Yoga Trial Shows Significant Reduction in Cancer Survivors' Distress, Anxiety, Fatigue, and Insomnia

Yoga can reduce emotional distress, anxiety, fatigue and insomnia in people living with cancer, according to the results of the first clinical trial of its kind.

Hundreds of millions of people worldwide are living with cancer, with advances in treatments meaning more patients are surviving the disease than ever before. But for many, the physical and mental side-effects of their diagnosis and treatment regime can last long after treatment ends.

Up to 95% of cancer survivors experience sleep disturbances or insomnia at some point during or after their treatment, and more than half experience mood disturbances, anxiety or fatigue.

Now the first clinical trial of its kind has shown that regular gentle hatha and restorative yoga can help improve those side-effects, without the need for medication. The results were presented in Chicago at the world’s largest cancer conference, the American Society of Clinical Oncology’s (ASCO) annual meeting.

Researchers recruited 410 cancer survivors in the US to the trial. None had participated in yoga in the previous three months, and their cancer had not spread. Their average age was 54 and three in four of them had been diagnosed with breast cancer, the world’s most common type of cancer.

A total of 204 participants were randomly assigned to receive standard survivorship care, which typically includes maintenance therapy, follow-up visits and monitoring for side-effects.

The other 206 participants received standard survivorship care and took part in Yoga for Cancer Survivors (YOCAS). The four-week programme uses 18 gentle hatha and restorative yoga poses, breathing exercises and mindfulness to improve symptoms in cancer survivors.

The programme included two 75-minute instructor-led yoga classes and additional home-based yoga practice for at least 30 minutes or more a week. The hatha and restorative yoga focused on slow, gentle movements and still postures using props. They also both integrated breathing and mindfulness techniques.

Participants’ mood, anxiety, fatigue and insomnia was assessed and scored using questionnaires during the trial, which was funded by the National Cancer Institute.

Compared with the standard care participants, yoga participants experienced meaningfully less overall mood disturbance, corresponding to a moderate-to-large effect of yoga. They also had less anxiety, corresponding to a small-to-medium effect of yoga, and experienced less fatigue, corresponding to a medium-to-large effect.

“There is no single gold standard behavioural treatment available to survivors for treating overall mood disturbance, anxiety, fatigue, and insomnia,” said Yuri Choi, lead study author and a research assistant professor at the University of Rochester medical centre.

“By demonstrating that YOCAS intervention improves all four of these cancer-related side effects and showing how improvements in overall mood disturbance, anxiety, and fatigue influence yoga’s effect on insomnia, this trial helps to fill that gap.”

Dr Fumiko Chino, a cancer researcher and associate professor in breast radiation oncology at MD Anderson Cancer Center and an ASCO expert in survivorship, who was not involved with the trial, said: “This large, randomised study shows that structured yoga may help relieve some of the most consistently reported and hard-to-treat issues in cancer survivorship, leading to decreased insomnia.

“It’s an important advance because it offers survivors, who are likely already managing multiple medications, a non-pharmaceutical solution for reducing four different side-effects at once.”