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A pilot study of yoga for breast cancer survivors: Physical and psychological benefits

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Abstract

Physical activity provides a number of physical and psychological benefits to cancer survivors, including lessening the impact of detrimental cancer-related symptoms and treatment side-effects (e.g. fatigue, nausea), and improving overall well-being and quality of life. The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer survivors. Eligible participants (per-screened with PAR-Q/PAR-MED-X) were randomly assigned to either the intervention (n=20) or control group (n=18). All participants completed pre- and post-testing assessments immediately before and after the yoga program, respectively. The yoga program participants (M age=51.18 (10.33); 92% female) included primarily breast cancer survivors, on average 55.95 (54.39) months post-diagnosis. Significant differences between the intervention and the control group at post-intervention were seen only in psychosocial (i.e. global quality of life, emotional function, and diarrhea) variables (all p's <0.05). There were also trends for group differences, in the hypothesized directions, for the psychosocial variables of emotional irritability, gastrointestinal symptoms, cognitive disorganization, mood disturbance, tension, depression, and confusion (all p's <0.10). Finally, there were also significant improvements in both the program participants and the controls from pre- to post-intervention on a number of physical fitness variables. These initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors. Future research might attempt to include a broader range of participants (e.g. other types of cancer diagnoses, male subjects), a larger sample size, and a longer program duration in an RCT.

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... The studies differed in geographical location, design, and type of clinical trial [ Table 1]. Sixteen articles was conducted in the United States, [27,28,31,33,[35][36][37]39,40,[42][43][44][45][46]48,51] three in Canada, [30,34,47] two in South Korea [32,53] and one in China, [41] Germany, [38] Iran, [26] Sweden, [29] England, [52] Turkey, [50] and India. [49] Eighteen studies from 28 included articles were randomized controlled trial (RCT). ...
... [49] Eighteen studies from 28 included articles were randomized controlled trial (RCT). [28,30,[33][34][35][36][37][38][39][41][42][43]45,[49][50][51][52][53] Study design in one study was non-RCT, [29] and two studies were quasi-experimental. [31,40] Another six articles benefited from other clinical trial designs. ...
... Moreover, 9 of the articles reported that they were pilot studies. [27,28,33,34,39,40,44,47,48] The total sample size of each study varied from 21 to 271 individuals. Fifteen studies had a sample size of 21-50, and 4 studies had a sample size of 51-100. ...
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Background: Breast cancer disease and its classic treatment lead to decrease in patients' quality of life (QOL). This systematic review aimed to compare the effectiveness of complementary and alternative medicines (CAMs) categories on the QOL of women with breast cancer. Methods: English clinical trials from PubMed, Emabase, Scupos, and Google Scholar databases were searched electronically by the end of 2018 with the Cochrane Collaboration protocol. Two researchers independently extracted data such as participants' characteristics, CAM methods, QOL assessment tools. CAMs were classified into three categories of dietary supplements, herbal medicine, and mind-body techniques. Results: During the initial search, 1186 articles were found. After reviewing titles, abstracts, and full texts based on inclusion and exclusion criteria, 28 clinical trials were included in the systematic review, 18 of which was randomized controlled trial (RCT). Participants included women with breast cancer who were undergoing the first three phases of breast cancer or postcancer rehabilitation. Among CAM interventions, one article used a dietary supplement, and the other 27 articles included a variety of mind-body techniques. Twenty-seven studies showed improved QOL (P > 0.05). Conclusion: The findings may indicate the potential benefits of CAMs, especially mind-body techniques on QOL in breast cancer patients. Further RCTs or long-term follow-up studies are recommended. Moreover, the use of similar QOL assessment tools allows for more meta-analysis and generalizability of results, especially for the development of clinical guidelines.
... Three studies' control group received no intervention. 24,30,45 Two studies' control group received supportive group psychotherapy. 46,47 And the other study's control group received therapeutic massage. ...
... Two studies reported dropout but did not give the reasons for dropouts. 43,45 Other studies gave the detailed reasons for dropouts. All studies were judged to be at low risk bias of selective reporting. ...
... A total of 17 studies explored the effects of spiritual care on QOL. Among them, 12 studies 27,30,31,38,39,[41][42][43][44][45]47,48 representing 1115 participants reported that spiritual care was significantly associated with improvement of QOL statistically and clinically. Zamaniyan et al. 30 conducted a study to evaluate the effectiveness of spiritual group therapy on QOL among patients with breast cancer. ...
Article
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Background: Terminal illness not only causes physical suffering but also spiritual distress. Spiritual care has been widely implemented by healthcare professionals to assist patients coping with spiritual distress. However, the effects of spiritual care need to be clear. Aim: To evaluate the effects of spiritual care on quality of life and spiritual well-being among patients with terminal illness. Design: Systematic review according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Data sources: A comprehensive search was conducted in nine electronic databases from date of inception to May 2017. Hand searches of the bibliographies of relevant articles were also performed. The studies were independently reviewed by two investigators who scored them for methodological quality using the Cochrane Risk of Bias Tool. Results: No statistical pooling of outcomes was performed and a narrative summary was chosen to describe the included studies. A total of 19 studies with 1548 participants were identified in the systematic review, corresponding to seven kinds of interventions. The risk of bias for these studies were all rated as moderate. A majority of studies indicated that spiritual care had a potential beneficial effect on quality of life and spiritual well-being among patients with terminal illness. Conclusion: It is suggested that healthcare professionals integrate spiritual care with usual care in palliative care. When providing spiritual care, healthcare professionals should take into consideration patients' spiritual needs, preference, and cultural background. More multicenter and disciplinary studies with rigorous designs are needed in the future.
... Parmi les onze études sélectionnées, on trouve 9 ECR ; quatre études comptaient toutefois des participants souffrant d'autres types de cancers, notamment de cancers hématologiques, gastro-intestinaux et gynécologiques, ainsi que des cancers de la prostate et du poumon (Culos-Reed et al., 2006;Janelsins et al., 2016;Oh et al., 2012;Reid-Arndt et al., 2012). L'efficacité des approches corps-esprit a été évaluée pendant (n = 5) ou après (n = 6) le traitement anticancéreux. ...
... Le nom des styles de yoga variait d'une étude à l'autre, mais trois parmi les plus connus étaient représentés : le hatha yoga (Derry et al., 2015), la combinaison du hatha yoga et du yoga restaurateur (Janelsins et al., 2016) et le yoga Iyengar (Lötzke et al., 2016). Parmi les autres types d'interventions se trouvaient divers éléments propres au yoga comme la relaxation, la méditation, la respiration profonde et les postures de faible intensité (Komatsu et al., 2016), les étirements combinés à des exercices de respiration, les étirements légers, et le renforcement musculaire ciblé (Culos-Reed et al., 2006;Pasyar et al., 2019;Vadiraja et al., 2009). Les programmes de yoga s'étalaient sur 4 à 12 semaines. ...
... Dans les sept études, la fonction cognitive était autoévaluée avant et après l'intervention. Pour six d'entre elles, les résultats ont été comparés à ceux d'un groupe témoin sur liste d'attente (Culos-Reed et al., 2006;Derry et al., 2015), à ceux de patients recevant les soins usuels (Janelsins et al., 2016;Pasyar et al., 2019) ou à ceux d'un groupe témoin actif (Lötzke et al., 2016;Vadiraja et al., 2009). Trois études ont recueilli des données supplémentaires un à deux mois (Pasyar et al., 2019) et trois mois (Derry et al., 2015;Lötzke et al., 2016) après l'intervention. ...
Article
Objectif: Plusieurs survivants du cancer souffrant de troubles cognitifs liés à la maladie se tournent vers des approches non pharmacologiques pour soulager leurs symptômes. La présente revue systématique avait pour objectif d’évaluer l’effet des « exercices corps-esprit » sur les fonctions cognitives des survivants du cancer. Devis de l’étude: Les bases de données PubMed, Embase, Scopus et Web of Science ont été interrogées afin de trouver des études pertinentes sur le sujet. L’échelle du Joanna Briggs Institute et l’échelle de Jadad ont servi à évaluer la qualité des études sélectionnées. Résultats: Onze études comptant 1 032 participants et publiées entre 2006 et 2019 ont été choisies pour la revue à partir de certains critères d’inclusion. Nos résultats indiquent que les activités comme le yoga, le tai-chi et le qi gong peuvent améliorer de manière objective et subjective la fonction cognitive des survivants du cancer. Conclusion: Les survivants du cancer qui présentent des symptômes cognitifs peuvent bénéficier d’exercices agissant sur le corps et l’esprit. Il faudra cependant mener des essais contrôlés randomisés ayant la puissance statistique nécessaire pour établir les effets à court et à long terme de ce type d’exercices sur les facultés cognitives.
... QOL measures varied but commonly included cancer-specific measures, such as the Functional Assessment of Cancer Therapy (FACT) and European Organization for Research and Treatment of Cancer questionnaires. Of the 5 studies that examined QOL, 4 reported between-group improvements in various domains (global QOL, 46 emotional function [n = 2], 46,60 decreased diarrhea, 46 QOL subscale of symptoms, 58 FACT-Breast QOL total, 60 social. 60 and functional well being), 60 although 1 study (which examined breast cancer-related QOL) was limited to a subgroup analysis based on attendance. ...
... QOL measures varied but commonly included cancer-specific measures, such as the Functional Assessment of Cancer Therapy (FACT) and European Organization for Research and Treatment of Cancer questionnaires. Of the 5 studies that examined QOL, 4 reported between-group improvements in various domains (global QOL, 46 emotional function [n = 2], 46,60 decreased diarrhea, 46 QOL subscale of symptoms, 58 FACT-Breast QOL total, 60 social. 60 and functional well being), 60 although 1 study (which examined breast cancer-related QOL) was limited to a subgroup analysis based on attendance. ...
... 60 and functional well being), 60 although 1 study (which examined breast cancer-related QOL) was limited to a subgroup analysis based on attendance. 23 Of those 5 studies, nonsignificant findings also were reported for several QOL domains, including physical well being 48,49 or function, 46 social well being 48,49 or function, 46 emotional well being, 48,49 cognitive function, 46 role function, 46 and functional well being. 48,49 Finally, a range of additional outcomes improved after yoga, including cognition (eg, memory difficulties, cognitive disorganization, cognitive complaints), lymphedema, vitality/vigor, and biomarkers (eg, inflammation, stress/cortisol). ...
