Yoga for Cancer Patients Provides Benefits of Sleep, Vitality

Touch toes. Downward dog. Breathe. It’s a yoga routine that cancer doctors have prescribed for years without evidence it would do much good. Now the biggest ever scientific study of yoga finds their instincts were right.

While yoga doesn’t cure the disease, its stretching and breathing exercises did improve sleep, reduce dependence on sedatives and help cancer patients resume the routine activities of everyday life, according to a 410-participant study being highlighted at the American Society of Clinical Oncology’s annual meeting in Chicago next month.

Health insurers and government programs don’t pay for yoga even as mounting evidence from dozens of smaller studies show benefits for treating chronic disease. The research and more than $5 million in additional tests funded this year by the National Institutes of Health may convince skeptical doctors and provide scientific evidence to allow coverage.

“Clinicians should now feel pretty comfortable prescribing gentle Hatha yoga or restorative yoga for their patients,” said Karen Mustian, lead author of the study and assistant professor in the department of radiation oncology and preventive medicine at the University of Rochester Medical Center. “The data from this study is one of the first steps in the direction toward insurance coverage, but we’re not there yet.”

Doctors at Beth Israel Medical Center in New York aren’t waiting for more studies to start prescribing yoga. The hospital is one of the few facilities in the country to offer personal yoga therapy instruction for all of its sickest cancer patients.

Fighting Leukemia

David Goldberg, a 30-year-old computer programmer and recreational athlete, learned earlier this month that he has leukemia. The cancer cut short his five-mile runs and pick-up basketball games even before his diagnosis. Goldberg hadn’t considered yoga until checking into Beth Israel’s emergency department a few weeks ago and learning of his disease.

“I was certainly a little skeptical, but so far it’s been very helpful in relaxing me, getting me in a good state of mind,” Goldberg said before a 20-minute lesson in his hospital room. His instructor wears a mask to protect Goldberg, whose immune system has been weakened by five rounds of chemotherapy. “I’m hooked up to a machine, so I can’t totally forget that I have this. For me, it’s just an amazing experience to feel where my body is and what I’m experiencing.”

Cancer Meeting Highlight

The yoga study released yesterday by the cancer group is one of more than 4,500 reports showcased at this year’s meeting of 30,000 oncologists. Doctors have been especially interested in yoga’s muscle-toning stretches and meditative breathing, which practitioners say clears the mental fog of chemotherapy and the chronic fatigue that plagues some survivors for years.

In the Rochester study, about 8 out of 10 cancer survivors reported significant sleep impairment that affected their lives before the study. Half of the patients were assigned to yoga classes twice a week for one month. By the end of the trial, 31 percent of yoga patients no longer had the sleep disruptions, twice the recovery rate of patients who didn’t take classes.

Yoga practitioners also reported a 42 percent reduction in fatigue, compared with a 12 percent reduction for the control group. Yoga users decreased the use of sleep medication by 21 percent, while the control group actually increased reliance on sleeping drugs by 5 percent.

Learning More

Scientists still don’t know exactly what makes yoga work, said Lorenzo Cohen, professor of behavioral science and cancer prevention at the University of Texas MD Anderson Cancer Center in Houston. Cohen and his research group were awarded a $4.5 million U.S. grant this year for the biggest yoga and meditation study. His research will compare yoga to meditation and to stretching and will analyze economic benefits from increased productivity at work.

“Once we can show an economic impact, you’ll start to see changes,” Cohen said in an interview in New York. “Companies want to provide services that keep their employees healthy and productive.

“The concept that the brain can change if you put it into different states is a whole new wonderful science that’s emerging,” Cohen said.

Yoga began in India as a combination of physical and mental exercises. Historians have traced its roots back thousands of years to references in Buddhist and Hindu texts. In Western practices, muscle-stretching poses are accompanied by meditative breathing exercises. About 15.8 million Americans practiced yoga in 2008, according to a study commissioned by Yoga Journal.

The health benefits of yoga have been explored in scores of smaller studies looking at everything from weight loss to depression. Previous studies were too small to be considered definitive, and they are difficult to compare because most of them use differing definitions for just what “yoga” is.

Skepticism at First

“Ten years ago, there was almost complete skepticism from oncologists, but now most of them are coming around” said Woodson Merrell, chairman of the department of integrative medicine at Beth Israel. Merrell’s center is completing its own studies comparing patient improvements before and after the hospital’s holistic cancer floor was finished in March 2009.

Beth Israel’s yoga program was developed with celebrity instructor Rodney Yee and the Urban Zen Foundation set up by fashion designer Donna Karan, whose husband died of lung cancer. The hospital’s cancer floor also offers acupuncture, aromatherapy, a meditation room called the “Sanctuary” and massage chairs for patients and visitors.

Integrating Mind, Body

“We’re not talking about using a Ouija board and using fern leaves instead of chemotherapy,” Merrell said. “We’re talking about relaxation techniques to integrate the mind and body -- instead of feeling disconnected from this cancer that’s in you, to feel that you’re a whole human being and you’re going on this path toward healing.”

For Goldberg’s fight against leukemia, yoga is a series of slow, gentle stretches, beginning with his feet and ending in his shoulders. The reclining poses are followed by guided breathing instructions that encourage him to let go of the sounds of the hospital and to focus on his thoughts and the sensations of his body.

After his session, Goldberg told his instructor that a headache that had been bothering him during a visit with his family had disappeared and his outlook on the world was little bit brighter than before. His doctors said his positive attitude is a strong medicine and his prognosis for recovery is good.

--Editors: Angela Zimm, Bruce Rule

To contact the reporter on this story: Tom Randall in New York at trandall6@bloomberg.net.

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net.