Hatha Yoga in Improving Physical Activity, Inflammation, Fatigue, and Distress in Breast Cancer Survivors

OBJECTIVES:

Primary

• To determine if the yoga intervention will decrease inflammation, fatigue, and depressive symptoms relative to the waiting-list controls in women who are stage 0-IIIa breast cancer survivors.

OUTLINE: Patients are stratified according to stage of cancer (stage 0 vs stage I vs stage II and stage IIIA) and prior radiation therapy (yes vs no). Patients are randomized to 1 of 2 intervention arms.

• Arm I (waiting-list control): Patients are encouraged to perform usual activities, but asked to refrain from any yoga practice or other related activities. After a six-month observation period, patients undergo yoga intervention as described in arm II .
• Arm II (yoga intervention): Patients participate in a Hatha yoga intervention session comprising body postures and breath control techniques for 1.5 hours twice a week for 12 weeks. Patients are encouraged to practice Hatha yoga at home. Patients complete daily diaries on home Hatha yoga practices and submit them at each session.

DISEASE CHARACTERISTICS:

• Stage 0-IIIA breast cancer survivor
• Completed cancer treatment within the past 36 months (except for tamoxifen/aromatase inhibitors)

• At least 2 months since prior surgery, adjuvant therapy, or radiotherapy, whichever occurred last
• Women who are not currently practicing yoga and have not participated in any of the following activities:

• Meditation, tai chi, or related activities
• Yoga or tai chi within the past 6 months
• Had classes for or practiced yoga for more than 3 months
• Women who typically engage in a total of 5 or more hours of vigorous physical activity per week are not eligible
• No inflammatory breast cancer

PATIENT CHARACTERISTICS:

Inclusion criteria

• Hemoglobin ≥ 10 g/dL (patients with a hemoglobin of < 10 g/dL may be retested in 6 weeks after treatment of anemia and allowed to participate in study if blood counts recovered)
• Physically able to fully participate in yoga intervention

Exclusion criteria

• Inability to comfortably get up and down from the floor 2-3 times in a session
• Breathing problems requiring use of oxygen
• Problems walking without a cane or walker assistance
• Prior knee or hip replacement with limited movement in the joint
• Inability to comfortably lie on the stomach
• Alcohol, or drug abuse
• Diagnosis of any of the following conditions:

• Diabetes
• Chronic obstructive pulmonary disease
• Uncontrolled hypertension
• Evidence of liver or kidney failure
• Symptomatic ischemic heart disease
• Significant visual or auditory problems
• Mental disorder or cognitive impairment
• Notable serious cardiovascular history (e.g., prior life-threatening abnormal heart rhythms)
• Other medical conditions involving the immune system such as autoimmune and/or inflammatory diseases including rheumatoid arthritis and ulcerative colitis
• History of breast or any other cancer, except basal or squamous cell skin cancer

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No regular use of medications with major immunological consequences (e.g., steroids)