Article
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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. Randomized controlled trials conducted both during and after cancer treatment provide evidence for the efficacy of yoga to improve quality of life and fatigue. Yoga has potential to improve additional cancer‐related symptoms (eg, sleep, depression, anxiety, distress, cognition) and biomarkers of stress and inflammation/immunity, but further research is needed.
... The 11 selected studies were nine RCTs (Culos-Reed et al., 2006;Derry et al., 2015;Janelsins et al., 2016;Larkey et al., 2016;Lötzke et al., 2016;Myers et al., 2019;Oh et al., 2012;Pasyar et al., 2019;Vadiraja et al., 2009), one feasibility study (Komatsu et al., 2016), and one single-arm pilot study (Reid-Arndt et al., 2012) (Table 2). These 11 studies involved 1,032 cancer survivors, were published between 2006 and 2019, and were conducted primarily in the USA (n = 5). ...
... These included: Hatha Yoga (Derry et al., 2015), Combination Hatha and Restorative Yoga (Janelsins et al., 2016), and Iyengar-yoga (Lötzke et al., 2016). The remaining yoga interventions involved combinations of yoga elements, including: relaxation, meditation, deep breathing, and low-intensity postures (Komatsu et al., 2016), stretching and breathing exercises, gentle stretching and strengthening exercises of specific muscle groups (Culos-Reed et al., 2006;Pasyar et al., 2019;Vadiraja et al., 2009). Yoga programs ranged from 4 to 12 weeks in duration. ...
... One was supported by an educational DVD (Pasyar et al., 2019). All seven studies assessed cognitive function via self-report at baseline and post-intervention, with six comparing outcomes to either a waitlist control (Culos-Reed et al., 2006;Derry et al., 2015), standard of care (Janelsins et al., 2016;Pasyar et al., 2019), or active control group (Lötzke et al., 2016;Vadiraja et al., 2009). Three studies collected additional follow-up at one to two months (Pasyar et al., 2019) and three months (Derry et al., 2015;Lötzke et al., 2016) after the intervention. ...
Article
Objective: Cancer-related cognitive impairments experienced by cancer survivors cause many to seek non-pharmacological intereventions to manage these symptoms. The aim of this systematic review was to evaluate the effects of one such intervention, mindbody exercise (MBE), on cognitive function in cancer survivors. Design: Searches for relevant studies were conducted in four electronic databases, including PubMed, Embase, Scopus, and Web of Science. The Joanna Briggs Institute and Jadad scales were utilized to evaluate the quality of the selected studies. Results: Eleven studies including 1,032 participants, published between 2006 and 2019, were selected for review based on specific inclusion criteria. Our results indicated that interventions including, yoga, tai chi, and qigong may improve objective and subjective cognitive function in cancer survivors. Conclusion: Cancer survivors experiencing cognitive symptoms may benefit from participation in MBE. Adequately powered randomized controlled trials are required to establish the short- and long-term effects of MBE on cognitive functioning.
... Since the first published research articles evaluating the benefits of a support group therapy, [18] several researchers have used mind-body techniques, such as yoga, in combination with conventional treatment and seen a plethora of benefits in cancer care. Yoga-based lifestyle changes have been studied for their beneficial effects on cancer-related symptoms, morbidities, [19] immune functioning, [20,21] treatment adherence, [22] psychological profiles (anxiety, depressions, and stress), and QoL. [23,24] Among survivors practicing yoga, enhanced QoL, [25] fatigue, [26] sleep, [27] depression, other psychological measures, [28] and restoration of menopausal health has also been observed. ...
... [23,24] Among survivors practicing yoga, enhanced QoL, [25] fatigue, [26] sleep, [27] depression, other psychological measures, [28] and restoration of menopausal health has also been observed. [19,29] Yoga, a more popular of the CAM modalities, opted for by cancer survivors, is defined as the willful mastery over the modifications of the mind. [30] Yoga defines the human system as comprising five personalities, [31] that is, the physical, the vital energy, the mind, the intellect, and the existential happiness. ...
Article
Aim: Breast cancer has become a pandemic with an ever-increasing incidence. Although better diagnostics and treatment modalities have reduced mortality, a large number of survivors face cancer and treatment-related long-term symptoms. Many survivors are taking up yoga for improving the quality of life (QoL). The present study attempts to evaluate predictors of psychological states in breast cancer survivors with long-term yoga experience. Materials and Methods: A case-control study recruited early breast cancer survivors, 30–65 years, completing treatment > 6 months before recruitment, and grouped them based on prior yoga experience (BCY, n = 27) or naïve (BCN, n = 25). Demography, cancer history, diet, exercise habits, and yoga schedule were collected and tools to assess stress, anxiety, depression, general health, and QoL were administered. Multivariate linear regression was done to identify predictors of psychological variables. Results: BCY had significantly lower stress, anxiety, depression, better general health, and QoL (P < 0.001). Global QoL and trait anxiety were significantly predicted by Yoga practice; depression was predicted by yoga practice, annual income, and sleep quality; state anxiety was predicted by Yoga practice and income, and stress was predicted by Yoga practice and sleep quality. Conclusion: Results indicate that breast cancer survivors, doing yoga, have better psychological profiles and are able to deal with demanding situations better. The psycho-oncogenic model of cancer etiology suggests that a better psychological state in survival has the potential to improve prognosis and survival outcomes and Yoga may be a suitable practice for staying cancer-free for a longer time. Keywords: Anxiety and depression, breast cancer survivors, perceived stress, quality of life, Yoga
... Even compared to a supportive or psychoeducative group of patients with fatigue, yoga therapy showed significant effects . However, there are also contradictory findings that do not support significant differences in fatigue symptoms through yoga intervention compared to a control group (Chandwani et al., 2010;Culos-Reed et al., 2006;Moadel et al., 2007). ...
... Many yoga studies included only "cancer survivors" in their sample, patients who had already successfully completed cancer therapy (Banasik et al., 2011;Culos-Reed et al., 2006;Kiecolt-Glaser et al., 2014;Littman et al., 2012;Mustian, 2013;Peppone et al., 2015). Fatigue was not even considered as an inclusion criterion and the yoga therapies were thus not specifically designed for patients with fatigue. ...
Thesis
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The incidence of cancer cases is rising steadily, while improved early detection and new cancer-specific therapies are reducing the mortality rate. In addition to curing cancer or prolonging life, increasing the quality of life is thus an important goal of oncology, which is why the burdens of cancer and treatment are becoming more important. A common side effect of cancer and its therapy is cancer-related fatigue, a tiredness that manifests itself on physical, emotional and cognitive levels and is not in proportion to previous physical efforts. Since the etiology of fatigue has not yet been fully clarified, symptom-oriented therapy is preferable to cause-specific therapy. In addition to activity management, sleep hygiene, and cognitive behavioral therapy, mind-body interventions such as yoga are recommended for reducing fatigue. Previous studies with small sample sizes were able to examine the efficacy of yoga regarding fatigue predominantly in patients with breast cancer. Long-term effects of yoga have rarely been studied and there have been no attempts to increase long-term effects through interventions such as reminder e-mails. This dissertation takes a closer look at these mentioned aspects of the study sample and long-term effects. An 8-week randomized controlled yoga intervention was conducted, including patients with different cancer types reporting mild to severe fatigue. Following the 8-week yoga therapy, a randomized group of participants received weekly reminder e-mails for 6 months for regular yoga practice, whereas the control group did not receive reminder e-mails. The first paper is a protocol article, which addresses the design and planned implementation of the research project this dissertation is based upon. This serves to ensure better replicability and comparability with other yoga studies. Due to a very low consent rate of patients in the pilot phase, it was necessary to deviate from the protocol article in the actual implementation and the planned inclusion criterion of fatigue >5 was reduced to fatigue >1. The second paper examines the efficacy of the eight-week yoga intervention. Patients in the intervention group who participated in the yoga classes seven times or more showed a significantly greater reduction in general and physical fatigue than those who participated less often. The efficacy of yoga was related to the number of attended yoga sessions. Women with breast cancer who participated in yoga reported greater reductions in fatigue than women with other cancer types. There was also an improvement for depression and quality of life after eight weeks of yoga therapy compared to no yoga therapy. These results imply that yoga is helpful in reducing depression and cancer-related fatigue, especially in terms of physical aspects and improving quality of life. The third paper focuses on the efficacy of reminder e-mails in terms of fatigue and practice frequency. Patients who received reminder e-mails reported greater reductions in general and emotional fatigue, as well as significant increases in practice frequency, compared to patients who did not receive reminder e-mails. Compared to fatigue scores before yoga, significantly lower fatigue and depression scores and higher quality of life were reported after yoga therapy and at follow-up six months later. Weekly e-mail reminders after yoga therapy may have positive effects on general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher improvement in physical fatigue as found in Paper 2. This may indicate other factors that influence the efficacy of yoga practice on physical fatigue, such as mindfulness or side effects of therapy. This research project provides insight into the efficacy of yoga therapy for oncology patients with fatigue. It is important that such interventions be offered early, while fatigue symptoms are not too severe. Regular guided yoga practice can reduce physical fatigue, but subsequent yoga practice at home does not further reduce physical fatigue. Reminder emails after completed yoga therapy could only reduce patients' emotional fatigue. It may be that physical fatigue was reduced as much as possible by the previous yoga therapy and that there was a floor effect, or it may be that reminder emails are not suitable as an intervention to reduce physical fatigue at all. Further research is needed to examine the mechanisms of the different interventions in more detail and to find appropriate interventions that reduce all levels of fatigue equally.
... These include cognitive rehabilitation strategies [14][15][16][17][18] and those targeting factors associated with cognitive function, such as fatigue [19][20][21][22], stress [23,24], or physical activity [25][26][27][28]. Overall, cognitive rehabilitation strategies were successful in improving some subjective and objective aspects of cognitive performance, but required significant time commitments ranging from four [17,18] to 12 weeks [29]. ...
... Studies aimed at improving cognition by reducing fatigue showed no changes to objective performance, whether administering dmethylphenidate [20,22] or delivering cognitive behavioral therapy [19]. There were also no changes in objective cognitive performance by reducing stress with meditation [30], and concomitantly increasing physical activity with yoga [27,28], or medical qigong [25]. ...
