ESTEEM. ALTHOUGH THIS KIND OF RELAXATION TRAINING CAN BE APPLIED TO CLINICAL ONCOLOGY IN SLOVENIA, MORE STUDIES NEED TO BE DONE. 2011 19 1042 32 EFFECTS OF YOGA INTERVENTIONS ON FATIGUE IN CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: FATIGUE IS ONE OF THE MOST FREQUENTLY REPORTED, DISTRESSING SIDE EFFECTS REPORTED BY CANCER SURVIVORS AND OFTEN HAS SIGNIFICANT LONG-TERM CONSEQUENCES. RESEARCH INDICATES THAT YOGA CAN PRODUCE INVIGORATING EFFECTS ON PHYSICAL AND MENTAL ENERGY, AND THEREBY MAY IMPROVE LEVELS OF FATIGUE. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW WAS TO EXAMINE THE LITERATURE THAT REPORTS THE EFFECTS OF RANDOMIZED, CONTROLLED YOGA INTERVENTIONS ON SELF-REPORTED FATIGUE IN CANCER PATIENTS AND SURVIVORS. THE ONLINE ELECTRONIC DATABASES, PUBMED AND PSYCINFO, WERE USED TO SEARCH FOR PEER-REVIEWED RESEARCH ARTICLES STUDYING THE EFFECTS OF YOGA INTERVENTIONS ON FATIGUE IN CANCER SURVIVORS. COMBINATIONS OF YOGA, CANCER, AND FATIGUE-RELATED SEARCH TERMS WERE ENTERED SIMULTANEOUSLY TO OBTAIN ARTICLES THAT INCLUDED ALL THREE ELEMENTS. STUDIES WERE INCLUDED IF THEY MET THE FOLLOWING INCLUSION CRITERIA: PARTICIPANTS WERE MALE OR FEMALE CANCER PATIENTS OR SURVIVORS PARTICIPATING IN RANDOMIZED, CONTROLLED YOGA INTERVENTIONS. THE MAIN OUTCOME OF INTEREST WAS CHANGE IN FATIGUE FROM PRE- TO POST-INTERVENTION. INTERVENTIONS OF ANY LENGTH WERE INCLUDED IN THE ANALYSIS. RISK OF BIAS USING THE FORMAT OF THE COCHRANE COLLABORATION'S TOOL FOR ASSESSING RISK OF BIAS WAS ALSO EXAMINED ACROSS STUDIES. RESULTS: TEN ARTICLES MET INCLUSION CRITERIA AND INVOLVED A TOTAL OF 583 PARTICIPANTS WHO WERE PREDOMINANTLY FEMALE, BREAST CANCER SURVIVORS. FOUR STUDIES INDICATED THAT THE YOGA INTERVENTION RESULTED IN SIGNIFICANT REDUCTIONS IN SELF-REPORTED FATIGUE FROM PRE- TO POST-INTERVENTION. THREE OF THE STUDIES REPORTED THAT THERE WERE SIGNIFICANT REDUCTIONS OF FATIGUE AMONG PARTICIPANTS WHO ATTENDED A GREATER NUMBER OF YOGA CLASSES. RISK OF BIAS WAS HIGH FOR AREAS OF ADEQUATE SELECTION, PERFORMANCE, DETECTION, AND PATIENT-REPORTED BIAS AND MIXED FOR ATTRITION AND REPORTING BIAS. RISK OF BIAS WAS UNIFORMLY LOW FOR OTHER FORMS OF BIAS, INCLUDING FINANCIAL CONFLICTS OF INTEREST. CONCLUSIONS: RESULTS OF THE STUDIES INCLUDED IN THIS REVIEW SUGGEST THAT YOGA INTERVENTIONS MAY BE BENEFICIAL FOR REDUCING CANCER-RELATED FATIGUE IN WOMEN WITH BREAST CANCER; HOWEVER, CONCLUSIONS SHOULD BE INTERPRETED WITH CAUTION AS A RESULT OF LEVELS OF BIAS AND INCONSISTENT METHODS USED ACROSS STUDIES. MORE WELL-CONSTRUCTED RANDOMIZED CONTROLLED TRIALS ARE NEEDED TO DETERMINE THE IMPACT OF YOGA INTERVENTIONS ON FATIGUE IN CANCER PATIENTS AND SURVIVORS. 2013 20 1574 31 MANAGING LYMPHEDEMA, INCREASING RANGE OF MOTION, AND QUALITY OF LIFE THROUGH YOGA THERAPY AMONG BREAST CANCER SURVIVORS: A SYSTEMATIC REVIEW. LYMPHEDEMA IS A COMMON COMPLICATION OF BREAST CANCER TREATMENT. YOGA IS A NONCONVENTIONAL AND NONINVASIVE INTERVENTION THAT IS REPORTED TO SHOW BENEFICIAL EFFECTS IN PATIENTS WITH BREAST CANCER-RELATED LYMPHEDEMA (BCRL). THIS STUDY ATTEMPTED TO SYSTEMATICALLY REVIEW THE EFFECT OF YOGA THERAPY ON MANAGING LYMPHEDEMA, INCREASING THE RANGE OF MOTION (ROM), AND QUALITY OF LIFE (QOL) AMONG BREAST CANCER SURVIVORS. THE REVIEW SEARCH INCLUDED STUDIES FROM ELECTRONIC BIBLIOGRAPHIC DATABASES, NAMELY MEDLINE (PUBMED), EMBASE, AND GOOGLE SCHOLAR TILL JUNE 2019. STUDIES WHICH ASSESSED THE OUTCOME VARIABLES SUCH AS QOL AND MANAGEMENT OF LYMPHEDEMA OR RELATED PHYSICAL SYMPTOMS AS EFFECT OF YOGA INTERVENTION WERE CONSIDERED FOR REVIEW. TWO AUTHORS INDIVIDUALLY REVIEWED, SELECTED ACCORDING TO COCHRANE GUIDELINES, AND EXTRACTED THE ARTICLES USING COVIDENCE SOFTWARE. SCREENING PROCESS OF THIS REVIEW RESULTED IN A TOTAL OF SEVEN STUDIES. THE DIFFERENT STYLES OF YOGA EMPLOYED IN THE STUDIES WERE IYENGAR YOGA (N = 2), SATYANANDA YOGA (N = 2), HATHA YOGA (N = 2), AND ASHTANGA YOGA (N = 1). THE LENGTH OF INTERVENTION AND POST INTERVENTION ANALYSIS RANGED FROM 8 WEEKS TO 12 MONTHS. FOUR STUDIES INCLUDED HOME PRACTICE SESSIONS. QOL, ROM, AND MUSCULOSKELETAL SYMPTOMS SHOWED IMPROVEMENT IN ALL THE STUDIES. YOGA COULD BE A SAFE AND FEASIBLE EXERCISE INTERVENTION FOR BCRL PATIENTS. EVIDENCE GENERATED FROM THESE STUDIES WAS OF MODERATE STRENGTH. FURTHER LONG-TERM CLINICAL TRIALS WITH LARGE SAMPLE SIZE ARE ESSENTIAL FOR THE DEVELOPMENT AND STANDARDIZATION OF YOGA INTERVENTION GUIDELINES FOR BCRL PATIENTS. 2021