Yoga practice benefits men with prostate cancer who are undergoing radiation therapy, reducing treatment side effects and improving life quality. These were the conclusions of a recent study, to be published in early 2016, presented at the 12th International Conference of the Society of Integrative Oncology on Nov. 16 by team of researchers from the Perelman School of Medicine at the University of Pennsylvania.
The first-of-its-kind study, conducted by Neha Vapiwala, MD, an associate professor in the department of Radiation Oncology at PSOM and Penn’s Abramson Cancer Center, and colleagues, found that an intensive yoga program delivered to prostate cancer patients during the course of outpatient radiation therapy helped to stabilize the debilitating side effects frequently experienced by these patients — including urinary incontinence, sexual health and fatigue. “Data have consistently shown declines in these important measures among prostate cancer patients undergoing cancer therapy without any structured fitness interventions, so the stable scores seen with our yoga program are really good news,” Dr. Vapiwala said in a news release.
The fatigue associated with cancer is different from that experienced in everyday life, which normally can be relieved by sleep or rest. Evidence from studies has shown that fatigue related to cancer, or caused by cancer treatments, lowers patients’ quality of life even more than pain, with 60% to 90% of patients undergoing radiation therapy reporting fatigue.
The positive clinical benefits of yoga might be explained by physiologic data showing it to reduce cancer and treatment-associated fatigue while increasing blood flow and strengthening pelvic floor muscles. According to Dr. Vapiwala, these latter clinical aspects, in turn, can improve patients’ urinary incontinence and erectile dysfunction, symptoms frequently associated with prostate cancer. “There may also be a psychosocial benefit that derives from participation in a group fitness activity that incorporates meditation and promotes overall healthiness. And all of this ultimately improves general quality of life,” she added.
The majority of studies assessing yoga in cancer patients have evaluated its effects on breast, not prostate, cancer patients, mainly because men are thought to be less disposed toward yoga programs (72% of yoga practitioners are women). “Despite these figures, we found that a structured yoga intervention in the form of twice-weekly classes is feasible for patients during a six- to nine-week course of outpatient radiotherapy for prostate cancer,” said Dr. Vapiwala. “Our participation-rate finding alone is important because it is a caution against making assumptions about patients without proper evidence.”
The research team identified 68 eligible patients with prostate cancer. Of these, 45 (66%) agreed to attend yoga classes of 75 minutes twice a week, taught by trained Eischens yoga instructors within the Abramson Cancer Center. “Eischens yoga incorporates ideas from movement theory and kinesiology and is accessible to all body types and experience levels,” said Tali Mazar Ben-Josef, DMD, a certified Eischens yoga instructor and researcher in the Abramson Cancer Center. Eighteen patients (40%) had to withdraw from the study due to conflicts between radiation therapy and yoga class schedules.
The results revealed that most patients taking part in the yoga classes reported a sense of well-being at the end of each class. According to Ben-Josef, many at the study’s end requested and received an at-home yoga practice routine. The effects of yoga were evaluated by assessing patients’ cancer-related fatigue, overall quality of life, and prevalence of urinary incontinence, sexual and erectile dysfunction. The team observed a significant variability over the time of treatment in fatigue severity scores, with an anticipated increase in fatigue by week four that improved in subsequent weeks. Steady trends were seen in general quality of life, urinary incontinence, and erectile dysfunction scores.
This randomized trial expands the Abramson Cancer Center’s integrative medicine and wellness services for patients and cancer survivors. In addition to yoga, it offers meditation, acupuncture, stress-reduction practises, reiki therapy, and massage. “We offer several ways to enhance quality of life, minimize or reduce side effects of cancer and cancer treatment, and promote healing and recovery,” Dr. Vapiwala said. “This study represents one of many research projects we are conducting in an effort to pinpoint the best, most effective practices to help patients with these needs.”