Article
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Background A significant subset of breast cancer survivors experience cognitive difficulties in attention and memory, which persist for years following treatment. Transcranial direct current stimulation (tDCS) has been shown to be effective in improving working memory, attention, processing speed, and other cognitive functions in both healthy and clinical populations. To date, no studies have examined tDCS in rehabilitation of cancer-related cognitive dysfunction. Objective/Hypothesis We aimed to provide preliminary evidence for feasibility, tolerability, acceptability, and efficacy of tDCS in improving performance on a measure of sustained attention. Methods In a within-subjects design, 16 breast cancer survivors underwent 2 consecutive days of active tDCS over the prefrontal cortex, and 2 days of sham tDCS, counterbalanced for order of stimulation condition, while performing a continuous performance test. Results Stimulation was feasible and tolerable, with 89% of participants completing all sessions, and none reporting more than mild to moderate discomfort. Analyses of efficacy showed that during active stimulation, participants had significantly lower standard errors of reaction times overall, indicating better sustained attention ability, as compared to sham stimulation (p<0.05). Furthermore, the effect of stimulation on standard errors of reaction times differed by inter-stimulus interval (ISI): for 1 and 2 second ISIs, there was no significant difference in performance between sham and active tDCS conditions, but for 4 second ISIs, stimulation improved variability in response times relative to sham (p<0.05). Conclusions Results suggest that tDCS is feasible, tolerable, and may be an effective intervention to improve sustained attention difficulties in survivors with cancer-related cognitive dysfunction.
... There is a growing body of research that emphasizes the important role of different interventions in reducing postmastectomy pain: healing touch [14,15], hypnosis [7], yoga exercises [16][17][18][19][20], integrative therapies [21,22] for treating breast cancer-related pain and lymphoedema. ...
... our study supports the findings that progressive muscle relaxation is an effective tool to reduce pain [35] and yoga is really important for women's health [36]. The majority of previous studies focused on the effects of yoga on reducing fatigue, depression, sleep disturbances, and poor quality of life in patients with breast cancer [16,[18][19][20]24]. our data agree with the considerable body of research that recommends regular physical exercises as an effective tool for reducing breast cancer treatment-related pain complications, fatigue, stress, and depression, as well as improving life quality in patients with breast cancer [16,17,21]. The results from this study indicate that special yoga exercises enhanced by progressive muscular relaxation and visualization exercises are effective on pain in women after breast cancer surgery. ...
... Finally, 26 articles that met our study's criteria were included in the systematic review. Of these, articles with no information on exercise frequency [18][19][20][21], time of session [22][23][24][25], and with wide ranges in the time of session [26,27] were excluded. Finally, 16 studies possessing sufficient information regarding exercise characteristics and clinical outcomes were included in the meta-analysis. ...
... The number of patients in the trials (exercise and control) ranged from 16 to 220, and their cancer stages were from 0 to IV. For the systematic review, the included studies had conducted various types of exercise interventions, including aerobic exercise [24,25,[27][28][29][30][31][32][33], resistance exercise [33][34][35][36], a combination of both [18,22,23,[37][38][39][40], yoga [19][20][21]41,42], and Qigong [26,43]. The details of the patients and exercise characteristics are presented in Table 1. ...
Article
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This study examined the effects of exercise intervention on the quality of life (QoL), social functioning (SF), and physical functioning (PF) of breast cancer survivors, and identified the responsible and optimal exercise characteristics for amelioration of outcomes. Randomized controlled trials (RCTs) that adopted exercise intervention and measured the QoL, SF, and PF of breast cancer patients were included. We used meta-analysis to calculate the pooled effect, and meta-regression to identify the responsible exercise characteristics (type, frequency, duration, and time). Subgroup analysis assessed the optimal “time of session” for an improved QoL. The Cochrane risk-of-bias tool was used to determine the quality of studies. In the systematic review, we included 26 RCTs with a total of 1892 breast cancer patients, whilst 18 trials were considered for meta-analysis (exercise = 602; control = 603). The pooled effect showed that exercise intervention substantially improved the QoL (standardized mean difference (SMD) = 0.35; I2 = 61%; 95% confidence internal (CI): 0.15–0.54; p = 0.0004), SF (SMD = 0.20; I2 = 16%; 95% CI:0.08–0.32; p = 0.001), and PF (SMD = 0.32; I2 = 32%; 95% CI:0.20–0.44; p < 0.00001). Meta-regression analysis showed that improved QoL was associated (p = 0.041) with the “time of session”. More specifically, sessions conducted for medium-time (>45 to ≤60 min; p = 0.03) and longer-time (>60 to 90 min; p = 0.005) considerably improved the QoL, whilst shorter-time (≤45 min; p = 0.15) did not. To summarize, exercise interventions improved the QoL, SF, and PF of breast cancer survivors, where the “time of session” appeared to be crucial for an effective improvement in the QoL.
... The practice of yoga is therapeutically unique in that it conjointly emphasizes body, mind, and spirit, which may be particularly useful for enhancing patients' social and spiritual well-being 12 . Some studies have reported the effectiveness of Yoga, meditation and mindfulness as a rehabilitative and palliative therapy in various types of cancer [13][14][15][16][17][18][19][20][21] . ...
... Given that a majority of patients end up depressed after completing modern anti-cancer therapy, we used standard tools such as WHO Quality of Life, Hospital Anxiety and Depression Score (HADS) and Profile of Mood States (POMS). These are standardized tools that enable us to document the state of mind, levels of anxiety and depression and understand the subjective feelings of our participants both before and after the program 12,15,16,18,19 . Such tools are used regularly in both in-patient and out-patient scenarios to understand psychological affect of different treatment modalities and hence their application gives us a hard core scientific understanding of the subjective changes in our participants. ...
... Physical exercises are considered as the basis for the treatment of post-mastectomy pain syndrome and they are an integral part of physical rehabilitation. Many reports have shown the effectiveness of acupuncture [11,12], yoga exer-cises [13][14][15][16][17], Pilates-based exercises [18][19][20], and hydrotherapy [21] in the treatment of breast cancer-related pain and lymphedema. The results of several randomized controlled trials suggest that yoga may be a useful practice for normalization of the psycho-emotional state, as well as anxiety and depression reduction in women with post-mastectomy syndrome [13,15]. ...
... The quality of pain was evaluated by selecting from 78 descriptors in 20 subclasses. in addition, the qualitative data consisted of 78 descriptors that characterized pain in 3 directions: sensory pain (word groups 1-10, [17][18][19], described in terms of temporal, pressure-related, spatial, and other properties; affective pain (word groups [11][12][13][14][15]20), described in terms of tension; and cognitive pain (word groups 16,20), described as the total estimation of pain. Also, the women pointed out the pain location in their bodies [24]. ...
Article
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Introduction. The aim of the study was to determine the effectiveness of individualized physical rehabilitation programs targeted at reducing post-mastectomy pain in breast cancer survivors. Methods. overall, 115 women with post-mastectomy pain were enrolled. The subjects had undergone surgical treatment and adjuvant radiation therapy for breast cancer. They were randomly assigned for the first (group A, n = 45), second (group B, n = 40), and third individualized physical rehabilitation program (group C, n = 30). The first program included aqua aerobics (aqua jogging, aqua building, aqua stretching), conditional swimming, and recreational aerobics; the second program included conditional swimming and Pilates exercises; the third program included yoga-based exercises and stretching. All participants received 140 sessions of rehabilitation intervention during the year and were evaluated at the beginning of the study, at 6, and at 12 months. Results. it was observed that most of the investigated pain characteristics in all studied groups steadily improved during the year of rehabilitation. After 6 months of rehabilitation, the average value of cognitive quality of pain was statistically higher in group C compared with group A by 0.43 points (p < 0.01). Conclusions. The findings suggest that the first individualized physical rehabilitation program brought about the greatest pain reduction in the affected breast and upper extremity in breast cancer survivors of the studied groups.
... Overall, the results indicate that yoga practice had a positive impact on mood, quality of life and stress within the intervention group compared to the control group. Even with such limitations, it appears that yoga offers a promising alternative choice as a physical activity for cancer survivors, promoting a number of similar psychological benefits that have been previously highlighted in the physical activity and cancer literature [23]. ...
... The pelvis is in a neutral position, and arms are abducted with palms facing toward the ceiling; 10-60min}a series of 6-10 modified Yoga asanas which are comprised of gentle stretching and strengthening exercises of specific groups of muscle, tendons and ligaments inside of the participant's pain-free zone (these asanas changed over the course of 7 weeks as participants' flexibility and strength improved); 60-75 min}shevasana or relaxation (corpse pose). As a distinct entity from the previous 60 min, the body is in a supine position with legs slightly abducted or with knees in flexion with the plantar side of the feet placed on the floor, arms slightly abducted, palms up.The student focuses attention on breathing and on the internal sensations of the body[23]. ...
... In recent years, mind-body approaches such as yoga, acupuncture, and meditation have been commonly studied in adult cancer populations for management of CRF [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116]. Some studies evaluated the effects of yoga on CRF in patients with cancer receiving chemotherapy or radiotherapy [105,108,109,111,113,114]; others investigated the efficacy of yoga on CRF in cancer survivors after the completion of cancer treatment [101-104, 106, 107, 109-112, 115, 116]. ...
... Eight studies showed that yoga significantly reduced CRF at the end or months after the intervention has been completed compared to the control group, which was usual cancer care [101,104,106,115,116] or a health education intervention [102,103,114]. However, six studies did not find a group difference for the effects of the mindbody intervention on CRF [108][109][110][111][112][113]. These studies are heterogeneous in terms of the type, duration, intensity, frequency, and length of the yoga intervention. ...
... The trial by Lotzke et al. [31] was methodologically sound but suffered from high attrition (59%) and thus was rated as "fair." Two studies [30,32] were small pilot RCTs and were also rated as "fair." The study by Bragard et al. [35•] was an underpowered, non-randomized study with several unmet criteria on the NIH Quality Assessment Tool and, therefore, received a rating of "poor." ...
... Three studies of "fair" or "poor" quality showed nonsignificant results, but patterns of change supported improvements in cancer-related cognitive impairment (CRCI) after the yoga program. Culos-Reed et al. [30] evaluated the physical and psychological benefits of a modified hatha yoga program (70-min sessions; once weekly; 7 weeks) in 38 cancer survivors (85% breast cancer). The average score for cognitive disorganization at baseline was 3.2 on a 5-point scale, with zero being never and five being frequently. ...
