Skip to main content

Advertisement

SpringerLink
Log in

Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

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.

Results

In 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psychooncology. 2006;15:891–7.

    Article  Google Scholar 

  2. Banasik J, Williams H, Haberman M, Blank SE, Bendel R. Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract. 2011;23:135–42.

    Article  Google Scholar 

  3. Banerjee B, Vadiraj HS, Ram A, Rao R, Jayapal M, Gopinath KS, et al. Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integr Cancer Ther. 2007;6:242–50.

    Article  Google Scholar 

  4. Jong MC, Boers I, van der Velden SAP, Meij SV, Göker E, Timmer-Bonte ANJH, et al. A Randomized Study of Yoga for Fatigue and Quality of Life in Women with Breast Cancer Undergoing (Neo) Adjuvant Chemotherapy. J Altern Complement Med. 2018;24:942–53.

    Article  Google Scholar 

  5. El-Hashimi D, Gorey KM. Yoga-specific enhancement of quality of life among women with breast cancer: systematic review and exploratory meta-analysis of randomized controlled trials. J Evid Based Integr Med. 2019;24:2515690x19828325.

    Article  Google Scholar 

  6. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.

    Article  Google Scholar 

  7. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

    Article  Google Scholar 

  8. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–88.

    Article  CAS  Google Scholar 

  9. Yagli NV, Ulger O. The effects of yoga on the quality of life and depression in elderly breast cancer patients. Complement Ther Clin Pract. 2015;21:7–10.

    Article  Google Scholar 

  10. Winters-Stone KM, Moe EL, Perry CK, Medysky M, Pommier R, Vetto J, et al. Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial. Support Care Cancer. 2018;26:905–12.

    Article  Google Scholar 

  11. Vadiraja HS, Raghavendra RM, Nagarathna R, Nagendra HR, Rekha M, Vanitha N, et al. Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Integr Cancer Ther. 2009;8:37–46.

    Article  CAS  Google Scholar 

  12. Taylor TR, Barrow J, Makambi K, Sheppard V, Wallington SF, Martin C, et al. A restorative yoga intervention for African-American breast cancer survivors: a pilot study. J Racial Ethn Health Disparities. 2018;5:62–72.

    Article  Google Scholar 

  13. Taso CJ, Lin HS, Lin WL, Chen SM, Huang WT, Chen SW. The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. J Nurs Res. 2014;22:155–64.

    Article  Google Scholar 

  14. Stan DL, Croghan KA, Croghan IT, Jenkins SM, Sutherland SJ, Cheville AL, et al. Randomized pilot trial of yoga versus strengthening exercises in breast cancer survivors with cancer-related fatigue. Support Care Cancer. 2016;24:4005–15.

    Article  Google Scholar 

  15. Raghavendra RM, Nagarathna R, Nagendra HR, Gopinath KS, Srinath BS, Ravi BD, et al. Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients. Eur J Cancer Care (Engl). 2007;16:462–74.

    Article  CAS  Google Scholar 

  16. Porter LS, Carson JW, Olsen M, Carson KM, Sanders L, Jones L, et al. Feasibility of a mindful yoga program for women with metastatic breast cancer: results of a randomized pilot study. Support Care Cancer. 2019;27:4307–16.

    Article  Google Scholar 

  17. Peppone LJ, Janelsins MC, Kamen C, Mohile SG, Sprod LK, Gewandter JS, et al. The effect of YOCAS©® yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Res Treat. 2015;150:597–604.

    Article  CAS  Google Scholar 

  18. Moadel AB, Shah C, Wylie-Rosett J, Harris MS, Patel SR, Hall CB, et al. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol. 2007;25:4387–95.

    Article  Google Scholar 

  19. Littman AJ, Bertram LC, Ceballos R, Ulrich CM, Ramaprasad J, McGregor B, et al. Randomized controlled pilot trial of yoga in overweight and obese breast cancer survivors: effects on quality of life and anthropometric measures. Support Care Cancer. 2012;20:267–77.

    Article  Google Scholar 

  20. Lanctôt D, Dupuis G, Marcaurell R, Anestin AS, Bali M. The effects of the Bali Yoga Program (BYP-BC) on reducing psychological symptoms in breast cancer patients receiving chemotherapy: results of a randomized, partially blinded, controlled trial. J Complement Integr Med. 2016;13:405–12.

    PubMed  Google Scholar 

  21. Kovačič T, Zagoričnik M, Kovačič M. Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery. J Complement Integr Med. 2013;10:153-64.

  22. Kiecolt-Glaser JK, Bennett JM, Andridge R, Peng J, Shapiro CL, Malarkey WB, et al. Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol. 2014;32:1040–9.

    Article  Google Scholar 

  23. Harder H, Langridge C, Solis-Trapala I, Zammit C, Grant M, Rees D, et al. Post-operative exercises after breast cancer surgery: results of a RCT evaluating standard care versus standard care plus additional yoga exercise. Eur J Integr Med. 2015;7:202–10.

    Article  Google Scholar 

  24. Eyigor S, Uslu R, Apaydın S, Caramat I, Yesil H. Can yoga have any effect on shoulder and arm pain and quality of life in patients with breast cancer? A randomized, controlled, single-blind trial. Complement Ther Clin Pract. 2018;32:40–5.

