Healing Refuge

For many women with breast cancer, yoga offers relief from the side effects of treatment while transforming a sense of loss into an experience of wholeness.

By Katherine Griffin

Sometimes the first inkling that something is wrong comes when you're alone. Sometimes it comes when your doctor's number pops up on your cell phone a few days after a mammogram.

What you feel first is the fear—that sudden flash of dread that washes over you, too quickly for you to name. Then you realize that what you fear has a very familiar name: breast cancer. You know women who've had it—many who have survived, some who have not. And you know that if the as-yet-unidentified lump in your breast turns out to be cancerous, you may be facing months of debilitating treatments. You're likely to lose your appetite, your energy, your hair, and perhaps also your sense of your body as a safe, whole place for your spirit to reside.

At such a moment, beginning a yoga practice might seem unlikely.

But that's exactly what Debra Campagna, a former hospital executive in Hartford, Connecticut, did. On Valentine's Day of 2000, her doctors told her that the lump she'd found in her left breast a week earlier was indeed cancer. In fact, it was a large, fast-growing tumor, so she would need the most powerful tools in the Western medical arsenal: chemotherapy, radiation, and surgery.

Campagna, who was 50 at the time, was accustomed to working out at her gym five times a week. She knew she wouldn't be able to keep that up. "I saw a flier for a Kundalini teacher offering private yoga sessions," she says. "I signed up." She'd had no yoga experience but hoped to find the practice gentle enough to continue during treatment. In fact, she was able to work with the teacher once a week for the following year.

Prior to starting chemotherapy, Campagna had two surgeries: the first to remove the lump and the several lymph nodes where the malignancy had spread, and the second to remove stray cancer cells the first surgery had missed. Then, beginning in April, she went through eight rounds of chemotherapy. She also had 30 radiation treatments. Along the way she had to contend with CT and PET scans, biopsies, and innumerable other tests, consultations, and medications.

"It was very frightening," Campagna says. "You wonder, obviously—Am I going to live through this?"

Now, eight years later, Campagna is cancer free. And while she gives grateful credit to what she calls her "amazing" team of doctors for their part in her recovery, she deeply believes that yoga was an essential element in her healing.

"I'm convinced that yoga made all the difference in my treatment," she says. "The breathing was the thing that always came back for me—keeping the fear and panic down. I was in a PET scan machine for an hour. You just lie there and think terrible thoughts. I found my breathing. That was the most valuable thing."

Increasing numbers of women caught in the fear, pain, and uncertainty of a breast cancer diagnosis are turning to yoga to ease their way forward. Some hear about it through word of mouth; others are encouraged by their doctors to seek out the practice. These women—and the researchers who are studying how yoga may be helpful—are finding that the ancient discipline can soothe, comfort, and help them feel whole once again.

"Studies suggest that doing yoga while going through breast cancer treatment helps you get through it with fewer side effects," says Dr. Timothy McCall, Yoga Journal's medical editor and author of Yoga as Medicine. "Often doctors have to stop chemo or lower doses to levels that may not be as effective because people don't tolerate the side effects. But yoga appears to decrease all kinds of side effects."

Being able to gently revive their energy is especially important for cancer patients, because fatigue is the most common side effect of both cancer and its treatment. "Yoga can make a huge difference in a person's fatigue level," McCall says. Last year, researchers at Duke University published a study showing that an eight-week yoga program focusing on gentle postures, meditation, and breathing significantly lessened fatigue and pain in women who were seriously ill with metastatic breast cancer. Other research has shown that yoga can ease the nausea, depression, and anxiety that often accompany treatment.

Special Appeal for Breast Cancer Patients

Yoga benefits people with other kinds of cancer as well. But breast cancer patients seem especially drawn to it. The reason for this may be that they, as a group, advocate for research and support services more than people with other cancers do, spurring researchers to find funding for studies. Once those studies show the benefits of yoga, doctors are more likely to recommend it. Then, too, breast cancer patients are often diagnosed earlier in the course of the disease—when they are stronger and generally healthier—than people with, say, ovarian or lung cancer. That means it's often easier for women with stage I breast cancer to do a strong practice than it might be for people with other kinds of cancer.

