Good news just in time for Breast Cancer Awareness Month: A new study has found that participation in a yoga program helped cancer survivors feel better physically, emotionally, and spiritually. It also showed a correlation between practicing the more "contemplative" aspects of yoga -- intention setting, mudra, pranayama, and final relaxation -- and a greater increase in emotional and spiritual well-being.
“Participation in the Healing Yoga for Cancer Survivorship (HYCS) protocol showed an 8.8% decrease in physical symptom severity (i.e., fatigue, sleep disturbance, pain, and interference of side effects), a 6.6% increase in functional well-being (i.e., ability to work, concentration, ability to sleep, and acceptance of illness), a 10.3% decrease in emotional symptom severity (i.e., sadness, nervousness, worry about recurrence, and hopelessness), and a 13.9% increase in spiritual well-being (i.e., peacefulness, life purpose, harmony, self-reliance, and gratitude),” says study author and yoga therapist Cheryl Fenner Brown, who developed the HYCS protocol. She presented the preliminary findings of her study in a poster session at the International Association of Yoga Therapists Symposium on Yoga Research at Kripalu on Monday and will speak about the study at next month's Society of Integrative Oncology's annual conference in Boston.
Study participants included 19 mixed gender cancer survivors with an average age of 56 years and an average time since completing radiation and chemotherapy treatment of just over three years. Their diagnoses included breast cancer, lymphoma, leukemia, melanoma, and neuroendocrine, endometrial, ovarian, brain, rectal, and kidney cancers. Breast cancer made up 35% of the yoga participants, but the data from this particular group are still being analyzed. The control data were not analyzed due to a small sample size.
Below, we asked Brown tell us more about her encouraging findings and why the more contemplative aspects of yoga may play a key role in increasing well-being for cancer survivors and for everyone.
YJ: Tell us more about how yoga was found to help cancer survivors improve their overall well-being.
Brown: Yoga positively affected 76% of the well-being factors measured among physical, functional, emotional, and spiritual domains. The greatest increase in well-being was found among emotional (10.3%) and spiritual (13.9%) well-being with patients practicing the more contemplative practices (mudra, pranayama, intention setting, and final relaxation) most frequently at home. In fact, there was a 22% decrease in hopelessness and a 24% decrease in worry about dying in the emotional domain; and a 26% increase in the ability to find harmony within oneself in the spiritual domain.
YJ: How do the benefits of the more contemplative practices compare to the benefits of asana practice?
Brown: How the benefits of asana practice compare to the more contemplative practices can be viewed through the lens of the koshas, or five sheaths of being. The physical practice of asana moves the muscles, bones, and joints of the body, which nourishes annamaya kosha, the physical sheath. Asana practice is important, especially for survivors who have residual physical and functional symptoms such as pain, neuropathy, lymphedema, and constipation. Physical movement also assists the lymphatic system in optimal functioning, which is key for immune system health.
The more subtle koshas are reached through the contemplative practices such as mudra, pranayama, intention setting, and relaxation. Specifically, mudra creates a connection between annamaya kosha and pranamaya kosha, the energy sheath, by redirecting prana into the body through specific gestures of the hands to elicit particular responses in the body. Pranayama nourishes pranamaya kosha by directing prana through the nadis or energy channels. Setting a sankalpa, or intention, nourishes manomaya kosha, the mental/emotional sheath and vijnanamaya kosha, the wisdom sheath. Repetition of the sankalpa plants a transformative resolve deep in the mind, allowing word, thought, and action to come into alignment toward a goal. And practices such as guided relaxation and Savasana nourish vijnanamaya kosha by quieting the mind so that the inner voice can be heard. All of these practices set the stage to experience anandamaya kosha, the bliss sheath, and in the case of cancer survivors, this experience of the self as whole is key to increasing emotional and spiritual well-being.
YJ: Why do you differentiate in the study between yoga practiced in class and yoga practiced at home?
Brown: The participants in the study met with me for 90 minutes, once weekly for eight weeks. In class they learned the HYCS protocol sections: intention setting, chanting, pranayama, mudra, reclining, kneeling, sitting, standing and restorative asana, body scan, and final relaxation. They were also given the Healing Yoga for Cancer Survivorship DVD that is organized into these same sections. Each person could combine the sections to create a customized home practice that would meet their changing daily needs. They then reported on their physical, functional, emotional, and spiritual well-being and which sections of the protocol they practiced each day. This provided data that showed a dose-relationship response -- the more frequently they practiced, the better they felt. It also showed a correlation between more frequent contemplative practice leading to a greater increase in emotional and spiritual well-being.
YJ: Other studies have also found yoga to be beneficial for cancer survivors. How is your research different?
Brown: Much of the previous research does not address whether the benefits to well-being are a result of physical yoga practice (i.e., asana) or the more contemplative and meditative aspects of the yoga practice, especially in considering the effect on spiritual well-being. This study differs in that measurements were taken that allowed correlation between the specific yoga techniques practiced and the domains of well-being improved.
YJ: How did the participants seem to change over the eight-week study period?
Brown: Many seemed much more embodied and connected with themselves. Several commented that the program helped them to release an "all-or-nothing" attitude they had held about exercise and that the practices, especially the mudras, empowered them to reengage in self-care. These positive changes as well as the study findings both support the need for further investigation into how the contemplative and meditative practices of yoga may further increase emotional and spiritual well-being.
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Since 2007, Brown has been fiscally sponsored by the Piedmont Yoga Community (PYC), which funds classes for cancer patients and people with disabilities. The 2014 Healing Yoga for Cancer Survivorship research was funded by a grant from the Robert Wood Johnson Foundation. The Cancer Support Community of the San Francisco Bay Area has housed the Healing Yoga for Cancer Survivorship research since 2012 and offers support services for cancer patients and their caregivers. Since 2011, Brown has expanded their yoga for cancer program to include gentle active, restorative, yoga nidra, and chanting classes taught by teachers trained in her methodology. Brown’s new DVD, Healing Yoga for Cancer Survivorship, is available for purchase at yogacheryl.com.