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Purpose of review: To summarize and evaluate evidence available on the effects of yoga on cancer-associated cognitive decline (CACD). Recent findings: A systematic review was conducted using four databases of articles published before January 1, 2020. Ten articles met the inclusion criteria (six randomized controlled trials, two single-arm studies, one non-randomized controlled trial, and one case series study). Studies were predominantly conducted with breast cancer patients using low-intensity hatha yoga programs. Of the 10 articles, five reported some positive effects on CACD, but significant biases were possible due to design shortcomings. Cohen's d effect sizes ranged from |0.03| to |0.74|. The evidence to date is insufficient to suggest that yoga is beneficial for attenuating CACD. More rigorous trials controlling for non-specific factors are warranted. The field would also benefit from examining self-delivered modes of yoga for treating CACD in various cancer populations to enhance practice sustainability and generalizability.
... Even compared to a supportive or psychoeducative group of patients with fatigue, yoga therapy showed significant effects [16]. However, there are also contradictory findings that do not support significant differences in fatigue symptoms through yoga intervention compared to a control group [17][18][19]. ...
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Background: Almost 90% of cancer patients suffer from symptoms of fatigue during treatment. Supporting treatments are increasingly used to alleviate the burden of fatigue. This study examines the short-term and long-term effects of yoga on fatigue and the effect of weekly reminder e-mails on exercise frequency and fatigue symptoms. Methods: The aim of the first part of the study will evaluate the effectiveness of yoga for cancer patients with mixed diagnoses reporting fatigue. We will randomly allocate 128 patients to an intervention group (N = 64) receiving yoga and a wait-list control group (N = 64) receiving yoga 9 weeks later. The yoga therapy will be performed in weekly sessions of 60 min each for 8 weeks. The primary outcome will be self-reported fatigue symptoms. In the second part of the study, the effectiveness of reminder e-mails with regard to the exercise frequency and self-reported fatigue symptoms will be evaluated. A randomized allocated group of the participants ("email") receives weekly reminder e-mails, the other group does not. Data will be assessed using questionnaires the beginning and after yoga therapy as well as after 6 months. Discussion: Support of patients suffering from fatigue is an important goal in cancer patients care. If yoga therapy will reduce fatigue, this type of therapy may be introduced into routine practice. If the reminder e-mails prove to be helpful, new offers for patients may also develop from this. Trial registration: German Clincial Trials Register ( DRKS00016034 , 12/2018), retrospectively registered.
... 15,16 To do this, randomized control trials have prescribed various modes and doses of exercise for breast cancer survivors that varied from strength exercises and light physical activities (e.g., yoga) to vigorous intensity resistance and aerobic training (e.g., walking and dance). [17][18][19] The intensity of exercises, generally, varied from one to five times a week and the duration of the activities varied from 20 to 60 minutes. 17 Despite the benefits of physical activities among cancer survivors, having regular physical activity has been a challenge for cancer survivors. ...
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Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence) orientations, exercise motivation, and psychological well-being of breast cancer survivors. Method: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) were measured at baseline and post-intervention sessions. Results: As excepted, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The exercise motivation did not significantly differ between the two conditions. Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.
... Yoga is a meditative movement therapy that improves body conditioning, flexibility, and balance through mind-body awareness. A myriad of pilot and feasibility studies suggest that yoga may help improve quality of life (7)(8)(9)(10)(11)(12)(13), anxiety (9,(14)(15)(16), depression (8,9,14-18), fatigue (13,(17)(18)(19)(20), and functional outcomes (13,21,22) in breast cancer patients and survivors who received chemotherapy (23). Although CIPN can substantially impact function and increase the risk of falls among cancer patients, only 2 small single arm (N ¼ 10) and randomized controlled studies (N ¼ 26, randomized to yoga, Reiki, meditation, or educational control) have evaluated the effects of yoga on improving CIPN symptoms and reducing CIPN-related falls in cancer patients (24,25). ...
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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 ≥4 (0-10 Numeric Rating Scale (NRS)) for ≥3 months after chemotherapy to eight 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 eight. 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 randomized 41 participants into yoga (N = 21) or usual care (N = 20). At week eight, 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.
... Women with breast cancer are exposed to stress related to the diagnosis, treatment and prognosis of the disease, and these are factors that affect the quality of life (QoL) 1 3 (Björneklett et al. 2012;Svensk et al. 2009). It is usual that the patients' physical conditions get worst, but also the psychological status, as the body image and low selfesteem may influence tiredness and sexual dysfunction (Culos-Reed et al. 2006;Carpenter et al. 2004;Savard et al. 2004). Duijts et al. (2011) conducted a meta-analysis to assess the effects of psycho-behavioral interventions and exercises for tiredness, depression, anxiety, body image and QoL in patients who went through breast cancer treatment. ...
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The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.
... One concern is that despite the reported efficacy of particular CAM practices, they are not often accessible to all populations. For instance, insurance companies often do not cover the costs of interventions that use Eastern approaches because they are not considered medical necessities even though studies have shown mindfulness meditation and group prayer in recovery programs and cancer treatment programs have resulted in positive effects (Kissman & Maurer, 2002;Nahin, Barnes, & Stussman, 2016;Nicole Culos-Reed, Carlson, Daroux, & Hately-Aldous, 2006). Therefore, only individuals who can afford the cost of such programs can experience any potential benefits (Nahin et al., 2016). ...
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This research is a qualitative case study of the perspectives and behaviors of individuals in the practice of sound bathing. Sound bathing is a recently popular Eastern health and wellness practice in which a group of reposed attendees are induced into meditation and introspection through the sonic experience and vibrations of percussion instruments played by professional practitioners. Because of the rising demand for holistic health and wellness options, including the growth of integrated an Eastern and Western healthcare approach, research on why individuals participate in and how they interpret specific Eastern practices can offer insight into trends disrupting the health and wellness-consumer landscape. Through evidence from interviews and observations, I argue that individuals maintain a holistic view of health and wellness that focuses on proactive self-care. However, due to perceived limitations in many options, participants have become seekers attempting to address and balance multiple dimensions of health and health. This holistic framework coupled with the sacred atmosphere of a sound bath creates a practice that individuals perceive as ideal to attending to their unmet needs. My findings add to the body of knowledge about how and why individuals participate in Eastern practices and can be applied in a number of settings including how to approach future studies of the integrated health and wellness model.
... Given that a majority of patients end up depressed after completing modern anti-cancer therapy, we used standard tools such as WHO Quality of Life, Hospital Anxiety and Depression Score (HADS) and Profile of Mood States (POMS). These are standardized tools that enable us to document the state of mind, levels of anxiety and depression and understand the subjective feelings of our participants both before and after the program 12,15,16,18,19 . Such tools are used regularly in both in-patient and out-patient scenarios to understand psychological affect of different treatment modalities and hence their application gives us a hard core scientific understanding of the subjective changes in our participants. ...
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This is a small introduction to our 3 week residential program for cancer patients to empower them in their journey, “back to health”. The curriculum was geared specifically for those who had undergone chemotherapy and/or radiation, and the program utilized the life-sciences of Yoga with a healthy dose of self-education to assist patients in their recovery from the devastation of cancer and its modern treatment. The first of these programs was held in 2013 at Kaivalyadhama Yoga Institute in Lonavla, India. The biggest benefit of the program lies in the empowerment of the participants. They are given the yogic tools, which make them feel in control of their health and wellbeing. They arrive with long drawn faces, often with a lot of pain and suffering. In the3 weeks of the program their faces slowly light up, the moods change and their outlook on life becomes optimistic. They leave as different people with new, health enhancing attitudes and often new values. The advantage of such program is that in most cases it is very effective and with proper training of yoga teachers it can be conducted in any medical facility, which has an in-patients department. The program is completely transferable and adaptable to any setting providing the patients stay at the facility continuously for 3 weeks, have common space in which the group can perform group activities 4 – 6 hrs per day. It is our hope that soon such healing programs will be available at every facility dealing with cancer patients.
... A systematic review and meta-analysis were performed of such RCTs comparing yoga (led by yoga instructors) to a control group who were wait-listed or on supportive therapy with education, counselling, or coping preparation. The outcomes of the RCTs on physical and psychological well-being are presented in Table 2 [49][50][51][52][53][54][55][56][57][58][59][60][61]. Despite the reasonably high methodological quality of the majority of the studies, the authors of the systematic review could not come to a definite conclusion on the benefit of yoga. ...
Article
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Breast cancer is the most frequently diagnosed cancer among women in both transitioned and transitioning countries and has become a major women’s health problem. Although recent advances in our understanding of the biological nature of cancer, improved awareness coupled with better early detection facilities, use of chemotherapy, hormone therapy, and targeted therapy have significantly improved survival from cancer, there are many gaps in providing individual-centric, holistic care. Integrative medicine refers to the use of traditional medicine alongside conventional preventive or therapeutic interventions (allopathic medicine) as a comprehensive, individual-centered, evidence-based care. The three pillars of complementary medicine (lifestyle modifications, mind–body practices, and use of natural products) have the potential for cancer prevention and improving quality-of-life and even treatment response in cancer patients when combined with conventional oncology care. Therefore, continued research into integrative therapies is required to extend the benefits to a broader patient population and improve outcomes in breast and other common cancers. In the present review article, the possible role of integrative medicine across the breast cancer care continuum has been discussed along with the concept of integrating complementary practices into mainstream health delivery. We have focused on breast cancer as a model cancer that is well amenable to prevention, early detection and stage appropriate treatment. However, our observations are pertinent for other common cancers, for which there are several opportunities for improving the continuum of care, especially in developing countries like India.
... The Borg Rating of Perceived Exertion Scale [46] was completed by participants in the intervention group to measure the intensity of walking exercises. Subjective measures of perceived exertion are often measured using the RPE in this population [67][68][69][70]. The scale asked participants to rate how hard they feel their bodies are working based on the physical sensations they experience, including increased heart rate, breathing rate and sweating. ...
