Yoga-based intervention benefits patients with head and neck cancer
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Key takeaways:
- Most patients assigned to the two yoga groups attended at least 10 yoga sessions.
- Patients assigned to patient-caregiver yoga group experienced a significant effect on physical function and nutrition intake.
A yoga-based intervention provided beneficial supportive care among a cohort of patients undergoing radiotherapy for head and neck cancer and their caregivers, according to study results.
The findings — presented during ASCO Quality Care Symposium — specifically showed improvements in physical function and nutrition intake among those assigned the yoga-based intervention vs. those assigned usual care.
Rationale and methods
“The idea with descriptive studies is to help figure out how to best support patients and their families and what type of intervention may be best for the problems that they’re dealing with,” Kathrin Milbury, PhD, associate professor of behavioral science at The University of Texas MD Anderson Cancer Center, told Healio.
“From a supportive care perspective, head and neck cancer hasn’t been that widely studied,” she added. “I have noticed that the physical symptom burden of this type of cancer is very distressing and so just addressing the distress without the physical symptoms wouldn’t be as effective, and that is where the yoga intervention comes in because it addresses both mind and body.”
Researchers assigned 100 patients (mean age, 60.3 years; 85% men; 79% white; 67% early-stage disease) with head and neck cancer undergoing radiotherapy to one of three groups: dyadic yoga-based supportive care intervention (n = 34), patient yoga-based intervention (n = 33) or usual care (n = 33).
Both yoga programs included 15 in-person or videoconferencing sessions in parallel with radiotherapy treatment and consisted of poses that focused on preventing and reducing common side effects of head and neck cancer treatment. Techniques included stretching and strengthening the neck and facial muscles, whole-body postures to prevent muscle loss, and breathing and meditation exercises to create a relaxed state and sense of wellbeing.
Of note, patients frequently experience anxiety during radiation treatment and some patients who participated in this trial used the relaxation exercises during treatments in lieu of benzodiazepines, according to the researchers.
Findings
Investigators found that 88% of patients assigned the two yoga groups attended at least 10 yoga sessions (mean, 13.1 sessions in the patient-caregiver group vs. 13.3 sessions in the patient group).
Results showed a significant effect on patient-reported physical function (F = 5.27; P = .03) and nutrition intake (F = 4.97; P = .03) favoring the patient-caregiver yoga group compared with the usual care group.
Researchers also found that patients in both the dyadic (P = .05) and patient-based (P = .02) yoga groups experienced significantly fewer feeding tubes placed compared with those in the usual care group.
Future research
These results demonstrate that a focused yoga intervention can be successfully delivered in person or online not only to patients with cancer undergoing radiation therapy but also to their caregivers,” Charu Aggarwal, MD, MPH, FASCO, assistant professor for lung cancer excellence at University of Pennsylvania's Perelman School of Medicine and Healio | HemOnc Today Editorial Board member — who was not involved with the study — said in the ASCO release. “Such an intervention can be beneficial for physical functioning, recovery and nutrition intake.”
The researchers are currently studying the dyadic yoga intervention for patients with head and neck cancers undergoing concurrent chemoradiation that evaluates use of feeding tubes and ER visits as primary outcomes. They also plan to test the acceptability of this intervention among historically underserved populations, according to an ASCO press release.
“Patients should engage in relaxation techniques because it is very important. We would love for patients to practice yoga that focuses on areas in the neck region, the jaw and facial muscles, because exercising the neck and facial areas reduces lymphedema, which is associated with swallowing difficulties,” Milbury told Healio. “We are hoping to make an exercise intervention — such as yoga — part of standard of care for these patients. That is our long-term hope, but we still need to complete confirmatory work. We are also performing cost effectiveness analyses with a health economist that will hopefully help us to show the cost benefit of this type of intervention so that we can have enough data to support implementing it as part of usual care.”
References:
- Milbury K, et al. Abstract 292. Presented at: ASCO Quality Care Symposium; Oct. 27-28, 2023; Boston.
- Yoga may help prevent treatment-related complications in patients with head and neck cancer undergoing radiation (press release). Available at: https://old-prod.asco.org/about-asco/press-center/news-releases/yoga-may-help-prevent-treatment-related-complications-patients. Published Oct. 23, 2023. Accessed Oct. 31, 2023.
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Milbury K, et al. Abstract 292. Presented at: ASCO Quality Care Symposium; Oct. 27-28, 2023; Boston.
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