Longitudinal Impact of Yoga on Chemotherapy-Related Cognitive Impairment and Quality of Life in Women with Early Stage Breast Cancer: A Case Series

Richard Stockton College of NJ, Program in Physical Therapy, Pomona, NJ 08240, USA.
EXPLORE The Journal of Science and Healing (Impact Factor: 1). 03/2012; 8(2):127-35. DOI: 10.1016/j.explore.2011.12.001
Source: PubMed


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).
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.
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.
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.

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    • "significantly; for every 1 h of yoga practiced, the quality-of-life scores improved by a specific coefficient found for each subscale (e.g., depression, stress, physical component) Galantino et al., 2012 14 Pretest–post-test design; 4 women with early-stage breast cancer "
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    • "Evidence-Based Complementary and Alternative Medicine Table 3: Components of Yoga. West [USA, Europe, Australia, Brazil, and Turkey] Back pain Other pain CVD Cancer Total Percentage Postures 9 (Galantino 04, Jacobs 04, Williams 05, Sherman 05, Williams 09, Saper 09, Cox 10, Tilbrook 11, and Sherman 11) 6 (Carson 2011 (fibromyalgia), da Silva 2007 (fibromyalgia), Evans 2011 (IBS), Evans 2011 (rheumatoid arthritis), Garfinkel 1998 (carpal tunnel syndrome), and Kuttner 2007 (IBS)) 5 (Cade 2010, Cheema 2011, Pullen 2008, Pullen 2010, and van Montfrans 1990) 7 (Banasik 2011, Carson 2009, Cohen 2004, Culos-Reed 2006, Galantino 2012, Moadal 2007, and Ulger 2010) 27 96% Breathing 6 (Galantino 04, Sherman 05, Saper 09, Cox 10, Tilbrook 11, and Sherman 11) 3 (Carson 2011 (fibromyalgia), da Silva 2007 (fibromyalgia), and Kuttner 2007 (IBS)) 5 (Cade 2010, Cheema 2011, Pullen 2008, Pullen 2010, and van Montfrans 1990) 7 (Carson 2009, Cohen 2004, Culos-Reed 2006, Galantino 2012, Kovacic 2011, Moadal 2007, and Ulger 2010) 21 75% Relaxation 7 (Galantino 04, Jacobs 04, Sherman 05, Saper 09, Cox 10, Tilbrook 11, and Sherman 11) 2 (da Silva 2007 (fibromyalgia), Garfinkel 1998 (carpal tunnel syndrome)) 4 (Cade 2010, Pullen 2008, Pullen 2010, and van Montfrans 1990) 4 (Culos-Reed 2006, Galantino 2012, Kovacic 2011, and Ulger 2010) 17 61% "
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