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Background Cancer related cognitive impairments have been subjectively reported and objectively detected in breast cancer patients treated with chemotherapy and are known to have a profound negative impact on productivity, psychosocial well-being and overall quality of life. Moderate levels of walking are known to be of benefit to the psychosocial well-being of those affected by breast cancer and for managing cognitive impairment in healthy adults, children, and the elderly. The purpose of this study is to investigate the effects of a home-based, self-managed, moderate intensity walking intervention on subjective and objective cognitive functioning in breast cancer patients undergoing chemotherapy. Methods A home-based, self-managed intervention that consisted of moderate levels of walking was compared to usual care among breast cancer patients treated with chemotherapy in a randomised controlled trial. Outcome measures included changes in subjective (CFQ) and objectively detected cognitive functioning (Stroop, SART and two subscales from the WAIS- Digit Span and Block Design). Fifty participants were randomised to either the intervention group (n = 25), who completed 12 weeks of moderate intensity walking, or to the control group (n = 25) mid-way through chemotherapy. Results Compared with the control group, the self-managed walking intervention had positive effects on perceived cognitive function but not on sustained attention, executive function, memory or visual spatial skills when assessed objectively using neuropsychological measures. Conclusion This home-based, self-managed intervention is beneficial for protecting against perceived cognitive decline in breast cancer patients treated with chemotherapy. There is a need for further research to objectively assess cognitive decline within this population with larger sample sizes of patients. Trial registration Current Controlled Trials ISRCTN50709297
... Yoga was long studied primarily as a medical therapy that treats physical pain [1,2] and illness [3,4], as well as mental anxiety [5,6] and depression [7,8], enhancing the sustainability of personal lives in terms of both physical wellness and mental happiness. However, yoga is seldom investigated as a leisure service or business [9][10][11][12], which affects the sustainability of consumers' personal lives by fulfilling their motivation and triggering their satisfaction [13][14][15][16]. ...
Article
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Understanding the motivation and satisfaction of yoga consumers is of critical importance for both leisure service providers and leisure researchers to enhance the sustainability of personal lives in terms of physical wellness and mental happiness. For this purpose, this study investigated 25,120 pairs of online ratings and reviews from 100 yoga centres in Shanghai, China using latent Dirichlet allocation (LDA)-based text mining, and successfully established the relationship between rating and review. Findings suggest that Chinese yogis are motivated by improving physical condition, improving psychological condition, gracing appearance, establishing social connection, and creating social isolation. In addition to teaching mainstream yoga, yoga centres also provide additional courses. From a consumer perspective, yogis are relatively satisfied with teachers, courses, and the environment, but complain about the supporting staff, membership price, and reservation service. Managerially, yoga centres are encouraged to continue attending to the motivations of yogis, specialising their guidance, and fostering strengths and circumventing weaknesses in their service. This study also contributes by verifying, elaborating on, and tentatively extending the framework of the Physical Activity and Leisure Motivation Scale (PALMS).
... Do physical activities within your possibilities and reality of oncologic treatment: light walks, Yoga practice, and meditation (93). ...
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The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies.
... In patients with cancer diagnosis, benefits of yoga from multiple randomized trials and meta-analysis include increases in body flexibility and balance, and reductions in stress and anxiety. [4][5][6] Yoga has also been shown to relieve cancer and treatment-related symptoms such as nausea, pain, fatigue, and insomnia, and to improve the quality of life in people from different ethnic and language backgrounds. [7][8][9][10] In patients with CIPN, exercise has been shown to be beneficial for improving functionality, warranting further research of yoga in this specific population. ...
Article
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Background: Yoga is a meditative movement therapy focused on mind-body awareness. The impact of yoga on health-related quality of life (HRQOL) outcomes in patients with chemotherapy-induced peripheral neuropathy (CIPN) is unclear. Methods: We conducted a pilot randomized wait-list controlled trial of 8 weeks of yoga (n = 21) versus wait-list control (n = 20) for CIPN in 41 breast and gynecological cancer survivors with persistent moderate to severe CIPN. HRQOL endpoints were Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), and Insomnia Severity Index (ISI). The Treatment Expectancy Scale (TES) was administered at baseline. We estimated mean changes and 95% confidence intervals (CIs) from baseline to weeks 8 and 12 and compared arms using constrained linear mixed models. Results: At week 8, HADS anxiety scores decreased -1.61 (-2.75, -0.46) in the yoga arm and -0.32 (-1.38, 0.75) points in the wait-list control arm (p = 0.099). At week 12, HADS anxiety scores decreased -1.42 (-2.57, -0.28) in yoga compared to an increase of 0.46 (-0.60, 1.53) in wait-list control (p = 0.017). There were no significant differences in HADS depression, BFI, or ISI scores between yoga and wait-list control. Baseline TES was significantly higher in yoga than in wait-list control (14.9 vs. 12.7, p = 0.019). TES was not associated with HADS anxiety reduction and HADS anxiety reduction was not associated with CIPN pain reduction. Conclusions: Yoga may reduce anxiety in patients with CIPN. Future studies are needed to confirm these findings. Clinical trial registration number: ClinicalTrials.gov Identifier: NCT03292328.
... This may be due to that many CAM users in the survivor group had already used CAM when they received the anti-cancer treatment and they continued their CAM use as long-term survivors; therefore, the significance of those variables was explained by prior experience of CAM use.CAM nursing intervention could improve quality of life among cancer survivors(Klafke et al., 2016). CAM literature revealed that mindbody therapies, yoga, acupressure, aroma therapies, massage or Tai Chi can alleviate depression, fatigue, and improve sleep quality as well as psychological and physical functions(Culos-Reed, Carlson, Daroux, & Hately-Aldous, 2006, D'silva, Poscablo, Habousha, Kogan, & Kligler, 2012, Klafke et al., 2016, Mansky et al., 2006, Waits, Tang, Cheng, Tai, & Chien, 2018. In addition, health professionals could initiate sexual health discussions with cancer survivors and provided plausible solutions, such as CAM, pharmaceuticals, vaginal moisturisers, vaginal lubricants, and referral to sexual health experts(Dizon, Suzin, & McIlvenna, 2014). ...
Article
This study compared symptom severity, symptom interference and use of complementary and alternative medicine (CAM) between cancer survivors after curative treatment and individuals who did not have cancer. Factors associated with CAM use among cancer survivors were examined. A cross‐sectional survey was conducted of 146 cancer survivors (77 breast and 69 colorectal cancer survivors who had completed conventional treatment 1–5 years previously and were cancer‐free) from a hospital's cancer registration system (survivor group), and 161 healthy individuals without cancer (comparison group). The two groups were frequency‐matched for sex and age. Findings indicated higher use of CAM in the survivor group (54.1%) than the comparison group (36.6%). There were no significant differences in overall symptom severity and interference between the two groups. Multivariate logistic regression showed that prior use of CAM (OR = 5.14, 95% CI: 2.34–10.69) and higher symptom interference (OR = 1.04, 95% CI: 1.001–1.08) were positively related to CAM use in the survivor group. The survivors did not have higher symptom severity and symptom interference with daily life, but were more likely to use CAM than the comparison group. Medical staff should discuss symptom interference and use of CAM with cancer survivors to guide them in the appropriate use of CAM.
... Most studies have shown a high frequency of cardiovascular side effects after breast cancer treatment [3,4]. This circumstance leads to a variety of interventions designed to improve the quality of life of patients with breast cancer [5][6][7][8][9][10]. ...
... Ray, Mukhopadhyaya, Purkayastha, Asnani, Tomer, Prashad, Thakur and Selvamurthy (2001) conducted a study to observe any beneficial effect of yogic practices during training period on the young trainees. There was improvement in performance at submaximal level of exercise and in VOLUME Yoga has been reported to decrease stress, reactivity to stressors and enhance stress related coping (Brown and Gerbarg 2005;Culos-Reed et al., 2006), reduce symptoms of depression (Jorm et al., 2002;Ernst et al., 1998;David et al., 2007) and anxiety (Ray et al., 2001;Janakiramaiah et al., 2000;Woolery et al., 2004), enhance psychological well-being (Damodaran et al., 2002;Malathi 2000), and reduce sleep disturbance (Cohen et al., 2004). Studies also show that Yoga improves mood states (Lavey et al., 2005;Schell et al., 1994;Berger and Owen, 1992). ...
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Yoga is a universal science of mind and body. Yoga philosophy teaches that a healthy person is a harmoniously integrated unit and body, mind and spirit. Yoga is a scientific technique of mastering the sensory impulses. The limits of the physical body can never be transgressed without knowing and thoroughly mastering the sensory impulses with governs the process of living. Yoga keeps aloof from emotional and sentimental impulses. The regular practice of yoga can maintain the body and mind in healthy manner. The number of research studies on yoga proved that the practice of yoga improves the physical, mental health and promote the wellbeing in the yoga practitioners. The present study, an attempt is made to explore the effect of yoga on certain psychological problems like anxiety, phobic anxiety, depression and hostility.
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Health is multi-dimensional. Mortality, morbidity and cost are traditional health indicators, whereas outcomes research relates to quality of life and health-related quality of life. This article reviews the literature on quality of life issues in breast cancer surgery, highlighting the concepts of health and health outcome measures.
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Psychische und psychosoziale Beeinträchtigungen (PPB) sind im Rahmen der Therapie und Nachbehandlung bei Krebs von hoher Bedeutung. Umfang und Stärke dieser Beeinträchtigungen lassen sich durch Sport- und Bewegungsinterventionen positiv beeinflussen, was inzwischen durch eine Vielzahl von Übersichtsarbeiten belegt ist. Die wichtigsten Erkenntnisse hierzu werden im vorliegenden Beitrag auf der Grundlage einer Systematik von PPB zusammengetragen. Ausgehend vom Metakonzept Lebensqualität, das aus vielen Einzeldimensionen zusammengesetzt ist und daher meist eher praktischen als theoretischen Nutzen hat, wird eine Systematik der PPB in 2 Ebenen gebildet, nämlich der kontextuellen Ebene (affektiv-emotionaler, kognitiver, somatischer und psychosozialer Kontext) und der psychologischen Ebene (Gefühlslage, Bewertungen und Persönlichkeit). In den Übersichtsarbeiten ergeben sich die stärksten Evidenzen von Sport und Bewegung für die Gefühlslage und die Bewertungen der affektiv-emotionalen Dimension (insbesondere Stimmung, Angst, Depressivität) und der somatischen Dimension (insbesondere Fatigue), aber auch für kontextübergreifende Parameter (globale Lebensqualität, allgemeines Wohlbefinden). Inkonsistente oder nur wenige Befunde zeigen sich für das Körperkonzept, das Körperbild die Krankheitsbewältigung oder die Selbstwirksamkeit. Nur selten werden Befunde im Bereich des psychosozialen Kontextes explizit erforscht. Auch die Forschungslage zum Einfluss verschiedener Trainingsgestaltungen (Art, Intensität, Umfang, Organisationsform) auf PPB ist noch sehr begrenzt. Wenn auch Sport- und Bewegungsinterventionen zur Beeinflussung von PPB empfehlenswert sind, fehlen Forschungsarbeiten zu bestimmten Krebsformen oder Zielgruppen ebenso wie Arbeiten zum Verständnis von Wirkmechanismen.