    Article  Google Scholar 

  25. Danhauer SC, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, et al. Restorative yoga for women with breast cancer: findings from a randomized pilot study. Psychooncology. 2009;18:360–8.

    Article  Google Scholar 

  26. Chaoul A, Milbury K, Spelman A, Basen-Engquist K, Hall MH, Wei Q, et al. Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer. 2018;124:36–45.

    Article  Google Scholar 

  27. Chandwani KD, Perkins G, Nagendra HR, Raghuram NV, Spelman A, Nagarathna R, et al. Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy. J Clin Oncol. 2014;32:1058–65.

    Article  Google Scholar 

  28. Bower JE, Garet D, Sternlieb B, Ganz PA, Irwin MR, Olmstead R, et al. Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial. Cancer. 2012;118:3766–75.

    Article  Google Scholar 

  29. Lötzke D, Wiedemann F, Rodrigues Recchia D, Ostermann T, Sattler D, Ettl J, et al. Iyengar-yoga compared to exercise as a therapeutic intervention during (Neo) adjuvant therapy in women with stage I-III breast cancer: health-related quality of life, mindfulness, spirituality, life satisfaction, and cancer-related fatigue. Evid Based Complement Alternat Med. 2016;2016:5931816.

    Article  Google Scholar 

  30. Cramer H, Rabsilber S, Lauche R, Kümmel S, Dobos G. Yoga and meditation for menopausal symptoms in breast cancer survivors-A randomized controlled trial. Cancer. 2015;121:2175–84.

    Article  CAS  Google Scholar 

  31. Bower JE, Greendale G, Crosswell AD, Garet D, Sternlieb B, Ganz PA, et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial. Psychoneuroendocrinology. 2014;43:20–9.

    Article  CAS  Google Scholar 

  32. Carson JW, Carson KM, Olsen MK, Sanders L, Porter LS. Mindful Yoga for women with metastatic breast cancer: design of a randomized controlled trial. BMC Complement Altern Med. 2017;17:153.

    Article  Google Scholar 

  33. Derry HM, Jaremka LM, Bennett JM, Peng J, Andridge R, Shapiro C, et al. Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Psychooncology. 2015;24:958–66.

    Article  Google Scholar 

  34. Koch AK, Rabsilber S, Lauche R, Kümmel S, Dobos G, Langhorst J, et al. The effects of yoga and self-esteem on menopausal symptoms and quality of life in breast cancer survivors—a secondary analysis of a randomized controlled trial. Maturitas. 2017;105:95–9.

    Article  Google Scholar 

  35. Kovačič T, Kovačič M. Impact of relaxation training according to Yoga In Daily Life® system on self-esteem after breast cancer surgery. J Altern Complement Med. 2011;17:1157–64.

    Article  Google Scholar 

  36. Kovačič T, Kovačič M. Impact of relaxation training according to Yoga In Daily Life(R) system on perceived stress after breast cancer surgery. Integr Cancer Ther. 2011;10:16–26.

    Article  Google Scholar 

  37. Rao MR, Raghuram N, Nagendra HR, Gopinath KS, Srinath BS, Diwakar RB, et al. Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial. Complement Ther Med. 2009;17:1–8.

    Article  Google Scholar 

  38. Lipsett A, Barrett S, Haruna F, Mustian K, O’Donovan A. The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: A systematic review and meta-analysis. Breast. 2017;32:144–55.

    Article  Google Scholar 

  39. Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos GJ. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev. 2017;1:CD010802.

    PubMed  Google Scholar 

Download references

Acknowledgments

This manuscript was edited by Wallace Academic Editing.

Funding

This work was supported by a research grant from Yuan’s General Hospital and Taipei Medical University (Grant no.: 109YGH-TMU-07). The sponsoring organization was not involved in the study design, data analysis, or interpretation of results.

Author information

Author notes

  1. Ka-Wai Tam and Joyce Jui-An Lin contributed equally to this study.

Authors and Affiliations

  1. Cancer Center, Yuan’s General Hospital, Kaohsiung, Taiwan

    Er-Jung Hsueh

  2. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh & Ka-Wai Tam

  3. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

    El-Wui Loh & Ka-Wai Tam

  4. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    El-Wui Loh

  5. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Joyce Jui-An Lin

  6. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

  7. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan

    Ka-Wai Tam

Authors
  1. Er-Jung Hsueh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. El-Wui Loh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joyce Jui-An Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ka-Wai Tam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Joyce Jui-An Lin or Ka-Wai Tam.

Ethics declarations

Conflict of interest

Dr. Ka-Wai Tam has received research grants from Yuan’s General Hospital and Taipei Medical University. Drs. Er-Jung Hsueh, El-Wui Loh, and Joyce Jui-An Lin have no conflicts of interest or financial ties to disclose.

Ethical approval

Ethical approval is not required as our study will not include confidential participant data and intervention.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 21 KB)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hsueh, EJ., Loh, EW., Lin, J.JA. et al. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer 28, 264–276 (2021). https://doi.org/10.1007/s12282-020-01209-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-020-01209-6

Keywords

Search

Navigation