Written by Karen Pilkington and the CAM-Cancer Consortium.
Updated August 18, 2015

Yoga

Abstract and key points

  • Yoga is a practice consisting of physical exercises, breathing techniques, and meditation or relaxation.
  • It has small beneficial effects on quality of life and well-being of cancer patients.
  • It is generally safe when practised appropriately.

Yoga is a practice originating in India which usually consists of physical exercises (stretches orasanas), breathing techniques and meditation or relaxation. It is taught in yoga classes, can be practised by the individual or is incorporated into stress management programmes.

Yoga is claimed to have a range of physical, psychological and spiritual benefits.

Evidence from ten systematic reviews of small clinical trials mainly in breast cancer patients suggests yoga has small, short-term beneficial effects on quality of life, perceived stress and well-being. Evidence is conflicting, heterogeneous or non-significant for effects on other outcomes:

  • Anxiety: Positive short-term effects are reported but results are heterogeneous.
  • Depression: Positive short-term effects are reported but results are heterogeneous.
  • Distress: Reports of effects are mixed.
  • Fatigue: Positive effects are reported in more recent trials.
  • Perceived stress: Positive effects are seen on perceived stress in the short-term.
  • Physical health: Effects on physical health are not significant.
  • Quality of life: Positive effects are reported on quality of life.
  • Sleep problems: Effects on sleep are reported as non-significant.
  • Wellbeing: Positive effects are reported on various aspects of wellbeing.

Only a few small trials have involved patients with other types of cancer. Several recent trials suggest some effects on physiological measures related to inflammation and stress but these results are preliminary at best.

Few adverse events are reported in clinical trials and adverse effects appear to be rare, based on the limited number of case reports in the literature. Single case reports of serious adverse events indicate that these are possible, particularly with certain practices applied too aggressively or in people with specific risk factors.

Citation

Karen Pilkington, CAM-Cancer Consortium. Yoga [online document]. http://www.cam-cancer.org/The-Summaries/Mind-body-interventions/Yoga. August 18, 2015.

Document history

Fully revised and updated in August 2015 by Karen Pilkington.

Summary first published in June 2013, authored by Karen Pilkington.

References

 

