October 24, 2017
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Yoga therapy benefits patients with lung cancer, their caregivers

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Kathrin Milbury

Patients with non-small cell lung cancer undergoing radiation therapy and their caregivers achieved a variety of benefits from yoga therapy, according to a feasibility study scheduled for presentation at the Palliative and Supportive Care in Oncology Symposium.

Patients with lung cancer demonstrated better physical function, stamina and mental health, and caregivers showed improvements in fatigue and stamina following the intervention.

“Patients with lung cancer tend to have difficulties with breathing, depression and fatigue, and cancer treatments may actually worsen these symptoms and can reduce patients’ overall physical function and quality of life,” Kathrin Milbury, MD, assistant professor of cancer medicine in the department of palliative care and rehabilitation medicine at The University of Texas MD Anderson Cancer Center, said during a press conference. “Importantly, family members providing care and support to a patient may also feel tired, anxious and sad.”

Yoga has shown benefits in studies of patients with breast cancer. Although patients with lung cancer typically have worse symptoms and are older, yoga is a low-impact exercise that these patients can perform easily. Further, the exercise emphasizes breathing, which can be important for patients with lung cancer who experience shortness of breath from thoracic radiation.

“There is reason to believe that a yoga therapy involving physical exercises, breathing exercises and meditation or guided imagery may benefit this understudied population and may be an effective behavioral-supportive care strategy,” Milbury said. “Our study goals were to examine if patients with advanced lung cancer undergoing treatment were physically able to participate in a 15-session yoga program, and to see if the yoga program improved patients’ physical fitness and improved patients’ and caregivers’ self-supportive quality of life.”

The analysis included 32 patients (median age, 73 years; 63% women; 67% stage III) with NSCLC and their caregivers (median age, 62 years; 38% women; 63% spouses) assigned to a 15-session yoga intervention — each 60 minutes long, with emphasis on physical postures, breathing exercises and meditation — or a waitlist control group. Because it is a gentle form of exercise readily modifiable for patients’ needs, researchers selected yoga poses known as chest openers — exercises that emphasize stretching the chest area along with deep breathing.

Researchers assessed patient and caregiver quality of life at baseline, the last day of radiation and 3 months later using the 36-Item Short Form Survey (SF-36). Patients also underwent the 6-minute walk test at these time points. Eighty-one percent of the partners completed all assessments.

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Patients and caregivers completed a mean of 12 yoga sessions, and 96% of participants rated the program as very useful.

Researchers observed clinically significant improvements in the physical function, role performance and mental health domains of the SF-36 among patients. Caregivers demonstrated significant improvements in vitality and role performance.

Patients assigned the intervention showed significantly better 6-minute walk test results than the control group (mean distance, 478 m vs. 402 m; P < .05).

“Overall, we were encouraged by the findings,” Milbury said. “We demonstrated patients undergoing treatment for advanced lung cancer are not too sick to participate in a behavior-supportive care intervention. Both patients and caregivers reported to have enjoyed the experience. It gave them time away from cancer to learn something new together.”

Caregivers sometimes have more anxiety and sleeping problems than patients. Milbury said she was “thrilled” to hear that many of the patients and caregivers said they would continue to do yoga on their own.

“This study is a welcome addition to an ever-growing body of literature on the benefit of yoga and other nonpharmacologic-supported therapies that can be integrated into, not only the care of cancer patients, but also the family caregivers who support them,” said Andrew S. Epstein, MD, ASCO expert and medical oncologist at Memorial Sloan Kettering Cancer Center, who was not involved in the study. – by Alexandra Todak and Chuck Gormley

Reference:

Milbury K, et al. Abstract 125. Scheduled for presentation at: Palliative and Supportive Care in Oncology Symposium; Oct. 27-28, 2017; San Diego.

Disclosures: NIH funded this study. Milbury reports no relevant financial disclosures. Please see the abstract for a list of all other authors’ relevant financial disclosures.