Leading cancer specialist Dr Lorenzo Cohen ran a clinical trial that was published this month, which revealed that women who did yoga during radiotherapy for breast cancer had a much better quality of life and better control of stress hormones.
So how did downward dog leave them feeling?
Amazingly, they had better general health, they found it easier to engage in their daily activities, and had lower levels of fatigue.
Dr Cohen - who is a professor and the director of the Integrative Medicine Program at the MD Anderson Cancer Center in Houston Texas - is interested in finding out how lifestyle affects cancer and recovery from the disease. In particular, he specialises in large-scale studies that examine the effects of practices such as yoga, meditation, tai chi and qi-gong.
He will be presenting his findings at the Yoga and Health: Research and Practice conference in early April, but we wanted to find out more about this groundbreaking study that involved 160 women with breast cancer.
What was the aim of the study?
That clinical trial was specifically to look at the benefits of incorporating yoga into the radiation treatment plan for women with breast cancer. We had done a smaller previous study using the same model comparing yoga to just standard care. But in this study what was important, and unique in comparison to all other studies of yoga in cancer, was that in addition to the standard care control group we also included a stretching control group.
The stretching and yoga participants - who were receiving radiotherapy treatment - did it three days a week for one hour each time for the 6 weeks of radiotherapy. We collected data before the start of radiotherapy and then again at the end and 1, 3, and 6 months later.
Story continues below the slideshow:
Yoga For Digestion
Apanasana(01 of13)
Open Image ModalYou'll want to do knees hugged to chest -- also known as the wind-relieving pose -- to gain relief from bloating and gas pains. How to do it: Lie down, relax and inhale, placing your hands on your knees. Exhale, and hug your knees to your chest. Rock your knees from side to side to maximize the stretch. Stay for five to 10 breaths, and release your knees. Repeat this move a few more times. Modification: Bring up your knees as far as it is comfortable. To vary the stretch, you can do one side at a time. Leaving your left leg extended, bring up your right knee and hold it for five or more breaths. Then, switch to the other side. (credit:Getty Images)
Spinal Twist(02 of13)
Open Image ModalUse this twist pose to soothe and tone your abdomen. How to do it: Lie down, hug your knees and inhale. As you exhale, drop your knees to the left, using your left hand to push them down gently. Then, turn your head and stretch your arm out to the right. Stay for five to 10 breaths. Inhale, and return your hands and knees to center. Repeat on the other side. (credit:Getty Images)
Setu Bandha Sarvangasana(03 of13)
Open Image ModalBridge pose's mild inversion helps your blood flow, making you feel more energized.How to do it: Lie on the floor and bend your knees. Keep your arms beside your body and your feet flat on the floor. Move your hips up to give your chest a good stretch. To better aid your digestion, try this variation. "Press one hip up and hold the pose. Take five breaths, then switch to the other side," says Gold. Modification: Keep your hands under you as you arch your back and open your chest. You can also clasp your hands and interlace your fingers under your back. (credit:Getty Images)
One-Legged Seated Spinal Twist(04 of13)
Open Image ModalSince you're doing this twist pose from a seated position, you have more control over your stretch. How to do it: Sit with your legs extended. Bend your right knee and place your heel close to your body. Reach your right arm behind you and place your palm on the floor. Your left elbow goes on the outside of the right knee to help you twist. Stay for five or more breaths, deepening the stretch every time you exhale. Then release the twist and repeat on the other side. (credit:Getty Images)
Paschimottanasana(05 of13)
Open Image ModalSeated forward bend pose helps you relax, and relieve some of the stress that's affecting your digestion.How to do it: Sit on the floor with your legs in front of you. Keeping your back straight, slowly hinge forward at the hips and lower your torso. Stay there for five to 10 deep breaths. Modification: Lower yourself as far as you can, but keep it comfortable and feel the stretch. (credit:Getty Images)
Seated Heart Opener(06 of13)
Open Image ModalUse this move when you've eaten too much. It will stretch out your belly and ease stomach cramps.How to do it: Sit down on your heels and lean back, placing your palms about eight inches behind you, with your fingertips pointing away from you. Press your hands into the ground, lift your chest and arch your back. You should feel your hips pushing into your heels. Increase the stretch by lowering your head behind you. Feel the stretch in your throat and chest. Hold for five breaths, and then sit up. Modification: You can do this pose while sitting in a chair. Lift your chest, arch your back and feel the stretch. (credit:Getty Images)
Marjaryasana And Bitilasana(07 of13)
Open Image ModalTransition between cat and cow poses to warm up your spine and relieve the tension in your back and neck.How to do it: Get on your hands and knees on the floor. Inhale, making sure your back is flat and your abs engaged. Exhale, drop your head and round up your spine for cat pose. On an inhale, arch your back, lifting your head and butt for cow pose. Switch back and forth between the two poses, connecting your inhale with cow pose and exhale with cat pose. Repeat several times. (credit:Getty Images)
Balasana(08 of13)
Open Image ModalChild's pose, also known as the resting pose, is a basic move you can use for a relaxing stretch. Stay in this position for five breaths or more.How to do it: Sit on your knees and feet with your legs spaced wide apart. Lean forward, stretching your arms in front of you. Then, keeping your back straight, place your forehead on the floor.Modification: To make it easier to hold the pose, rest your head on a block or a pillow. (credit:Getty Images)
