Yoga is not new, but yoga for people in active cancer treatment is a relatively new strategy. The story reported a scientific study of the effect of yoga on quality of life for women undergoing breast cancer treatment.
The story provides a good description of study design and some quantification of the benefits of treatment. Self-rated scores of well-being and physical stamina were higher in the yoga group vs. the group without a twice-a-week yoga class. Biophysical markers of stress and immune function are also being measured. The impact of “getting together” with a group of women in similar circumstances cannot be overlooked, and this study could not be blinded, so the women in the yoga group were aware they were in the “active” arm of the trial. This could have a strong placebo effect.The proposed study assigning one group to stretching and another to yoga will further evaluate the meditative value of group yoga for breast cancer patients.
The cost of yoga classes is not mentioned. While yoga is generally inexpensive and can be practiced with little to no equipment, it may not feel inexpensive to many people (particularly for the many women in the over 65 population at highest risk for breast cancer and living on a fixed income). The story mentions alternative treatments to yoga as simple stretching, however, the story could have included more information on strategies to feel well during active cancer treatment. This might include other complementary alternative therapies (e.g. massage, acupuncture), physical therapy, talk therapy, cancer support groups, etc.
Yoga is gentle and has little potential for harm, but women interested in pursuing this during breast cancer treatment should check with their oncologist before embarking on a yoga program, particularly if they have had more extensive surgery than simple lumpectomy. When lifting heavy weight (including body weight) there is the possibility of worsening arm lymphedema, excess fluid which collects in tissue and causes swelling in some women who have been treated with axillary node dissection surgery and radiation.
The initial results of this pilot study were presented at the recent American Society of Clinical Oncology meeting; they have yet to be peer-reviewed in a medical journal.
Overall, this was a generally well-written and reported piece.
The cost of yoga classes is not mentioned. While yoga is generally inexpensive and can be practiced with little to no equipment, it may not feel inexpensive to many people (particularly for the many women in the over 65 population at highest risk for breast cancer and living on a fixed income). Many women have difficulty paying for their medication. Although a DVD or VHS yoga tape may be relatively inexpensive, we don’t know that this intervention would have the same results.
The story provides some quantification of the benefits of treatment. The report was quite clear that self-reported outcomes were improved, not including anxiety and depression. The researchers are awaiting further quantitative data on immune function and stress levels via blood and saliva samples in both groups.
No mention of the harms of yoga. Yoga is gentle and has little potential for harm, but women interested in pursuing this during breast cancer treatment should certainly check in with their oncologist before embarking on a yoga program, particularly if they have had more extensive surgery than simple lumpectomy.When postures are performed incorrectly, there is the potential for physical injury. Also not mentioned was the possibility of worsening arm lymphedema, excess fluid which collects in tissue and causes swelling in women who have been treated with axillary node dissection and radiation as part of breast cancer surgery. Women with lymphedema would need to be especially careful so that they would not hurt their affected arm. They may also need to avoid certain postures, as lifting heavy weight (including body weight) may worsen lymphedema.
The story provides details of the study design and discusses how the effect of yoga was measured in two randomized groups of women treated for breast cancer. The comment by Dr. Alan Kristal, an epidemiologist not affiliated with the study, appropriately notes that scientific studies of yoga’s medical benefits are rare, but necessary. The proposed future study assigning one group to stretching and another to yoga will further evaluate if the meditative component of yoga is of value, or if the increased feelings of well-being are due to the physical movement involved in the postures. The impact of “getting together” with a group of women in similar circumstances cannot be overlooked. Also, this study could not be blinded, so the women in the yoga group were aware they were in the “active” arm of the trial. This could have a strong placebo effect.
No evidence of disease mongering. Yoga is presented as a complementary mind-body intervention to reduce some of the fatigue (mental and physical) of breast cancer treatment.
The story mentions that Dr. Lorenzo Cohen is the lead author of the pilot study on yoga to improve quality of life during breast cancer treatment. Dr. Cohen would have little to gain from this study or by promoting yoga.
The story mentions alternative treatments to yoga as simple stretching. However, the story could have included more information on strategies to feel well during active cancer treatment. This might include other complememtary alternative therapies (e.g. massage, accupuncture), physical therapy, talk therapy, cancer support groups, etc. Not enough information was presented.
Although it is not explicitly stated in this story, yoga is a form of exercise and meditation available to most people. Yoga is accessible in most areas of the country, although transportation to classes might be a barrier for some. Although books or video on yoga instruction would broaden availability, this was a story about a study of in-person instruction, which would probably have different results than an “in home” program.
Yoga is not new, but yoga for people in active cancer treatment is a relatively new strategy.
There is no evidence this story is taken from a press release. The results of this pilot study were recently presented at the American Society of Clinical Oncology meeting, and a source other than the study author is cited.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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