  1. Feuerstein G. The Yoga Tradition: Its History, Literature, Philosophy and Practice. 2001. Prescott, Arizona: Holm Press.
  2. American Yoga Association. General yoga information. Available at: http://www.americanyogaassociation.org/general.html. Accessed on: 23rd March 2013.
  3. Riley, D. Hatha yoga and the treatment of illness (commentary). Altern. Ther. Health Med. 2004 10 (2), 20-21.
  4. The British Wheel of Yoga. FAQs: What You Can Expect From Yoga. Available at: http://www.bwy.org.uk/faqs/. Accessed on 23rd March 2013.
  5. Wenger MA, Bagchi BK. Studies of autonomic functions in practitioners of Yoga in India. Behav Sci. 1961 6: 312-23.
  6. Patel C, North WR. Randomised controlled trial of yoga and bio-feedback in management of hypertension. Lancet. 1975 2(7925): 93-5.
  7. Patel C. 12-month follow-up of yoga and bio-feedback in the management of hypertension. Lancet. 1975 1(7898):62-4.
  8. Malhotra JC. Yoga and psychiatry: a review. J Neuropsychiatr. 1963 4:375-85.
  9. Ornish D, Scherwitz LW, Doody RS, Kesten D, McLanahan SM, Brown SE, DePuey E, Sonnemaker R, Haynes C, Lester J, McAllister GK, Hall RJ, Burdine JA, Gotto AM Jr. Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA. 1983 249(1):54-9.
  10. Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. 1990 336(8708):129-33.
  11. Khalsa, S.B. Yoga as a therapeutic intervention: A bibliometric analysis of published research studies. Indian J. Physiol. Pharmacol. 2004 48 (3), 269-285.
  12. Saper, R.B., Eisenberg, D.M., Davis, R.B., Culpepper, L., Phillips, R.S. Prevalence and patterns of adult yoga use in the United States: results of a national survey. Altern. Ther. Health Med. 2004 10 (2), 44-49.
  13. Streeter CC, Jensen JE, Perlmutter RM, et al. Yoga Asana Sessions Increase Brain GABA Levels: A Pilot Study. J Altern Complement Med. 2007 13(4):419-426.
  14. Barnes, P.M., Bloom, B. and Nahin, R. (2008) CDC National Health Statistics Report #12: Complementary and alternative medicine use among adults and children. Available at: nccam.nih.gov/news/camstats. Access on 25th March 2013.
  15. Barnes, P.M., Powell-Griner, E., McFann, K. and Nahin, R.L. (2004) Complementary and alternative medicine use among adults: United States, 2002, Advance Data, 343: 1–19.
  16. Molassiotis A, Scott JA, Kearney N, Pud D, Magri M, Selvekerova S, Bruyns I, Fernadez-Ortega P, Panteli V, Margulies A, Gudmundsdottir G, Milovics L, Ozden G, Platin N, Patiraki E. Complementary and alternative medicine use in breast cancer patients in Europe. Support Care Cancer. 2006 14(3):260-7.
  17. Molassiotis A, Browall M, Milovics L, Panteli V, Patiraki E, Fernandez-Ortega P. Complementary and alternative medicine use in patients with gynecological cancers in Europe. Int J Gynecol Cancer. 2006 Jan-Feb;16 Suppl 1:219-24.
  18. Molassiotis A, Fernandez-Ortega P, Pud D, Ozden G, Platin N, Hummerston S, Scott JA, Panteli V, Gudmundsdottir G, Selvekerova S, Patiraki E, Kearney N. Complementary and alternative medicine use in colorectal cancer patients in seven European countries. Complement Ther Med. 2005 Dec;13(4):251-7. Epub 2005 Sep 19.
  19. Molassiotis A, Panteli V, Patiraki E, Ozden G, Platin N, Madsen E, Browall M, Fernandez-Ortega P, Pud D, Margulies A. Complementary and alternative medicine use in lung cancer patients in eight European countries. Complement Ther Clin Pract. 2006 Feb;12(1):34-9. Epub 2005 Nov 14.
  20. Buettner C, Kroenke CH, Phillips RS, Davis RB, Eisenberg DM, Holmes MD. Correlates of use of different types of complementary and alternative medicine by breast cancer survivors in the nurses' health study. Breast Cancer Res Treat. 2006 100(2):219-27.
  21. Desai K, Bowman MA, Galantino ML, Hughes-Halbert C, Vapiwala N, Demichele A, Mao JJ. Predictors of yoga use among patients with breast cancer. Explore (NY). 2010 6(6):359-63.
  22. Buffart LM, van Uffelen JG, Riphagen II, Brug J, van Mechelen W, Brown WJ, Chinapaw MJ. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559. doi: 10.1186/1471-2407-12-559.
  23. Cramer H, Lange S, Klose P, Paul A, Dobos G. Can yoga improve fatigue in breast cancer patients? A systematic review. Acta Oncol. 2012 51(4):559-60.
  24. Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012 12:412.
  25. Harder H, Parlour L, Jenkins V. Randomised controlled trials of yoga interventions for women with breast cancer: a systematic literature review. Support Care Cancer. 2012 20(12):3055-64.
  26. Lin KY, Hu YT, Chang KJ, Lin HF, Tsauo JY. Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evid Based Complement Alternat Med. 2011;2011:659876.