Adho Mukha Savanasana(09 of13)
Open Image ModalDownward facing dog is an all-over stretch to energize your mind and body.How to do it: Stand with your feet hip-width apart. Keeping your back straight, hinge forward and press your palms to the ground. Hold the pose for five to 10 breaths. Alternate with child's pose.Modification: Place your feet further back, and bend your knees to make it easier to keep your back straight. (credit:Getty Images)
Uttanasana(10 of13)
Open Image ModalHold standing forward bend pose to strengthen your spine and relieve tension in your neck and back.How to do it: Stand with your legs apart, and bend forward from the waist. Keeping your back straight, place your hands on the floor.Modification: Can't reach the floor? Place your hands on a yoga block or your furniture to help you hold the pose. (credit:Getty Images)
Trikonasana(11 of13)
Open Image ModalTone your belly and get a good stretch and twist with open triangle pose.How to do it: Stand and take a big step back with your right foot, turning it towards the side of the mat. Spread out your arms. Keep your spine long as you hinge forward at the hip. Float your left hand down to the floor. Raise your right arm, keeping your arms spread out. Look up to your right hand. To exit the pose, look down to your left foot before you straighten up. Repeat on the other side.Modification: Float your forward hand down to your shin, or a yoga block placed beside your foot. (credit:Getty Images)
Utkatasana(12 of13)
Open Image ModalChair Pose opens up your chest, and helps strengthen and tone your legs.How to do it: Stand with your feet together. Bend your knees like you're sitting in a chair. At the same time, raise your arms up beside your ears. To exit the pose, straighten your arms on an exhale. Then, rise to a standing position, and bring your arms down to your sides. "For more dynamic action, you can move out of the pose and into a standing position on alternating breaths," says Gold.Modification: Leaning against a wall will help you hold the pose. If you're stiff, you can separate your feet so that they're hip-width apart. (credit:Getty Images)
Pranayama(13 of13)
Open Image ModalAs you end the exercise, take a moment to breathe deeply for up to five minutes. "This is the best way to wind up your yoga practice for a final healing to the digestive system," says Gold.How to do it: Exhale deeply through your nose. Then, inhale slowly through both nostrils. Repeat five to 10 times, each time focusing intently on your breath. (credit:Getty Images)
After finishing radiation treatment, which is linked with fatigue, only the yoga and stretching groups reported feeling less tired.
Over time, however, only the yoga group had benefits in physical functioning and general health perceptions, and better regulation of the stress hormone cortisol than the other two groups; with differences lasting as far as six months after the end of radiotherapy
Why the difference between the yoga and the stretching group?
So what’s interesting about yoga is that it incorporates physical movements and postures (asanas), controlled regulated breathing, as well as aspects of relaxation and meditation. Most importantly, one of the goals is to synchronise the body, breath and mind.
The origins of the Sanskrit word Yoga means to yoke or to join or union – the joining of mind and body.
With standard exercise there wasn’t an incorporation of breath and the mind. It was more mechanical stretching to help stretch muscles post-surgery.
So what our findings suggest is that this more comprehensive mind-body approach, following the roots of yoga, clearly leads to more beneficial effects than simple stretching alone. But it needs to be studied further and the ongoing phase III clinical trial involves 600 patients using a similar model, where the stretching control group will also learn some simple relaxation techniques.
Obviously yoga won’t cure cancer, but can it affect biological functioning ?
Our study found that by the end of radiotherapy and one month later, the women in the yoga group had better regulation of the stress hormone cortisol (steepest downward slope across the day). Previous research has found that better diurnal regulation of cortisol (steeper slope) was predictive of longer survival in breast cancer patients with stage IV disease.
We’ve found the same thing in kidney cancer patients with stage IV disease. People with less steep or blunted cortisol slopes don’t live as long.
Chronic stress can lead to biological changes in the body impacting the immune system as well as having direct impact on the tumour microenvironment. These could lead to worse survival, so programs that help patients to manage stress may be very useful. A recent yoga study in breast cancer survivors found that yoga led to improvements in immune function.
With that said, there hasn’t been specific research to document that mind-body interventions increase survival, but studies show that factors like depression shorten survival time.
We know chronic stress has a profound impact on quality of life and negatively affects all biological systems in the body. Now we have research that shows that stress can get right into the nucleus of every cell in the body, modifying gene expression, shortening telomeres (related to the aging process), and activates cancer-related pathways.
Studying stress in humans is difficult because of the challenges around the definition of stress and measuring stress. But animal research on stress and cancer shows that stress can increase vulnerability to cancer and progression of disease, and is documenting that stress clearly impacts the tumour microenvironment making it more hospitable to cancer growth.
To find out more about the Yoga and Health: Research and Practice conference, which takes place on 4,5 and 6 April, click here. It is run by The Minded Institute.