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 J Clin Oncol. 2014 Apr 1;32(10):1040-9. doi: 10.1200/JCO.2013.51.8860. Epub 2014 Jan 27.

Yoga exercise reduced fatigue and inflammation associated with decreased physical function.

Breast cancer survivors frequently cite myriad symptoms, including fatigue, deconditioning, and depression. In addition, their cardiorespiratory fitness is about 30% lower than that of their sedentary, age-matched, cancer-free counterparts. Survivors benefit from regular exercise but often limit their physical activity because of pain and fatigue. Would less vigorous yoga exercise provide health benefits for such individuals?

To find out, investigators conducted a 3-month, randomized, controlled trial in which 200 breast cancer survivors were assigned to a yoga program (twice-weekly, 90-minute, hatha yoga workouts for 12 weeks) or to usual activities (controls). The primary outcomes were measures of inflammation associated with decreased physical function — interleukin (IL)-6, tumor necrosis factor (TNF)-α), and interleukin (IL)-1β — as well as scores on validated assessments of vitality, fatigue, and depression. Women reporting more than 5 hours of vigorous exercise per week or prior or current yoga practice were excluded.

RESULTS:

Immediately post-treatment, fatigue was not lower (P > .05) but vitality was higher (P = .01) in the yoga group compared with the control group. At 3 months post-treatment, fatigue was lower in the yoga group (P = .002), vitality was higher (P = .01), and IL-6 (P = .027), TNF-α (P = .027), and IL-1β (P = .037) were lower for yoga participants compared with the control group. Groups did not differ on depression at either time (P > .2). Planned secondary analyses showed that the frequency of yoga practice had stronger associations with fatigue at both post-treatment visits (P = .019; P < .001), as well as vitality (P = .016; P = .0045), but not depression (P > .05) than simple group assignment; more frequent practice produced larger changes. At 3 months post-treatment, increasing yoga practice also led to a decrease in IL-6 (P = .01) and IL-1β (P = .03) production but not in TNF-α production (P > .05).

CONCLUSION:

Chronic inflammation may fuel declines in physical function leading to frailty and disability. If yoga dampens or limits both fatigue and inflammation, then regular practice could have substantial health benefits.

COMMENT

Modest exercise of any sort has been shown in prior studies to improve functional status, physiologic fitness, and many common symptoms that cancer survivors experience. Yoga appears to have similar effects on sedentary breast cancer survivors. Encouraging patients and survivors to exercise, even with modest exertion, can provide significant benefits and should be part of a survivorship plan.

William J. Gradishar, MD reviewing Kiecolt-Glaser JK et al. J Clin Oncol 2014 Jan 27.