  27. Smith KB, Pukall CF. An evidence-based review of yoga as a complementary intervention for patients with cancer. Psychooncology. 2009 18(5):465-75.
  28. Zhang J, Yang KH, Tian JH, Wang CM. Effects of yoga on psychologic function and quality of life in women with breast cancer: a meta-analysis of randomized controlled trials. J Altern Complement Med 2012; 18(11):994-1002.
  29. Sharma M, Haider T, Knowlden AP. Yoga as an Alternative and Complementary Treatment for Cancer: A Systematic Review. J Altern Complement Med. 2013 Mar 12. [Epub ahead of print]
  30. Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005 Dec;39(12):884-91; discussion 891.
  31. Johnson DB, Tierney MJ, Sadighi PJ. Kapalabhati pranayama: breath of fire or cause of pneumothorax? A case report. Chest. 2004 125(5):1951-2.
  32. Dacci P, Amadio S, Gerevini S, Moiola L, Del Carro U, Radaelli M, Figlia G, Martinelli V, Comi G, Fazio R. Practice of yoga may cause damage of both sciatic nerves: a case report. Neurol Sci. 2013 Mar;34(3):393-6.
  33. Patel SC, Parker DA. Isolated rupture of the lateral collateral ligament during yoga practice: a case report. J Orthop Surg (Hong Kong). 2008 Dec;16(3):378-80.
  34. de Barros DS, Bazzaz S, Gheith ME, Siam GA, Moster MR. Progressive optic neuropathy in congenital glaucoma associated with the Sirsasana yoga posture. Ophthalmic Surg Lasers Imaging. 2008 Jul-Aug;39(4):339-40.
  35. MSKCC (Memorial Sloan Kettering Cancer Centre) About Herbs, Botanicals and Other Products: Yoga. Available at: http://www.mskcc.org/cancer-care/herb/yoga. Accessed 10th May 2013.
  36. WebMD. Vitamins and Supplements: Yoga. Available at : http://www.webmd.com/vitamins-supplements/ingredientmono-1241-yoga.aspx?activeIngredientId=1241&activeIngredientName=yoga&source=1. Accessed 10th May 2013.
  37. Sadja, J. and P. J. Mills. Effects of yoga interventions on fatigue in cancer patients and survivors: a systematic review of randomized controlled trials. Explore (NY) 2013 9: 232-243.
  38. Felbel, S., J. Meerpohl Joerg, I. Monsef, A. Engert and N. Skoetz (2014) Yoga in addition to standard care for patients with haematological malignancies. Cochrane Database of Systematic Reviews  DOI: 10.1002/14651858.CD010146.pub2
  39. Bower, J. E., G. Greendale, A. D. Crosswell, D. Garet, B. Sternlieb, P. A. Ganz, M. R. Irwin, R. Olmstead, J. Arevalo and S. W. Cole (2014) Yoga reduces inflammatory signaling in fatigued breast cancer survivors: A randomized controlled trial. Psychoneuroendocrinology 43, 20-29 DOI: http://dx.doi.org/10.1016/j.psyneuen.2014.01.019
  40. Cadmus-Bertram, L., A. J. Littman, C. M. Ulrich, R. Stovall, R. M. Ceballos, B. A. McGregor, C. Y. Wang, J. Ramaprasad and A. McTiernan (2013) Predictors of adherence to a 26-week viniyoga intervention among post-treatment breast cancer survivors. Journal of alternative and complementary medicine (New York, N.Y.) 19, 751-758 DOI: 10.1089/acm.2012.0118
  41. Chandwani, K. D., G. Perkins, H. R. Nagendra, N. V. Raghuram, A. Spelman, R. Nagarathna, K. Johnson, A. Fortier, B. Arun, Q. Wei, C. Kirschbaum, R. Haddad, G. S. Morris, J. Scheetz, A. Chaoul and L. Cohen. Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy. J Clin Oncol 2014 32: 1058-1065.
  42. Kiecolt-Glaser, J. K., J. M. Bennett, R. Andridge, J. Peng, C. L. Shapiro, W. B. Malarkey, C. F. Emery, R. Layman, E. E. Mrozek and R. Glaser (2014) Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 32, 1040-1049 DOI: 10.1200/JCO.2013.51.8860
  43. Kovačič, T., M. Zagoričnik and M. Kovačič (2013) Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery. Journal of complementary & integrative medicine 10,  DOI: 10.1515/jcim-2012-0009
  44. Loudon, A., T. Barnett, N. Piller, M. A. Immink and A. D. Williams. Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial. BMC Complement Altern Med 2014 14: 214.
  45. Mustian, K. M., L. K. Sprod, M. Janelsins, L. J. Peppone, O. G. Palesh, K. Chandwani, P. S. Reddy, M. K. Melnik, C. Heckler and G. R. Morrow (2013) Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 31, 3233-3241 DOI: 10.1200/JCO.2012.43.7707
  46. Siedentopf, F., I. Utz-Billing, S. Gairing, W. Schoenegg, H. Kentenich and I. Kollak (2013) Yoga for patients with early breast cancer and its impact on quality of life - A randomized controlled trial. Geburtshilfe und Frauenheilkunde 73, 311-317 DOI: 10.1055/s-0032-1328438
  47. Ferreira, M. A. and N. Galvez-Jimenez. Sirsasana (headstand) pose causing compressive myelopathy with myelomalacia. JAMA Neurol 2013 70: 268.