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Patients with cancer may report neuropsychiatric abnormalities including cognitive impairment, behavioral disturbances, and psychiatric disorders that potentially worsen their quality of life, reduce their treatment response, and aggravate their overall prognosis. Neuropsychiatric disturbances have a different pathophysiology, including immuno-inflammatory and neuroendocrine mechanisms, as a consequence of oncologic treatments (chemo- and radio-therapy). Among clinicians involved in the management of such patients, psychiatrists need to pay particular attention in recognizing behavioral disturbances that arise in oncologic patients, and determining those that may be effectively treated with psychotropic medications, psychotherapeutic interventions, and an integration of them. Through the contribution of different clinicians actively involved in the management of oncological patients, the present review is ultimately aimed at updating psychiatrists in relation to the pathophysiological mechanisms responsible for the onset of cognitive, affective, and behavioral syndromes in these patients, along with epidemiologic and clinical considerations and therapeutic perspectives.
Article
Objective: Depressive symptoms are common comorbidities among breast cancer (BC) patients. Non-pharmacological therapies (NPTs) such as exercise and psychotherapy may reduce depressive symptoms; however, the evidence is inconclusive. The objective of this study is to evaluate if NPTs reduce depressive symptoms among BC patients. Methods: A systematic review and meta-analysis of randomized clinical trials (RCTs) of NPTs for BC patients were performed. A literature search was conducted from eight databases in English, Portuguese and Spanish from 2006 to 2017. Inclusion criteria were: RCTs that evaluated depressive symptoms as a primary or secondary outcome that did not include pharmacological interventions and did include a non-intervened control group, with at least 30 participants in non-terminal BC stage with no current psychiatric illness. A meta-analysis for each NPT was performed with DerSimonian and Laird's method for the random effects model. Sensitivity analyses were conducted. Heterogeneity and publication bias were assessed. Results: A total of 41 eligible RCTs were identified. Overall, NPTs significantly reduced depressive symptoms (Summary standardized mean difference (SMD) = -0.516; 95%CI: -0.814, −0.218; I ² = 96.2). Of the types of NPTs, psychotherapy significantly reduced depressive symptoms (Summary SMD = −0.819; 95% CI: -1.608, −0.030; I ² = 91.53). A significant difference emerged for Mindfulness (Summary SMD = −0.241; 95% CI: -0.412, −0.070; I ² = 28.6%) and yoga (Summary SMD = −0.305; 95% CI: -0.602, −0.007; I ² = 41.0%) when the heterogeneity was reduced. No evidence of publication bias was observed. Conclusions: Psychotherapy and mind-body therapies may reduce depressive symptoms in women with BC. Laughter and couples therapy warrant attention in future studies.
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Quickly rising in the Western world as a discipline for incorporating the psyche and body into association and amicability, when embraced as a lifestyle, yoga works on physical, mental, scholarly, and otherworldly wellbeing. Yoga offers a powerful technique for overseeing and diminishing pressure, tension, and melancholy and various investigations exhibit the adequacy of yoga on disposition-related issues. The discoveries of the previously mentioned consider analysing the mental and actual results of yoga demonstrate hard, to sum up and make substantial inferences because of variety in the examination plans, contrasts in the length and recurrence of yoga classes, and contrasts in the particular yoga projects and populaces being contemplated. Regardless, results for the included investigations exhibit a large number of the various restorative impacts, benefits, and significant mending force of yoga.
Article
Background: Cancer-related cognitive impairment (CRCI), often called "chemo-brain" or "chemo-fog," is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI. Purpose: The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI. Data sources: Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE. Study selection: Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures. Data extraction: Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials. Data synthesis: Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24-1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41-1.47). Limitations: Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses. Conclusions: Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.
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Introduction: Therapeutic yoga in Indian System of Medicine (ISM) is nowadays considered as one of the primary modalitiesof an integrated line of therapies for disease prevention, and in palliative care, as recognized by the World Health Organization (WHO). It is better to describe it as a vital part of drugless (Non-pharmacological) therapies that offer a supplemental or even alternative management system in the management of certain disease states. Most of the works on yoga on previous periods were conducted mainly in clinical subjects pertaining to lifestyle disorders, rheumatism, and psychosomatic disorders. Now recent investigators concentrate more on its effects for improving the quality of life in different variants of cancer survivors.Methodology: References from various published works of literature concerned with yoga, clinical research in cancer were reviewed and documented to acquire a better understanding in the success of implementing yoga as a complementary therapyfor cancer patients.Observationand Discussion: In all the reported research works pertaining to yoga and cancer, the response of yoga and its allied practical principles in cancer victims was remarkable. Most of the studies included control and test groups with a fixed module of yogic practices, relaxation techniques, and meditation steps. In spite of common procedures to all the subjects, all of them showed significant improvement in the particular measures on physical and psychological planes. In the review of various resourceful literature works, we may ascertain the fact that the feasibility and potential efficacy of yoga as a supplementary therapy in cancer types is to be understood in an angle of practicability, with much concern over patience and accuracyfor getting the desired results. The sessions are repeated for longer durations as indicated in most of the outcome studies. Long-term basis of well-disciplined practice only yields fruitful results.Conclusion: The divine practices of yoga and its principles may be advocated as supportive therapy in all the health care facilities in a view of prevention and management of metabolic diseases like cancers.
Article
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Background Women with breast cancer (BC) are living longer with debilitating side effects such as cancer-related fatigue (CRF) that affect overall well-being. Yoga promotes health, well-being and may be beneficial in reducing CRF. Although there have been previous systematic reviews and meta-analyses, the effects of yoga on CRF and quality of life (QOL) remain unclear, particularly in comparison with other types of physical activity (PA). Our objective is to carry out a systematic review and meta-analysis of the effects of yoga on CRF and QOL in women with BC. Methods Electronic databases were searched (MEDLINE, Embase Classic+Embase and EMB Reviews, Cochrane Central CT) from inception to May 2018. Randomized controlled trials were included if they were full text, in English, included a yoga intervention, a comparator (including non-PA usual care or alternate PA intervention), and reported on CRF or QOL. Effects of yoga were pooled using standardized mean difference (SMD) via a random effects model. Results Of the 2468 records retrieved, 24 trials were included; 18 studies compared yoga to a non-PA comparator and 6 to a PA comparator. Yoga demonstrated statistically significant improvements in CRF over non-PA (SMD −0.30 [−0.51; −0.08]) but not PA (SMD −0.17 [−0.50; 0.17]) comparators. Additionally, yoga demonstrated statistically significant improvements in QOL over non-PA (SMD −0.27 [−0.46; −0.07]) but not PA (SMD 0.04 [−0.22; +0.31]) comparators. Discussion This meta-analysis found that yoga provides small to medium improvements in CRF and QOL compared to non-PA, but not in comparison to other PA interventions.
Article
Zusammenfassung Yoga, ursprünglich eine spirituelle indische Praxis, ist längst als Präventionsmaßnahme etabliert, findet aber auch immer mehr seinen Weg in die unterstützende Therapie von chronischen Erkrankungen. In der supportiven Onkologie kann Yoga für verschiedene Symptome empfohlen werden. Die Evidenzlage überzeugt insbesondere zur Linderung von krebs- bzw. krebstherapieassoziierter Fatigue. Bei Patientinnen mit Mammakarzinom liegen darüber hinaus vielversprechende Studien zur Wirksamkeit von Yoga bei Ein- und Durchschlafstörungen und bei therapieassoziierten menopausalen Symptomen vor. Da unerwünschte Ereignisse unter Yoga nicht signifikant häufiger auftreten als bei anderen Formen körperlicher Aktivität oder unbehandelten Kontrollgruppen, ist insgesamt von einem positiven Nutzen-Risiko-Verhältnis für Patienten mit onkologischen Erkrankungen auszugehen.
Article
Background Complications of breast cancer treatment can cause physical and psychosocial distress in patients. Yoga demonstrates substantial potential as a supportive therapy for patients with breast cancer. Our aim is to conduct a meta-analysis of randomized controlled trials to evaluate the effectiveness of yoga in enhancing the quality of life (QoL) of patients with breast cancer.Methods We searched for studies published before March 2020 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and the pooled effect size was calculated using a random effect model. Measured outcomes included QoL, anxiety and depression, stress, fatigue, pain severity, and sleep quality.ResultsIn total, 26 trials involving 2069 patients were reviewed. Significant enhancement in QoL was observed immediately after the yoga intervention. The pooled mean differences in social (weighted mean difference [WMD]: 1.36, 95% confidence interval [CI] 0.12–2.61), emotional (WMD: 1.46, 95% CI 0.26–2.66), and functional well-being (WMD: 2.04, 95% CI 0.21–3.87) were significantly higher in the yoga group than in the control group. Patients practicing yoga exhibited significant improvements in physical well-being, mental well-being, and sleep quality as well as reductions in anxiety, depression, stress, fatigue, and pain severity after the intervention.Conclusions Yoga may enhance QoL in patients with breast cancer experiencing post-treatment complications. Therefore, we recommend yoga as a supportive therapy for patients with breast cancer to relieve post-treatment distress.