But the yoga that breast cancer patients are able to do might not be what you'd see in a typical asana class. What's most appropriate is a gentle approach that combines modified poses with meditation and pranayama (breathing techniques). Sometimes women are lucky enough to find a class created especially for people with cancer. Or they might learn of a class taught by someone who specializes in yoga therapy. Whatever the setting, the most important thing for patients is to feel comfortable and to go at their own pace.

"I always tell students to check their own experience," says Jnani Chapman, a nurse, massage therapist, and yoga teacher at the Osher Center for Integrative Medicine at the University of California, San Francisco. Chapman (who designed the asana sequence featured here) has been teaching yoga classes for cancer patients for more than 20 years. She says, "It should feel good. You should feel energized and relaxed afterward, not exhausted." Chapman's primary teacher, Swami Satchidananda, the founder of Integral Yoga, emphasized that there are many paths to the place of peace and wholeness within. "For some, it might be hatha, perfecting the physical body," she says. "For some it might be meditation." Chapman aims to introduce patients to various mind-body experiences that can facilitate healing.

Her classes are held in a room at the medical center that's carpeted (more comfortable than one with bare floors), and participants use thicker-than-usual cushioned mats for added ease. In a typical 90-minute class, Chapman will begin with 10 minutes of check-in, in which participants let the others know how they're doing. Then the class moves on to what she calls "witness practice," a sort of body meditation, in which each person goes within, observing the sensations in the body. About 35 minutes of asana come next, with many poses done in chairs so that everyone, no matter how ill, is able to participate. The rest of the class is given over to deep relaxation, breathing practices, and a brief meditation.

Support for the Divine Self

The groups, Chapman says, become an intentional community of like-minded souls, supporting each other. "People dealing with cancer have been 'specimenized,' she says. "When you've lost body parts and Western medicine is treating you like a thing, not a person, you have to reclaim your sense of self."

Robin Hall, a San Francisco yoga teacher who's now 56 and is modeling the poses on these pages, came to a massage therapy session conducted by Chapman after radiation therapy for breast cancer had burned the skin off part of her torso. "I felt like a monster," she says. Chapman's classes became a place where she could cry, feel safe, and share her experiences with other people. "The biggest thing I learned is that who we are inside doesn't change," she says. "Whether we lose a breast, or two, or can't lift our arms over our heads, that divine essence doesn't change."

Using yoga to access a sense of well-being doesn't have to happen in a class with others. For Leila Sadat, 48, of St. Louis, yoga became a lifeline as she lay alone in her bed for weeks. Diagnosed with breast cancer in 2006 when she was 19 weeks pregnant, Sadat learned she had a stage III estrogen-positive tumor that was feeding off the pregnancy hormones and growing quickly. She had practiced yoga for more than a decade and had done some teacher training with Rod Stryker, founder of ParaYoga. But after receiving her diagnosis, she experienced yoga in a whole new way.

"I knew yoga was more than just physical asana," she says, "but until my body could no longer move in the way it once did, I never fully appreciated it." Luckily, Sadat was far enough along in her pregnancy that it was safe for her to undergo chemotherapy. But in July she began having severe contractions (perhaps triggered by chemotherapy drugs) and was put on partial bed rest until the baby was due.

"I couldn't go for a short walk or anything," Sadat says. "I couldn't do much more than lie on my left side. The motion of my breath kept me from going crazy."

A healthy baby girl, Emily, was born via cesarean section that September. Sadat breast-fed her daughter for one week before resuming chemotherapy. In December of 2006 she had a mastectomy. After the surgery, she began to use asana to help her physical recovery, even though she couldn't move much at first.

All through her illness and its aftermath, Sadat drew strength from an image that came to her during a restorative yoga class, soon after her diagnosis. "I was deep in Yoga Nidra [yogic sleep]," she says. "I had a beautiful vision of being in a garden and falling into a pool, and being purified and coming out healed. I felt very reassured that I was going to be OK."

