Randomised controlled trials of yoga interventions for women with breast cancer: a systematic literature review
Yoga is increasingly used as a complementary therapy to manage disease and treatment-related side effects in patients with cancer and has resulted in an increase in the number of studies exploring the effectiveness of yoga interventions. This systematic review examines whether yoga interventions provide any measurable benefit, both physically and psychologically, for women with breast cancer. The results will inform future research in this field and advance the development of yoga programmes.
We performed electronic searches of MEDLINE, PsychINFO, the Cochrane Library, Embase, CINAHL, AMED, Web of Science and Scopus for articles published up to June 2012. Only randomised controlled trials (RCTs) were included and methodological quality rating scores were determined using the PEDro (Physiotherapy Evidence Database) Scale.
One hundred thirty-two studies were identified through a systematic search of eight electronic databases. Only published manuscripts that employed a RCT design were included (n = 18). The sample sizes for these studies varied widely from 18 to 164 participants and the associated PEDro scores ranged from 1 (poor) to 8 (good). All 18 studies reported positive effects for treatment-related side effects in favour of the yoga interventions, with the greatest impact on global quality of life (QoL) scores and emotional well-being.
Results from the few RCTs suggest there is moderate to good evidence that yoga may be a useful practice for women recovering from breast cancer treatments. Large-scale RCTs using objective measures and patient-reported outcomes with long-term follow-up are needed to substantiate whether the benefits are true and sustainable.
KeywordsBreast cancer Yoga Randomised controlled trial Quality of life
- 1.Breast cancer-UK incidence statistics. Cancer Research UK. http://info.cancerresearchuk.org/cancerstats/types/breast/incidence/#world. Accessed 13 Jun 2012
- 6.Lin K-Y, Hu Y-T, K-Jen C, Lin H-F, Tsauo J-Y (2011) Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evid-based Compl Alt. doi:10.1155/2011/659876
- 7.PEDro scale. Physiotherapy evidence database. http://www.pedro.org.au/english/downloads/pedro-scale/. Accessed 21 Feb 2012
- 9.de Morton NA (2009) The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother 55:29–33Google Scholar
- 12.Vadiraja HS, Rao MR, Nagarathna R, Nagendra HR, Rekha M, Vanitha N, Gopinath KS, Srinath BS, Vishweshwara MS, Madhavi YS, Ajaikumar BS, Bilimagga SR, Rao N (2009) Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Complement Ther Med 17:274–280PubMedCrossRefGoogle Scholar
- 13.Vadiraja HS, Raghavendra RM, Nagarathna R, Nagendra HR, Rekha M, Vanitha N, Gopinath KS, Srinath BS, Vishweshwara MS, Madhavi YS, Ajaikumar BS, Ramesh BS, Nalini R, Kumar V (2009) 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 8:37–46PubMedCrossRefGoogle Scholar
- 14.Rao MR, Raghuram N, Nagendra HR, Gopinath KS, Srinath BS, Diwakar RB, Patil S, Bilimagga SR, Rao N, Varambally S (2009) Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial. Complement Ther Med 17:1–8PubMedCrossRefGoogle Scholar
- 18.Bower JE, Garet D, Sternlieb B, Ganz PA, Irwin MR, Olmstead R, Greendale G (2011) Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial. Cancer. doi:10.1002/cncr.26702
- 22.Blank SE, Kittel J, Haberman MR (2003) Active practice of Iyengar yoga as an intervention for breast cancer survivors. Int J Yoga Ther 13:51–59Google Scholar
- 25.Banerjee B, Vadiraja HS, Ram A, Raghavendra R, Jayapal M, Gopinath KS, Ramesh BS, Rao N, Kumar A, Raghuram N, Hedge S, Nagendra HR, Hande P (2007) Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integr Cancer Ther 6:242–250PubMedCrossRefGoogle Scholar
- 35.Mustian KM, Palesh O, Sprod L, Peppone LJ, Heckler CE, Yates JS, Reddy PS, Melnik M, Giguere JK, Morrow GR (2010) Effect of YOCAS yoga on sleep, fatigue, and quality of life: a URCC CCOP randomized, controlled clinical trial among 410 cancer survivors. J Clin Oncol 28:15sGoogle Scholar
- 37.Haddad R, Chandwani K, Perkins G, Spelman A, Johnson K, Fortier A, Nagendra HR, Nagarathna R, Raghuram NV, Arun B, Wei Q, Kirschbaum C, Cohen L (2011) Randomized, controlled trial of yoga for women with breast cancer undergoing radiotherapy. Psychosom Med 73:A119–A120Google Scholar
- 38.Isabell UB, Maja R (2010) Yoga supports physical and mental well-being after breast cancer surgery. J Psychosom Obst Gyn 31:0167–482XGoogle Scholar