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Cancer is a chronic disease that reduces the quality of life of the sufferer. High stressors and low coping due to disease prognosis, therapy management, and minimal social support, have an impact on poor psychological conditions. Therefore, we need complementary therapies such as yoga that is easy, cheap, and can be done independently. Yoga practice increases oxygen supply and relaxes muscles and joints which can increase hormonal work which is beneficial for the body physically and psychologically for cancer patients. Objective: This study aims to explain the effectiveness of yoga on increasing QoL (Quality of Life) in cancer patients. Abstrak Saat ini kanker termasuk kanker payudara merupakan salah satu penyakit utama yang di rawat layanan perawatan paliatif. Kejadian kanker payudara semakin meningkat dari tahun ke tahun. Kanker payudara dapat berkembang ke stadium akhir atau lanjut. Pada stadium lanjut tersebut, kejadian luka laserasi kanker sekitar 5-10% pada pasien kanker payudara. Tujuan literature review ini untuk mengidentifikasi pengkajian dan manajemen gejala pada luka kanker payudara di perawatan paliatif. Desain penelitian ini merupakan literature review. Penelusuran artikel dengan menggunakan 4 basis data jurnal yaitu DOAJ, Google Scholar, Proquest, dan Science Direct. Sebanyak 17 artikel yang memenuhi kriteria inklusi yang di review. Hasil review menunjukkan bahwa pengkajian luka kanker
Article
Objective Cancer and its treatment can lead to a variety of physical and emotional concerns impacting on those affected, including subclinical or clinical depression and anxiety, which in turn have a significant impact on wellbeing, quality of life and survival. The aim of this review was to evaluate the effect of yoga‐based interventions on self‐reported depression and anxiety symptoms in people with cancer in randomized controlled trials. Method Six databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta‐analysis of suitable studies was conducted. Results 26 studies from our search criteria were eligible for inclusion for depressive and 16 for anxiety symptoms. Meta‐analyses revealed evidence for significant medium effects of yoga on depression symptoms (N = 1,486, g = −0.419, 95% confidence interval [CI] = −0.558 to −0.281, p < 0.001) and anxiety (N = 977, g = −0.347, 95% CI = −0.473 to −0.221, p < 0.001) compared to controls. Subgroup analyses for depressive symptoms revealed significant effects for all analyses performed (type of cancer, type of control, treatment status, duration of intervention or frequency of yoga sessions), with effect sizes being comparable between subgroups. Similar findings were found for anxiety symptoms except for treatment status, where the only significant effect was found when yoga was delivered during active treatment. Conclusions This review provides evidence that in people with cancer, yoga‐based interventions are associated with amelioration of depression and anxiety symptoms and therefore a promising therapeutic modality for their management. However, the potential for risk of bias together with control group design challenges means the results should be interpreted with caution.
Thesis
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El cáncer es una de las principales causas de mortalidad en España, siendo el cáncer de mama el más diagnosticado en mujeres. La propia enfermedad y los tratamientos oncológicos producen distintos efectos secundarios, entre los que se encuentra la fatiga relativa al cáncer (CRF). Ésta, es una de las secuelas más prevalentes y que más afecta la vida diaria de las supervivientes de cáncer de mama. Con una etiología compleja, la CRF se desencadena por distintos mecanismos fisiológicos, por lo que su tratamiento puede requerir la aplicación de terapias tanto farmacológicas, como no farmacológicas. Entre las últimas, el ejercicio físico es la terapia más efectiva para reducir su impacto. De modo general, existe amplia evidencia sobre los beneficios que el ejercicio físico produce en pacientes y supervivientes de cáncer. Los efectos de entrenamientos de tipo aeróbico, entrenamiento de fuerza, actividades cuerpo-mente y/o actividades deportivas, son una creciente área de estudio, especialmente prolífica en supervivientes de cáncer de mama. Así, para la reducción de la CRF, existen guías específicas donde el ejercicio forma parte esencial del tratamiento. Aunque en ellas se propone la práctica de actividad física de tipo concurrente (incluyendo tanto entrenamiento aeróbico, como de fuerza), diversos autores apuntan que es preciso individualizar la prescripción de ejercicio físico. Esto se debe, en parte, al diferente nivel de tolerancia al ejercicio de los supervivientes de cáncer, que incluso puede resultar una barrera para la práctica de actividad física. Dentro de los diferentes tipos de entrenamiento, el entrenamiento de la musculatura inspiratoria (IMT), ha sido propuesto como una herramienta válida para la mejora de la condición física y la función pulmonar en pacientes de diversas patologías. Debido a su sencillez y viabilidad a la hora de implementarlo, y a su demostrado efecto sobre el aumento de la tolerancia al ejercicio, el IMT ha sido estudiado en personas con distintas patologías, incluyendo tumores intratorácicos y abdominales. En supervivientes de cáncer de mama (SCM), aunque el IMT no ha sido analizado en profundidad, se ha reconocido que podría mejorar la capacidad de ejercicio en esta población. Sin embargo, no se ha publicado ningún estudio que analice su efectividad en la reducción de la fatiga. Por otro lado, el nivel de actividad física (AF), ha sido asociado a la mejora de la calidad de vida (QoL) en supervivientes de cáncer y la reducción de la CRF. Por este motivo, el nivel de actividad física ha sido estudiado en cohortes de SCM españolas. Sin embargo, y a pesar de que sería interesante conocer el estado de dicha cuestión, se desconoce cuáles son los niveles actuales de actividad física y calidad de vida de las SCM españolas. Dada la importancia que tiene el nivel de actividad física sobre la CRF y la QoL, y debido al efecto que el IMT podría tener sobre este efecto secundario de las SCM, esta Tesis Doctoral fijó dos objetivos. En primer lugar, analizar los niveles de actividad física y QoL en una muestra representativa de la población de supervivientes de cáncer de mama españolas (Estudio 1). En segundo lugar, analizar el efecto del IMT sobre su CRF, capacidad funcional y tolerancia al esfuerzo (Estudio 2). Para el primer objetivo (Estudio 1), se administraron dos cuestionarios a la población objetivo a través del contacto con distintas asociaciones de pacientes y entidades relacionadas. Uno para el registro de datos sobre patrón de AF (HUNT1-PAQ), y otro, específico para evaluar la QoL en supervivientes de cáncer de mama (FACT-B). Una vez se alcanzó el número de respuestas que se había considerado mínimo para que la muestra fuera representativa de la población española de SCM, se realizó un análisis descriptivo de los resultados. Para el segundo objetivo (Estudio 2) se realizó una intervención experimental, en el que se aplicó, a SCM, un programa de ejercicio, en el que se combinó un programa de IMT con un entrenamiento de fuerza con cargas ligeras. Las participantes, fueron asignadas a un grupo intervención (realizando el IMT) y un grupo placebo, realizando todas ellas el entrenamiento de fuerza. Entre las valoraciones seleccionadas, se administró un cuestionario específico de análisis del nivel de fatiga (FACIT-F). El Estudio 1 reveló que las supervivientes de cáncer de mama españolas, no cumplían con las recomendaciones mínimas de actividad física propuestas por las principales organizaciones internacionales. Por otro lado, el análisis de correlaciones realizado, mostró que el índice de masa corporal (IMC) y la intensidad del ejercicio, eran las variables más relacionadas con la QoL de las SCM españolas. Adicionalmente, se propuso el cuestionario HUNT1-PAQ como herramienta de fácil aplicación, en el ámbito clínico, para evaluar el nivel de actividad física de las supervivientes de cáncer de mama. Finalmente, los resultados del Estudio 2 mostraron un incremento en la puntuación del cuestionario FACIT-F en el grupo experimental, que había modificado su presión inspiratoria máxima tras 6 semanas de IMT. Esto muestra que el IMT es una herramienta segura, viable y efectiva en la reducción del nivel de CRF de las supervivientes de cáncer de mama.
Article
Objectives The aim of this scoping review is to provide an overview of the existing research that investigates the lived experience during the peri-diagnostic period of breast cancer. Methods Nine databases were searched for relevant literature between January 2007 and April 2019. Data were extracted and categorized using deductive and inductive approaches. Results A majority of the 66 studies included used qualitative methods to retrospectively explore the treatment decision making process of female breast cancer patients. Patients experienced uncertainty, emotional distress, and a need for more information from providers and relied on social support and family guidance during this period. Conclusions The results of this review show that the burdens experienced during the peri-diagnostic period parallel those in later periods of cancer care. However, these burdens are prompted by different circumstances. More research is needed to explore the lived experience during this period through the use of mixed-methods and by recruiting a diverse sample with regards to role in the breast cancer experience, age, gender, race, and ethnicity. Practice Implications Interventions positioned at earlier points in the breast cancer experience should provide informational support, which could be delivered through shared decision making models. Additional support could be facilitated by patient navigation programs and health information technology.
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Introduction: Several publications have theorized about the triggers of cancer-related fatigue, one of the side effects of the disease and its treatments that most stress cancer survivors. On the other hand, physical exercise has been analyzed as a therapy to reduce the impact of this sequel, and several institutions support its inclusion within care programs for the oncological population. However, cancer fatigue and the role that exercise plays in its control has been exposed without an overall assessment that shows its complexity and why physical exercise is so valuable to reducing it. Objectives: The objective of this work was to review the existing evidence about triggers of fatigue in cancer, to expose how physical exercise acts on each of them to control their symptoms and achieve a comprehensive therapeutic effect. Material and method: Several bibliographic searches were carried out to find out which were the triggers of fatigue proposed by the research, how they develop and affect the oncological patient and, finally, to what extent physical exercise would be a viable tool to control its effects. Results: Exposed to more than twenty triggers and aggravating factors of cancer-related fatigue, we found that most of them could be prevented or at least controlled through physical exercise. Conclusions: It is impossible to isolate some triggers from others, and some of them are inevitable as they are part of the medical treatment of the disease. Understanding the relationships between triggers and knowing the positive effects of physical exercise on each one of them is clearly useful to control this side effect.
Article
Introduction:Research is increasingly demonstrating a range of benefits of practicing yoga, such as improved physical and mental health, social connectedness, and self-care. Mechanisms of action are less well understood, but may include both psychological and physiological changes. The aim of this study was to understand more about benefits and mechanisms of yoga practice, using qualitative data collected from a large-scale survey of yoga use in the United Kingdom. Methods: The mixed methods, cross-sectional online survey collected data on yoga use and perceived benefits from 2434 U.K. yoga practitioners. The qualitative survey element used open-ended questions to gain "real life" data regarding practice and perceived benefits. Data were analyzed thematically and deductively. A practice-based model describing yoga practice, mechanisms, and benefits, based on the Khalsa logic model of yoga, was developed to explain the data. Findings: Findings highlighted that a diverse range of yoga practices and nonspecific contextual factors related to practicing yoga, needed to be considered to understand how yoga was benefitting people. These practices encompassed both modern and traditional conceptions of yoga as a deeper lifestyle practice. Key mechanisms for change included improvements in physical strength and flexibility, stress regulation, resilience, equanimity, mind-body awareness, and spiritual/personal growth. These mechanisms resulted in diverse improvements in global health functioning, particularly physical and mental health and well-being. Conclusions: The Khalsa model provided a useful base upon which to guide the new population-practice-based model, to understand participants' "real life" experiences of yoga, how yoga is helping people and why. It provides important information for practitioners, teachers, and those delivering yoga interventions as to the range of skills and potential benefits of yoga practice. In addition, findings indicate directions for future research, by highlighting key yoga mechanisms that researchers may choose to focus on in future studies.