Having a way to connect to a strong sense of inner peace may even help people heal, McCall says. "There is some evidence that yoga boosts your immune system, perhaps by lowering cortisol," he says. The hormone cortisol is released when we experience stress, and when it is elevated over the long term, it can interfere with immune function, McCall explains. "If you feel it's your job to cure your cancer and monitor it 24 hours a day, your stress hormones will be elevated all the time, which may undermine your survival." Cancer treatments often weaken the immune system, so it's particularly important for people with cancer to keep their immunity as strong as possible; this can help them fight the cancer itself as well as keep other illnesses at bay."

Growing Acceptance

Since Jnani Chapman began teaching yoga to cancer patients, she has seen the practice gradually gain credibility in the medical world: "There are a lot of little hospitals that have yoga classes for cancer patients. There's more acceptance now."

In the city of Boise, Idaho, for instance, St. Luke's Regional Medical Center has been offering yoga to its cancer patients for the past 10 years. The seed was planted when Debra Mulnick, a nurse and yoga teacher, began giving classes to employees in 1998. "One nurse who came to that program was an oncology nurse and cancer survivor," Mulnick says. "It was the first time she ever felt really comfortable in her body. She decided she would love to see this become available to patients."

So she and Mulnick developed a program. "It got instituted and accepted because I was a nurse," Mulnick says. "People knew me." She also brought yoga to physicians in the hospital who were unfamiliar with it. "A committee of oncologists was trying to decide whether to do this," she says. "So I gave a restorative class. I think that cinched the deal."

Sue Robinson, 61, a manager for a telecommunications company in Boise, began attending the class at St. Luke's shortly after she was diagnosed with breast cancer in early 2007. "I've never done anything that seemed to be so simple but had so many benefits," she says. "I would get so in touch with everything in the here and now. The benefits lasted for days."

Teacher Shortage

Still, yoga is far from being a standard part of the therapies offered to women who have recently been diagnosed. One reason, says Julia Rowland, director of the Office of Cancer Survivorship at the National Cancer Institute, is that there are not enough yoga teachers trained to work with cancer patients.

Chapman is doing what she can to change that. Every year she leads the weeklong teacher training program Adapting Yoga for People with Cancer at the Satchidananda Ashram in Virginia. And designer Donna Karan's Urban Zen Initiative is training Integrative Yoga Therapists to use yoga, meditation, healing touch, and aromatherapy with cancer patients at Beth Israel Medical Center in New York City.

Rowland suggests that, as more and more patients experience yoga, they need to make sure that their physicians know how helpful they've found it. "One way I've seen programs accepted is when patients come to their doctors and say, "'Yoga is the best thing I did for myself, and it helped me in these ways,'" she says.

Debra Campagna agrees. She knows firsthand that yoga can be transformative in helping women get through breast cancer. The Kundalini class she turned to as a substitute for the gym was the first step in a journey that's changed her life. "I got so interested in more than just the postures," she says. "I learned to look at everything in my life differently."

When she started yoga, Campagna was very driven. Gradually, as yoga helped her make it through the rigors of her treatment, it became easier for her to let go and receive. "I was more relaxed and less afraid," she says. "More accepting."

After she returned to work, she started sharing what she had learned from her yoga classes with the hospital staff. Then she decided to sign up for teacher training at the Kripalu Center for Yoga and Health in Stockbridge, Massachusetts, in 2003.

"I remember one day standing at Kripalu there in the fog with a cup of hot tea, looking toward the lake and thinking to myself, 'I can change my whole life,'" says Campagna. "From that point I started thinking about not just adding being a yoga teacher to an already full work life, but making that transformation more deeply—having yoga shape who I was at every level.'

Today, she still works for hospitals, doing fundraising and marketing, but only 15 hours a week. She spends the rest of her time working as a yoga therapist, with people who are undergoing various types of medical challenges. She teaches one class for women with cancer, another for people suffering from chronic pain.

What Campagna and her students continue to discover together, she says, is that while illness often comes in a frightening package, it can still lead to beautiful discoveries.

Katherine Griffin, former deputy editor of Yoga Journal, is a Bay Area writer and editor.

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