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Supportive Care in Cancer

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01-10-2009 | Original Article

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial

Authors: James W. Carson, Kimberly M. Carson, Laura S. Porter, Francis J. Keefe, Victoria L. Seewaldt

Published in: Supportive Care in Cancer | Issue 10/2009

Abstract

Goal of work

Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA–IIB).

Materials and methods

Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat.

Main results

At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance.

Conclusions

This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

Yoga poses consisted of either a mat-based sequence (Warm-ups, Child’s pose, Table, Downward-Facing Dog Flow, Half Moon, Warrior 1 Flow, Extended Side Angle, Modified Locust, Supine Squats, Supine Big-Toe, Supine Sage Twist with Bolster, Corpse) or a chair-based sequence (Warm-ups, Cat/Cow, Thoracic Spine Twist Flow, Sun Salutation, Standing Wide Angle Fold, Standing Wide Angle Fold with Thoracic Twist, Prayer Flow, Seated Wide Angle Fold, Head To Knee, Pigeon, Forward Fold, Modified Sage Twist, Seal of Yoga, Corpse).

Banerjee B, Vadiraj HS, Ram A et al (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 6:242–250. doi:10.1177/1534735407306214 PubMedCrossRef

Berger BG, Owen DR (1992) Mood alteration with yoga and swimming: aerobic exercise may not be necessary. Percept Mot Skills 75:1331–1343. doi:10.2466/PMS.75.8.1331–1343 PubMedCrossRef

Booth-LaForce C, Thurston RC, Taylor MR (2007) A pilot study of a Hatha yoga treatment for menopausal symptoms. Maturitas 57:286–295. doi:10.1016/j.maturitas.2007.01.012 PubMedCrossRef

Borkovec TD, Nau SD (1972) Credibility check of analogue therapy rationales. J Behav Ther Exp Psychiatry 3:257–260. doi:10.1016/0005–7916(72)90045–6 CrossRef

Carpenter JS, Storniolo AM, Johns S et al (2007) Randomized, double-blind, placebo-controlled crossover trials of venlafaxine for hot flashes after breast cancer. Oncologist 12:124–135. doi:10.1634/theoncologist.12–1–124 PubMedCrossRef

Carson JW, Carson KM, Gil KM et al (2004) Mindfulness-based relationship enhancement. Behav Ther 35:471–494. doi:10.1016/S0005–7894(04)80028–5 CrossRef

Carson JW, Carson KM, Porter LS et al (2007) Yoga for women with metastatic breast cancer: results from a pilot study. J Pain Symptom Manage 33:331–341. doi:10.1016/j.jpainsymman.2006.08.009 PubMedCrossRef

Carson JW, Keefe FJ, Affleck G et al (2006) A comparison of conventional pain coping skills training and pain coping skills training with a maintenance training component: a daily diary analysis of short- and long-term treatment effects. J Pain 7:615–625. doi:10.1016/j.jpain.2006.02.008 PubMedCrossRef

Cohen BE, Kanaya AM, Macer JL et al (2007) Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas 56:198–204. doi:10.1016/j.maturitas.2006.08.003 PubMedCrossRef

10.

Cohen L, Warneke C, Fouladi RT et al (2004) Psychological adjustment and sleep quality in a randomized controlled trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer 100:2253–2260. doi:10.1002/cncr.20236 PubMedCrossRef

11.

Culos-Reed SN, Carlson LE, Daroux LM et al (2006) A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psychooncology 15:891–897. doi:10.1002/pon.1021 PubMedCrossRef

12.

Elavsky S, McAuley E (2007) Physical activity and mental health outcomes during menopause: a randomized controlled trial. Ann Behav Med 33:132–142. doi:10.1007/BF02879894 PubMedCrossRef

13.

Freedman RR (2005) Hot flashes: behavioral treatments, mechanisms, and relation to sleep. Am J Med 118:124–130. doi:10.1016/j.amjmed.2005.09.046 PubMedCrossRef

14.

