Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial

Anand Dhruva, Christine Miaskowski, Donald Abrams, Michael Acree, Bruce Cooper, Steffanie Goodman, Frederick M Hecht, Anand Dhruva, Christine Miaskowski, Donald Abrams, Michael Acree, Bruce Cooper, Steffanie Goodman, Frederick M Hecht

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00982748.

Figures

FIG. 1.
FIG. 1.
Enrollment, patient flow, and attrition of the randomized controlled clinical trial.

References

    1. Bruera E. El Osta B. Valero V, et al. Donepezil for cancer fatigue: A double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2007;25:3475–3481.
    1. Bruera E. Valero V. Driver L, et al. Patient-controlled methylphenidate for cancer fatigue: A double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2006;24:2073–2078.
    1. Iyengar B. Light on Pranayama. London: Harper Collins; 1992.
    1. Mohan M. Saravanane C. Surange SG, et al. Effect of yoga type breathing on heart rate and cardiac axis of normal subjects. Indian J Physiol Pharmacol. 1986;30:334–340.
    1. Bhargava R. Gogate MG. Mascarenhas JF. Autonomic responses to breath holding and its variations following pranayama. Indian J Physiol Pharmacol. 1988;32:257–264.
    1. Singh V. Wisniewski A. Britton J. Tattersfield A. Effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma. Lancet. 1990;335:1381–1383.
    1. Telles S. Nagarathna R. Nagendra HR. Breathing through a particular nostril can alter metabolism and autonomic activities. Indian J Physiol Pharmacol. 1994;38:133–137.
    1. Bhattacharya S. Pandey US. Verma NS. Improvement in oxidative status with yogic breathing in young healthy males. Indian J Physiol Pharmacol. 2002;46:349–354.
    1. Pal GK. Velkumary S. Madanmohan Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res. 2004;120:115–121.
    1. Jovanov E. On spectral analysis of heart rate variability during very slow yogic Breathing. Conf Proc IEEE Eng Med Biol Soc. 2005;3:2467–2470.
    1. Upadhyay Dhungel K. Malhotra V. Sarkar D. Prajapati R. Effect of alternate nostril breathing exercise on cardiorespiratory functions. Nepal Med Coll J. 2008;10:25–27.
    1. Martarelli D. Cocchioni M. Scuri S. Pompei P. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evid Based Complement Altern Med. 2009;2011:1–10.
    1. Pramanik T. Sharma HO. Mishra S, et al. Immediate effect of slow pace bhastrika pranayama on blood pressure and heart rate. J Altern Complement Med. 2009;15:293–295.
    1. Saxena T. Saxena M. The effect of various breathing exercises (pranayama) in patients with bronchial asthma of mild to moderate severity. Int J Yoga. 2009;2:22–25.
    1. Vialatte FB. Bakardjian H. Prasad R. Cichocki A. EEG paroxysmal gamma waves during Bhramari Pranayama: A yoga breathing technique. Conscious Cogn. 2009;18:977–988.
    1. Pramanik T. Pudasaini B. Prajapati R. Immediate effect of a slow pace breathing exercise Bhramari pranayama on blood pressure and heart rate. Nepal Med Coll J. 2010;12:154–157.
    1. Banerjee B. Vadiraj HS. Ram A, et al. Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integr Cancer Ther. 2007;6:242–250.
    1. Carson JW. Carson KM. Porter LS, et al. Yoga for women with metastatic breast cancer: Results from a pilot study. J Pain Symptom Manage. 2007;33:331–341.
    1. Cohen L. Warneke C. Fouladi RT, et al. Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer. 2004;100:2253–2260.
    1. Culos-Reed SN. Carlson LE. Daroux LM. Hately-Aldous S. A pilot study of yoga for breast cancer survivors: Physical and psychological benefits. Psychooncology. 2006;15:891–897.
    1. Danhauer SC. Mihalko SL. Russell GB, et al. Restorative yoga for women with breast cancer: Findings from a randomized pilot study. Psychooncology. 2009;18:360–368.
    1. Danhauer SC. Tooze JA. Farmer DF, et al. Restorative yoga for women with ovarian or breast cancer: Findings from a pilot study. J Soc Integr Oncol. 2008;6:47–58.
    1. Moadel AB. Shah C. Wylie-Rosett J, et al. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: Effects on quality of life. J Clin Oncol. 2007;4:4.
    1. Raghavendra RM. Nagarathna R. Nagendra HR, et al. Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients. Eur J Cancer Care (Engl) 2007;16:462–474.
    1. Rao MR. Raghuram N. Nagendra HR, et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: A randomized controlled trial. Complement Ther Med. 2009;17:1–8.
    1. Vadiraja HS. Raghavendra RM. Nagarathna R, et al. Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: A randomized controlled trial. Integr Cancer Ther. 2009;8:37–46.
    1. Vadiraja HS. Rao MR. Nagarathna R, et al. Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: A randomized controlled trial. Complement Ther Med. 2009;17:274–280.
    1. Chandwani KD. Thornton B. Perkins GH, et al. Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol. 2010;8:43–55.
    1. Carson JW. Carson KM. Porter LS, et al. Yoga of Awareness program for menopausal symptoms in breast cancer survivors: Results from a randomized trial. Support Care Cancer. 2009;17:1301–1309.
    1. Smith KB. Pukall CF. An evidence-based review of yoga as a complementary intervention for patients with cancer. Psychooncology. 2009;18:465–475.
    1. Karnofsky D. Performance Scale. New York: Plenum Press; 1977.
    1. Piper BF. Dibble SL. Dodd MJ, et al. The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. Oncol Nurs Forum. 1998;25:677–684.
    1. Lee KA. Self-reported sleep disturbances in employed women. Sleep. 1992;15:493–498.
    1. Miaskowski C. Lee KA. Pain, fatigue, and sleep disturbances in oncology outpatients receiving radiation therapy for bone metastasis: A pilot study. J Pain Symptom Manage. 1999;17:320–332.
    1. Zigmond AS. Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–370.
    1. Herrmann C. International experiences with the Hospital Anxiety and Depression Scale: A review of validation data and clinical results. J Psychosom Res. 1997;42:17–41.
    1. Cohen S. Kamarck T. Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–396.
    1. Ware J., Jr Kosinski M. Keller SD. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–233.
    1. Prue G. Rankin J. Allen J, et al. Cancer-related fatigue: A critical appraisal. Eur J Cancer. 2006;42:846–863.
    1. Palesh OG. Roscoe JA. Mustian KM, et al. Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. J Clin Oncol. 2009;28:292–298.
    1. Moliver N. Mika E. Chartrand M, et al. Increased Hatha yoga experience predicts lower body mass index and reduced medication use in women over 45 years. Int J Yoga. 2011;4:77–86.
    1. Kim SD. Kim HS. Effects of a relaxation breathing exercise on fatigue in haemopoietic stem cell transplantation patients. J Clin Nurs. 2005;14:51–5.
    1. Kim SD. Kim HS. Effects of a relaxation breathing exercise on anxiety, depression, and leukocyte in hemopoietic stem cell transplantation patients. Cancer Nurs. 2005;28:79–83.

Source: PubMed

3
Předplatit