Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial

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Citation

Dhruva A, Miaskowski C, Abrams D, Acree M, Cooper B, Goodman S, Hecht FM. Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial. J Altern Complement Med. 2012 May;18(5):473-9. doi: 10.1089/acm.2011.0555. Epub 2012 Apr 23. PMID: 22525009; PMCID: PMC3353818.

4 FUNDAMENTALS

 

1. Essential Background Material

  • Cancer chemotherapy usually has harmful effects, such as fatigue, sleep disturbances, stress and anxiety, and a general worsening of quality of life.

  • However, chemotherapy patients have very few options—additional drugs often come with more side effects.

  • Pranayama breathing exercises (defined as “regulation and expansion of breath”) are appealing because they are free, relatively easy to perform, and have virtually no adverse side effects.

  • Moreover, physiologically, some pranayama exercises have been shown to increase parasympathetic tone, which could be helpful with chemotherapy side effects.

  • Previous studies using pranayama in cancer patients were encouraging.  However, they used multidimensional yoga approaches, making it hard to know how much pranayama alone contributed to positive outcomes.

  • This study aimed to see if pranayama (without other yoga components) could help cancer patients undergoing chemotherapy.


2. What Did this Research Do?

 

A total of 16 participants enrolled in the study throughout two cycles of chemotherapy (labeled “Cycle A” and “Cycle B”) over a 1-year period.

Side Note:

Based on the info provided, my quick calculations say that the total duration of the experiment was about 42 weeks.

 

The treatment group (n=8) received pranayama training throughout both cycles.  The control group (n=8) did not receive pranayama during Cycle A but did receive it during Cycle B.

 

Pranayama Protocol

 

Once a week, the participants received a 60-minute group pranayama class.  They were also instructed to practice at home twice a day for 10-15 minutes (totaling 20-30 minutes daily).

 

The protocol used the following exercises:

  1. Breath Awareness

  2. Ujjayi with slow, deep, extended exhales and slightly closed glottis

  3. Kapalabhati (the number of cycles depended on the participant’s health and comfort during this practice).

  4. Alternate Nostril Breathing (ANB)

 

These exercises were chosen because they were easy to learn and had an effective history with cancer patients.

 

Measurements

 

Self-assessments of fatigue, sleep disturbances, stress, anxiety, depression, and overall quality of life were given at the start of the experiment, after the first cycle of chemotherapy (Cycle A), and at the end of the investigation (after Cycle B).  They used established, clinically-accepted questionnaires for each of these self-assessments.



3. What Were the Major Findings?


  • Weekly pranayama class attendance was almost 100%, indicating that pranayama is feasible for cancer patients undergoing chemotherapy.


  • Patients averaged 20-27 daily minutes of at-home pranayama practice, signifying excellent adherence to the protocol.


  • All of the control group’s symptoms got worse during the first round of chemotherapy (when they weren’t practicing pranayama).  Then, they got better after they began pranayama.


  • The patients who practiced pranayama for both cycles of chemotherapy improved in all symptom and quality of life measurements. 


    • Caveat: In this group, fatigue and depression initially worsened from baseline during the first chemo treatment (meaning the pranayama couldn’t “overpower” the chemotherapy).  Then, it got better during the second treatment with continued pranayama practice.


  • Increases in practice time were correlated with decreases in symptoms.  This means the more time people practiced pranayama, the better their chemo symptoms got, and the more their quality of life improved. 


A Limitation + Nick’s Note:

All participants were also using other forms of complementary and alternative medicine.  Who wouldn’t?  And I personally think that makes these results even more powerful because the breathing practice was applied in the patients’ real life.  However, scientifically, this confounds the results because there’s no way of knowing how much those other therapies played a role.

 

 

4. Why Do These Results Matter?

 

This was the first study to show that pranayama (by itself) improves chemotherapy symptoms and enhances cancer patients’ quality of life.  This is extremely meaningful because the breathing exercises used here are safe and relatively easy to perform, regardless of health status.  This makes them an attractive supplemental treatment option for chemotherapy patients.

 

Moreover, the pranayama classes had almost 100% attendance, indicating that this treatment option is feasible and perhaps even enjoyable to the patients (which is the most important, in my opinion).

 

Lastly, this study is significant because it discovered a dose-response correlation: The more pranayama practice a person did, the fewer symptoms they felt and the better their quality of life.

 

 

 

1 BIG TAKEAWAY

 

A simple pranayama practice (without additional yoga components) was safe and improved stress, anxiety, depression, sleep disturbances, and overall quality of life in cancer patients undergoing chemotherapy, suggesting that pranayama may be a helpful supplemental treatment for these patients.

 

 

 

1 PRACTICAL APPLICATION

 

Although our personal life stressors seem insignificant compared to what cancer patients endure during chemotherapy, we can still apply this pranayama protocol to help improve our sleep, stress, anxiety, and overall quality of life.

 

Moreover, the protocol is simple and safe for most people (Kapalabhati can be dangerous in some cardiovascular conditions or if you are pregnant, so check with a pranayama instructor beforehand…or just skip it and add an extra minute to each of the other practices below).

 

Give it a try for a few days and see how it makes you feel:

 

  1. Mindful breathing (~4-5 min)

  2. Ujjayi breathing (~4-5 min)

  3. Kapalabhati (10-30 cycles; check with pranayama instructor to assess contraindications before practicing)

  4. Alternate nostril breathing (4-5 min)

 

 

Share the Research

 

Did any of these findings stand out based on your prior knowledge and experience?   If so, grab one, add your personal take on its importance, and share it, so people learn the importance of these findings from your unique perspective.