Freedman RR (2005) It’s all in your head. Menopause 12:483. doi:10.1097/01.gme.0000172272.10219.90 PubMedCrossRef

15.

Freedman RR, Woodward S (1992) Behavioral treatment of menopausal hot flushes: evaluation by ambulatory monitoring. Am J Obstet Gynecol 167:436–439PubMed

16.

Garfinkel MS, Schumacher HR Jr, Husain A et al (1994) Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol 21:2341–2343PubMed

17.

Garfinkel MS, Singhal A, Katz WA et al (1998) Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA 280:1601–1603. doi:10.1001/jama.280.18.1601 PubMedCrossRef

18.

Gross JJ (2002) Emotion regulation: affective, cognitive, and social consequences. Psychophysiology 39:281–291. doi:10.1017/S0048577201393198 PubMedCrossRef

19.

Keefe FJ, Caldwell DS, Baucom D et al (1999) Spouse-assisted coping skills training in the management of knee pain in osteoarthritis: long-term followup results. Arthritis Care Res 12:101–11 1999:101–111PubMedCrossRef

20.

Kronenberg F (1990) Hot flashes: epidemiology and physiology. Ann N Y Acad Sci 592:52–86. doi:10.1111/j.1749–6632.1990.tb30316.x PubMedCrossRef

21.

Lee MM, Lin SS, Wrensch MR et al (2000) Alternative therapies used by women with breast cancer in four ethnic populations. J Natl Cancer Inst 92:42–47. doi:10.1093/jnci/92.1.42 PubMedCrossRef

22.

MacLennan A, Lester S, Moore V (2001) Oral oestrogen replacement therapy versus placebo for hot flushes (Cochrane Review). Cochrane Database Syst Rev 1. CD002978.

23.

McCracken LM, Carson JW, Eccleston C et al (2004) Acceptance and change in the context of chronic pain. Pain 109:4–7. doi:10.1016/j.pain.2004.02.006 PubMedCrossRef

24.

Moadel AB, Shah C, Wylie-Rosett J et al (2007) Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol 25:4387–4395. doi:10.1200/JCO.2006.06.6027 PubMedCrossRef

25.

Morales L, Neven P, Timmerman D et al (2004) Acute effects of tamoxifen and third-generation aromatase inhibitors on menopausal symptoms of breast cancer patients. Anticancer Drugs 15:753–760. doi:10.1097/00001813–200409000–00003 PubMedCrossRef

26.

National Institutues of Health (2005) National Institutes of Health State-of-the-Science Conference Statement: management of menopause-related symptoms. Ann Intern Med 143:1003–1014

27.

Oken BS, Kishiyama S, Zajdel D et al (2004) Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 62:2058–2064PubMed

28.

Raghavendra RM, Nagarathna R, Nagendra HR et al (2007) Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients. Eur J Cancer Care (Engl) 16:462–474. doi:10.1111/j.1365–2354.2006.00739.x CrossRef

29.

Schwartz JE, Stone AA (1998) Strategies for analyzing ecological momentary assessment data. Health Psychol 17:6–16. doi:10.1037/0278–6133.17.1.6 PubMedCrossRef

30.

Sloan JA, Loprinzi CL, Novotny PJ et al (2001) Methodologic lessons learned from hot flash studies. J Clin Oncol 19:4280–4290PubMed

31.

Telles S, Naveen KV (1997) Yoga for rehabilitation: an overview. Indian J Med Sci 51:123–127PubMed

32.

Vempati RP, Telles S (2002) Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels. Psychol Rep 90:487–494. doi:10.2466/PR0.90.2.487–494 PubMedCrossRef

33.

Williams KA, Petronis J, Smith D et al (2005) Effect of Iyengar yoga therapy for chronic low back pain. Pain 115:107–117. doi:10.1016/j.pain.2005.02.016 PubMedCrossRef

Title: Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial
Authors: James W. Carson
Kimberly M. Carson
Laura S. Porter
Francis J. Keefe
Victoria L. Seewaldt
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 10/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-009-0587-5

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Abstract

Goal of work

Materials and methods

Main results

Conclusions

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