Sprod, L.K., Fernandez, I.D., Janelsins, M.C., Peppone, L.J., Atkins, J.N., Giguere, J., . . . Mustian, K.M. (2015). Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors. Journal of Geriatric Oncology, 6, 8–14. 

To analyze the effects of a four-week yoga intervention on cancer-related fatigue and the burden of overall side effects in older cancer survivors

This report is a secondary analysis of a previously published multi-site, randomized, controlled trial to assess the effects of yoga on fatigue and sleep problems among patients with cancer who completed initial treatment. Participants aged 60 years or older who had completed fatigue measures were included in this analysis. Group yoga sessions were provided two days per week for four weeks. The program included breathing exercises, postures, and mindfulness exercises involving meditation, visualization, and affirmation. Random sessions were independently observed by study coordinators to verify the content.

• N = 97  
• MEAN AGE = 65.96 years
• MALES: 6%, FEMALES: 94%
• KEY DISEASE CHARACTERISTICS: Multiple tumor types; breast cancer most prevalent (65%)

• SITE: Multi-site    
• SETTING TYPE: Outpatient    
• LOCATION: New York

• PHASE OF CARE: Transition phase after active treatment
• APPLICATIONS: Elder care 

Single, blinded, randomized, controlled trial

• Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF)
• Clinical symptom inventory 11-point rating scale (Global symptom burden was calculated as the sum of all individual symptom scores ranging from 0–120.)

Participants attended an average of 6.2 of the eight yoga sessions. After the intervention, yoga participants reported a significantly lower level of fatigue compared to the standard care patients (p = 0.03) and a significantly lower global side effect burden (p < 0.01). Significant results were only in the physical and mental components of fatigue.

The findings of this study showed that yoga improved fatigue.

• Small sample (< 100)
• Risk of bias (no appropriate attentional control condition)  
• Risk of bias (sample characteristics)
• Key sample group differences that could influence results
• Other limitations/explanation: There was high variability among the sample in the time since initial treatment ended, this ranged from 2–24 months. The sample included very few men, and the majority of participants were white and well-educated. The duration of follow-up was only four weeks. Participants were aware of the study outcomes of interest, so there was an associated potential threat to the internal validity of the study

The findings of this study suggest that yoga may be beneficial to older cancer survivors for the reduction and management of cancer-related fatigue. Studies of yoga have tended to be done in women and individuals with relatively high formal education. Additional research is needed to examine the effectiveness and acceptance of this type of intervention in more diverse patient groups.