Amritanshu, R.R., Rao, R.M., Nagaratna, R., Veldore, V.H., Usha Rani, M.U., Gopinath, K.S., & Ajaikumar, B.S. (2017). Effect of long-term yoga practice on psychological outcomes in breast cancer survivors. Indian Journal of Palliative Care, 23, 231–236.

To evaluate differences in psychological states between breast cancer survivors who do practice yoga and those who do not

This case-control exploratory study consisted of two groups. The first was breast cancer survivors doing regular yoga (more than six months of regular yoga practice in the last year), and the second was women who had no prior yoga experience (or less than three yoga sessions in the last year). Yoga experience was self-reported by the participants, including their regular yoga schedule. No changes to their yoga practice or schedule were made by the researchers.

• N = 52   
• AGE: 30-65
• FEMALES: 100%
• CURRENT TREATMENT: Other
• KEY DISEASE CHARACTERISTICS: Female breast cancer survivors diagnosed with stage II or III ILC or IDC who received adjuvant chemotherapy and completed all treatment at least six months prior. 
• OTHER KEY SAMPLE CHARACTERISTICS: Patients with neutropenia, grade 3 or 4 thrombocytopenia, and other reported chronic illnesses (diabetes, arthritis, hypertension, thyroid abnormalities, obesity, or recent acute infections) were excluded. Patients who participated in other complementary or alternative treatments within the past six months were also excluded.

• SITE: Multi-site   
• SETTING TYPE: Outpatient    
• LOCATION: Participants were screened at six-month follow-up appointment at three cancer centers in Bengaluru, India.

PHASE OF CARE: Late effects and survivorship

Case-control exploratory study

Perceived stress scale, Spielberg’s state and trait anxiety questionnaire, Beck’s depression inventory, General Health Questionnaire, WHO QOL Questionnaire-BREF

Analysis revealed significantly decreased anxiety, depression, and stress in the group that participated in yoga (p < 0.001). This group also reported better general health and overall quality of life (p < 0.001). Higher income predicted lower anxiety and depression scores, while better reported sleep quality predicted lower stress and depression scores as well.

This study supports yoga as an intervention to decrease anxiety, depression, and stress in breast cancer survivors.

• Small sample (< 100)
• Risk of bias (no appropriate attentional control condition)
• Findings not generalizable
• Other limitations/explanation: Differences in regular yoga practices among the participants could have influenced the results as yoga schedules were not controlled for. In addition, this study only looks at yoga in breast cancer survivors and may not be generalizable to other patients with cancer.

Yoga is an evidence-based intervention that may reduce anxiety and depression in patients with cancer. Although this study only examined breast cancer survivors, discussing yoga as a method to decrease anxiety and depression may be an appropriate option for many patients with cancer.