Once the hard decisions have been made about how to treat a patient's cancer, doctors face an even trickier question: how do you help patients deal with the side effects of treatment?
The issue is a challenge for physicians because, unlike with cancer therapies, there are few scientific studies on the most effective ways to handle the side effects including common symptoms such as poor sleep or fatigue. But addressing these seemingly mundane complications is crucial for helping patients maintain their regular lifestyle, which in turn may even encourage the success of their cancer treatment.
That's why Dr. Karen Mustian of the University of Rochester Medical Center decided to put a favorite practice of cancer survivors yoga to the test. In a paper she will present at the American Society of Clinical Oncology (ASCO) annual meeting in June, Mustian designed a standardized program based on hatha yoga a slow-moving form of the discipline and tested its effect on improving the quality of life for cancer survivors.
Called YOCAS, the four-week program involved sessions of hatha and restorative yoga twice a week for 75 minutes each, in combination with breathing exercises and meditation. Among the 410 participants, who were divided into yoga and traditional follow-up care groups, those practicing yoga recorded nearly double the improvement in sleep quality and reduction of fatigue compared to those not practicing yoga. They also reported better quality of life overall, Mustian says. "And the yoga group had all of these benefits while reducing their use of sleep medication," she says.
Volunteers answered detailed questionnaires to assess changes in their sleep, fatigue and quality of life at the start and end of the three-month study. They rated the accuracy of statements such as "My legs feel weak," or "I feel pooped," and recorded how long it took them to fall asleep once they went to bed.
For cancer physicians, the findings will be a welcome addition to their discussions with patients. "Many patients ask about complementary therapies, whether they are exercise or meditation or yoga or St. John's wort," says Dr. Douglas Blayney, medical director of the comprehensive cancer center at University of Michigan and president of ASCO. "I often don't know what to tell them because there isn't a lot of science on these complementary therapies. Here is a scientific study showing benefit, so at least we can have some assurance in telling women that here is a yoga program, here are its characteristics and it has been shown to have beneficial effects on sleep and quality of life."
Mustian points out that not all yoga programs may necessarily have the same effect as those that the study discovered. She worked with yoga experts to generate a series of specific yoga exercises and postures that are targeted to address fatigue and sleep issues. But, she says, "clinicians could recommend to their patients that they might want to try taking gentle hatha yoga or restorative yoga classes, or one that combines these two techniques along with breathing exercises and mindfulness." Now, she says, there is scientific proof that the benefits are worth the effort of seeking these programs out.