Yoga can lower fatigue, inflammation in breast cancer survivors

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Practicing yoga for as little as three months can reduce fatigue and lower inflammation in breast cancer survivors, according to a new research. The more the women, in the study, practiced yoga, the better was their results. At the six-month point of the study — three months after the formal yoga practice ended — results showed that on average, fatigue was 57 per cent lower in women who had practiced yoga compared to the non-yoga group, and their inflammation was reduced by up to 20 per cent.

The participants had completed all breast cancer treatments before the start of the study and only yoga novices were recruited for the randomised, controlled clinical trial. Participants practiced yoga in small groups twice a week for 12 weeks. Women were wait-listed to receive the same yoga sessions once the trial was over.

“This showed that modest yoga practice over a period of several months could have substantial benefits for breast cancer survivors,” said Janice Kiecolt-Glaser, professor of psychiatry and psychology at The Ohio State University and lead author of the study. “We also think the results could easily generalise to other groups of people who have issues with fatigue and inflammation,” she said .

Though many studies have suggested that yoga has numerous benefits, this is the largest known randomised controlled trial that includes biological measures, Kiecolt-Glaser said. Researchers recruited 200 women for the study.

The study is published in the journal of Clinical Oncology. The research team focused on breast cancer survivors because the rigors of treatment can be so taxing on patients. “One of the problems they face is a real reduction in cardiorespiratory fitness. The treatment is so debilitating and they are so tired, and the less you do physically, the less you’re able to do. It’s a downward spiral,” Kiecolt-Glaser said.

All women in the study completed a number of surveys assessing their fatigue, energy level, depressive symptoms, sleep quality, physical activities and food consumption. They also gave baseline blood samples that researchers used to measure levels of several inflammation-related proteins.

Participants ranged in age from 27 to 76 and were two months to three years past the latest surgical or radiation treatment. Kiecolt-Glaser and colleagues deliberately selected women of a variety of ages, stages of cancer (between 0 and 3A) and treatment methods so the results could be generalised to a broad population of cancer survivors, she said. Each yoga group included between four and 20 women who practiced the same poses during 90-minute sessions twice a week. Researchers encouraged the women to practice at home, as well; participants logged their total weekly practice time.

Immediately after the active phase of the trial ended, the women in the yoga group reported, on average, a 41 per cent drop in fatigue and a 12 per cent higher vitality score compared to the non-yoga group. To gauge the participants’ inflammation levels, the scientists measured the activation of three proteins in the blood that are markers of inflammation — called pro-inflammatory cytokines.

They generated the protein activity by injecting a compound that stimulated an immune response. The proteins are interleukin-6 (IL-6), interleukin-1 beta (IL-1B) and tumor necrosis factor-alpha (TNF-a).

At the three-month point immediately after the yoga sessions ended, all three pro-inflammatory cytokine levels were lower, on average, in the yoga group compared to the non-yoga group: TNF-a by 10 per cent, IL-6 by 11 per cent and IL-1B by 15 per cent.

“We were really surprised by the data because some more recent studies on exercise have suggested that exercise interventions may not necessarily lower inflammation unless people are substantially overweight or have metabolic problems,” Kiecolt-Glaser said. “In this group, the women didn’t lose weight, but we saw really marked reductions in inflammation. So this was a particularly striking finding biologically.” Revisiting the participants again at the six-month point, three months after the intervention was complete, the researchers discovered that health measures in the yoga group had continued to improve in that window of time: Fatigue was 57 per cent lower and inflammation was between 13 and 20 per cent lower than the non-yoga group.

“We think improved sleep could be part of the mechanism of what we were seeing. When women were sleeping better, inflammation could have been lowered by that,” Kiecolt-Glaser said. “Reducing fatigue enables women to engage in other activities over time. So yoga may have offered a variety of benefits in addition to the yoga exercises themselves,” she added.

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