Yoga Can Be an Effective Supportive Therapy for People With Lung Cancer and Their Caregivers

For immediate release
October 23, 2017

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Ashley Yum
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Expert Perspective
“We’ve known for some time that yoga can have a wide range of benefits for people who practice it. Ideally, the findings of this study will encourage people with advanced cancer and their caregivers to practice yoga,” said ASCO Expert Andrew S. Epstein, MD, moderator of today’s presscast.

ALEXANDRIA, Va. – In a feasibility trial of people with advanced lung cancer receiving radiation therapy, and their caregivers, yoga was beneficial to both parties. These findings will be presented at the upcoming 2017 Palliative and Supportive Care in Oncology Symposium in San Diego, California.

“It is never too late to engage in exercise, and we know from earlier studies that people can exercise while being treated with chemotherapy or radiation,” said lead study author, Kathrin Milbury, PhD, an assistant professor of cancer medicine in the Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center in Houston, Texas. “Caregivers sometimes have more anxiety and sleeping problems than patients. Therefore, we thought that having the patient and caregiver go through yoga instruction together would be beneficial for both partners.”

Prior research showed that women with breast cancer benefit from an exercise regimen. Because people with lung cancer usually have more symptoms, are older, and in worse physical shape than women with breast cancer, researchers believed yoga was a low-impact exercise that patients could perform easily. Additionally, yoga has a strong emphasis on breathing, an important issue for people with lung cancer who often have shortness of breath.

“Choosing yoga as the form of exercise to use in this study was important because it is a gentle form of exercise readily modifiable for patients’ needs, and it easily allowed for partners to participate in the yoga practices,” said Dr. Milbury. “Among the yoga poses we chose to include in this study are what are known as chest openers – exercises that emphasize stretching the chest area along with deep breathing.”

About Yoga and the Study
All the patients in the study had advanced lung cancers that could not be removed surgically, were receiving radiation therapy to their chest, and most also received chemotherapy. Each patient participated with a family caregiver. The pairs were then randomly assigned to either yoga classes or a waitlist for future yoga instruction (control group).

At study enrollment, participants completed a 36-point survey assessing their quality of life. The patients with lung cancer also completed a 6-minute walking test. Follow-up assessment of the pairs was done when radiation therapy for the patients ended and then again 3 months later.

This yoga program emphasized three key areas: physical postures, breathing exercises, and meditation. The design of the study to include 15 sessions of yoga lasting 60 minutes each was based on outcomes from earlier research on yoga in people with breast cancer in Bangalore, India, and confirmed by larger trials in the United States.

Key Findings
Twenty-six pairs completed all assessments, and the mean number of yoga sessions completed was 12. Slightly more than half of the patients were men with a mean age in their 60s, while two-thirds of the caregivers were women whose mean age was nearly 60. 

When comparing the yoga pairs with the control waitlist pairs, the researchers found that the patients who practiced yoga had significantly better physical function as assessed by the 6-minute walking test (a score of 478 vs. 402 for yoga vs. waitlist enrollees), better stamina to perform work or daily activities, and improved mental health, while the caregivers who received yoga instruction had improvements in fatigue and stamina while working.

“This was a feasibility study, so it is very hard to tease out the specific effects of our intervention, but that will be a next step in our research,” said Dr. Milbury.

Future Research
The researchers cautioned that they have not shown that yoga is superior to other forms of exercise, such as swimming or hiking, but they do believe that they have demonstrated that it is a holistic experience. Enrollees included only patients at MD Anderson and did not comprise a racially diverse population. Greater inclusiveness will be a goal of future research efforts.

“There is currently very little research on behavioral supportive care for people with lung cancer,” said Dr. Milbury. “We tried to look at one way to boost patient and caregiver well-being, both physically and mentally, as a means to enhance supportive care.”

Patients in the study reported that it was good to be away from their cancer experience during the yoga sessions, and the patients and caregivers both noted that they enjoyed learning something new together. “We were thrilled to hear that many of our pairs said they would continue to do yoga on their own,” concluded Dr. Milbury.

This study was funded by the National Institutes of Health. 

View the full abstract.

For your readers:

2017 Palliative and Supportive Care in Oncology Symposium News Planning Team:
Joseph Rotella, MD, MBA, HMDC, FAAHPM, American Academy of Hospice and Palliative Medicine (AAHPM); Andrew S. Epstein, MD, American Society of Clinical Oncology (ASCO); and David Warr, MD, FRCP, Multinational Association of Supportive Care in Cancer (MASCC).

Click here to view the disclosures for the News Planning Team.

ATTRIBUTION TO THE 2017 PALLIATIVE AND SUPPORTIVE CARE IN ONCOLOGY SYMPOSIUM IS REQUESTED IN ALL NEWS COVERAGE.

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About the American Academy of Hospice and Palliative Medicine:
The American Academy of Hospice and Palliative Medicine AAHPM) is the only national medical specialty society for hospice and palliative medicine. Since 1988, AAHPM has supported hospice and palliative medicine through professional education and training, development of a specialist workforce, support for clinical practice standards, research, and public policy advocacy. AAHPM’s membership includes 5,000 physicians and other healthcare professionals committed to improving the care of patients with serious illness. Learn more at www.aahpm.org or visit our patient website, www.PalliativeDoctors.org. Follow us on Twitter, Facebook, LinkedIn and YouTube.

About ASCO: 

Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube.

About the American Society for Radiation Oncology:
The American Society for Radiation Oncology (ASTRO) is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologist, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology, Biology, PhysicsPractical Radiation Oncology, and Advances in Radiation Oncology, developed and maintains an extensive patient website; and created the Radiation Oncology Institute, a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. 

About the Multinational Association of Supportive Care in Cancer:
The Multinational Association of Supportive Care in Cancer (MASCC) is an international, multidisciplinary organization with members from six continents and nearly 70 countries. It operates in collaboration with the International Society of Oral Oncology (ISOO). Founded in 1990, MASCC is dedicated to research and education in all areas of supportive care for patients with cancer, regardless of the stage of the disease. MASCC promotes professional expertise in supportive care through research and the scientific exchange of ideas. A focus on supportive care leads to better treatment outcomes and greater quality of life for people with cancer.