Chapter
Musculoskeletal and joint pain are common in women, especially in perimenopausal and aging women. In women diagnosed with breast cancer, cancer treatment can be associated with musculoskeletal symptoms, particularly arthralgia, or non-inflammatory joint pain. Evaluation of new-onset arthralgia should include the history, physical examination, and laboratory evaluation for common non-inflammatory and inflammatory causes of joint pain. After chemotherapy, the self-limited syndrome of post-chemotherapy rheumatism may develop within 3–4 months of treatment and can last several months before it subsides. This syndrome may overlap with the start of adjuvant endocrine therapy, which may also be associated with arthralgia, particularly endocrine therapy with aromatase inhibitors. Aromatase inhibitor-associated arthralgia (AIAA) is common and difficult to treat. Regular exercise and adequate vitamin D levels can alleviate arthralgia and are also associated with improved well-being and better breast cancer and overall outcomes. Other approaches to relieve AIAA include switching to another endocrine therapy, use of a complementary intervention (like acupuncture or a supplement), and duloxetine. In cases where inflammatory arthritis is suspected or arthralgia is more persistent or severe than is typical for AIAA, referral to a rheumatologist is warranted.
Experiment Findings
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Durante 6 semanas, un grupo de mujeres supervivientes de cáncer de mama (n = 10) realizaron IMT junto con un protocolo de ejercicio de fuerza con cargas ligeras (gomas elásticas). El grupo control (n=10) realizaba tan sólo el entrenamiento de cargas.
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Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.
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In 1986, the European Organization for Research and Treatment of Cancer (EORTC) initiated a research program to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. We report here the results of an international field study of the practicality, reliability, and validity of the EORTC QLQ-C30, the current core questionnaire. The QLQ-C30 incorporates nine multi-item scales: five functional scales (physical, role, cognitive, emotional, and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. Several single-item symptom measures are also included. The questionnaire was administered before treatment and once during treatment to 305 patients with nonresectable lung cancer from centers in 13 countries. Clinical variables assessed included disease stage, weight loss, performance status, and treatment toxicity. The average time required to complete the questionnaire was approximately 11 minutes, and most patients required no assistance. The data supported the hypothesized scale structure of the questionnaire with the exception of role functioning (work and household activities), which was also the only multi-item scale that failed to meet the minimal standards for reliability (Cronbach's alpha coefficient > or = .70) either before or during treatment. Validity was shown by three findings. First, while all interscale correlations were statistically significant, the correlation was moderate, indicating that the scales were assessing distinct components of the quality-of-life construct. Second, most of the functional and symptom measures discriminated clearly between patients differing in clinical status as defined by the Eastern Cooperative Oncology Group performance status scale, weight loss, and treatment toxicity. Third, there were statistically significant changes, in the expected direction, in physical and role functioning, global quality of life, fatigue, and nausea and vomiting, for patients whose performance status had improved or worsened during treatment. The reliability and validity of the questionnaire were highly consistent across the three language-cultural groups studied: patients from English-speaking countries, Northern Europe, and Southern Europe. These results support the EORTC QLQ-C30 as a reliable and valid measure of the quality of life of cancer patients in multicultural clinical research settings. Work is ongoing to examine the performance of the questionnaire among more heterogenous patient samples and in phase II and phase III clinical trials.
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The EORTC QLQ-C30 Health-Related Quality of Life (HRQOL) questionnaire was completed by 3069:3919 (78%) of a random sample of the Swedish population aged 18‐79 years. The aims of the study were to provide normative data on the questionnaire and to investigate differences in HRQOL with respect to age, gender, sociodemographic characteristics and reported chronic health problems. Women had lower scores than men on all but one of the EORTC QLQ-C30 subscales and reported more chronic health problems. The oldest respondents (70‐79 years) had a greater degree of impaired HRQOL than the other age groups, with one exception, ‘Emotional functioning’, in which they scored higher. Unemployed respondents reported poorer HRQOL than employed respondents. Higher income was associated with a more positive assessment of HRQOL. The results of the study present reference values for EORTC QLQ-C30 Version 3 questionnaire and clarify the influence of factors which should be taken into account when planning studies of HRQOL.
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A supportive family environment is thought to enhance the capacity of cancer patients to adapt to their illness and treatment. But families, like patients, vary in their ability to cope with the impact of a cancer diagnosis in a family member and in their ability to fulfill the patient's needs. Increased understanding of the interrelationships between the family's and patient's responses to illness is of fundamental importance to the care of the patient with cancer. A heterogeneous sample of 201 cancer patients and their relatives were studied to determine compatibility of psychological status and to isolate clinical and demographic variables associated with psychological distress. Self-report tests of anxiety, mood disturbance, and mental health were applied. Despite large individual variation, the psychological status of patients and their matched relatives was closely correlated. The patient's treatment status affected both patients and their next-of-kin. Psychological well-being worsened according to whether patients were receiving follow-up care, active treatment, or palliative therapy. These data suggest a mutuality of psychological response between patients and their families. Supportive intervention for the patient or relative who manifests distress, therefore, should benefit both. Because patients and relatives involved with palliative treatment are most in need of psychological assistance, particular attention should be paid to this group, as is attempted in hospice care.
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The aim of this study was to determine whether cardiac patients' perceptions of the barriers to and benefits of home exercise while in hospital and 6 weeks after discharge are predictive of nonadherence with regular home exercise 6 months after discharge from hospital. A prospective longitudinal study of 459 patients age 75 years or less and discharged from any of six public hospitals in the Lower Hunter Region of New South Wales, Australia, with a diagnosis of acute myocardial infarction or angina was conducted. Multivariate logistic regression analysis, using data provided by 281 (61.2%) patients, showed that cardiac patients' perceptions of the benefits of and the physical environment and time barriers to home exercise while in hospital were predictive of nonadherence with regular home exercise 6 months after discharge from hospital, after adjustment for potential confounders. Six weeks after discharge from hospital, patients' perceptions of the enjoyment and time barriers to home exercise were predictive of nonadherence at follow-up, after adjustment for potential confounders. Cardiac patients' perceptions of the barriers to and benefits of home exercise may be modifiable sources of nonadherence. A randomized controlled trial is required to confirm and extend upon these findings.
Article
Survival rates for certain types of cancer have improved over the past few decades. Changing unhealthy behaviors such as smoking, poor diet, and sedentary life-style among individuals who have been diagnosed with cancer may help to reduce cancer treatment sequelae, possibly reduce risk of recurrence for specific types of cancer, and reduce risk for other common diseases such as cardiovascular disease, obesity, and hypertension. This article reports the prevalence of each of these behaviors among those diagnosed with cancer and reviews interventions that have targeted these risk behaviors. There is considerable variation in the type of research questions asked, the methodologic quality of the research, sample sizes, and the outcomes observed across studies focusing on changing the three health risk behaviors. In the final section, we provide guidelines for researchers in developing health behavior interventions for individuals diagnosed with cancer and highlight challenges that should be addressed.
Article
The EORTC QLQ-C30 Health-Related Quality of Life (HRQOL) questionnaire was completed by 3069/3919 (78%) of a random sample of the Swedish population aged 18-79 years. The aims of the study were to provide normative data on the questionnaire and to investigate differences in HRQOL with respect to age, gender, sociodemographic characteristics and reported chronic health problems. Women had lower scores than men on all but one of the EORTC QLQ-C30 subscales and reported more chronic health problems. The oldest respondents (70-79 years) had a greater degree of impaired HRQOL than the other age groups, with one exception, 'Emotional functioning', in which they scored higher. Unemployed respondents reported poorer HRQOL than employed respondents. Higher income was associated with a more positive assessment of HRQOL. The results of the study present reference values for EORTC QLQ-C30 Version 3 questionnaire and clarify the influence of factors which should be taken into account when planning studies of HRQOL.
Article
The U.S. population is aging, bringing with it an increased prevalence of chronic disease and concomitant declines in physical function. The risk of developing cancer increases significantly with age, and functional decline is much more likely once a cancer diagnosis is rendered. Thus, functional status in later life is a key concern, one that is heightened among elders who have been diagnosed with cancer. To date, however, there have been few trials that have exclusively addressed issues related to cancer survivorship among older cancer patients, and to our knowledge, none has focused on preserving or enhancing physical functioning. This paper describes the study design and methodological considerations of a randomized controlled trial to determine if a personally tailored workbook and telephone counseling program can positively affect physical activity and dietary behaviors and ultimately the physical functioning of up to 420 older men and women newly diagnosed with breast or prostate cancer. This trial is unique because the cancer diagnosis is used not only as a marker of risk for functional decline, but also as a "teachable moment" - an opportune time when elders may be more receptive to making beneficial lifestyle changes. Undoubtedly, as cure rates for cancer increase and intersect with ever-growing numbers of elderly, there will be numerous opportunities to provide and test interventions within this vulnerable population and to target functional status as a primary outcome. In reporting our methods, we hope to give others "a leg up," so that they can hurdle with greater ease the barriers we experienced, and thus advance the field more rapidly.
Article
To provide an overview of research that has examined exercise in cancer survivors including recently completed trials at the University of Alberta. A search of published studies using electronic data bases and previous review articles. The review is divided into breast and nonbreast cancers, during and after treatment, and trials from the University of Alberta. Forty-seven published studies were located and summarized plus four trials from the University of Alberta. Almost all studies showed beneficial effects of exercise in breast and nonbreast cancer groups alike as well as during and after cancer treatment. Preliminary research suggests that exercise may be an effective intervention for enhancing quality of life (QOL) in cancer survivors. The effects of exercise on biomarkers, cancer recurrence, other diseases, and overall survival are unknown. Future research is needed to extend our knowledge beyond breast cancer survivors, conduct second generation studies in breast cancer survivors, examine mechanisms for changes in QOL, compare exercise with other QOL interventions, and examine biomarkers, cancer recurrence, and survival.
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