Yoga

What is yoga?

Yoga, which means "union," is a 5,000-year-old system of principles and practices originating in India. Yoga incorporates nutrition guidelines, ethics, exercise, and meditation with the intention of bringing together the mind, body, and spirit.

Most types of yoga practiced in the United States focus on movement and breathing, and do not require a total lifestyle change. More than a hundred variations of yoga are practiced in the United States — some slow and gentle and others active and fast-moving.

One of the most frequently practiced types of yoga is called hatha yoga, which uses physical poses and breathing techniques to increase strength, flexibility, and well-being.

Research in breast cancer patients has shown that yoga may be able to help:

• improve physical functioning
• reduce fatigue
• reduce stress 
• improve sleep
• improve quality of life

What to expect in a typical yoga session

A yoga session can last from 20 minutes to an hour and can be done alone at home or in a class setting with an instructor. During your yoga session you will:

• Learn and practice a series of poses: A typical hatha yoga session consists of a wide range of poses. If you're taking a class, the instructor will have students practice a list of poses in a specific order. Poses are designed in a variety of ways: lying down, sitting, or standing.
• Breathe: Another aspect of a typical yoga session is learning and practicing breathing techniques for better mind and body control. Techniques include breathing through one nostril at a time and focusing on your breath as it enters your nose and fills your lungs.
• Learn what your limits are: Some yoga poses may be too challenging. Start out with the basics and push yourself a little, but not too hard. The idea is not to force the body into any position but to ease and breathe into it. The longer you breathe in a posture, the more your muscles tend to give.
  • If you're practicing at home and have trouble with a pose, use pillows to ease into a more comfortable position or move on to another pose.
  • If you're taking a class and have difficulty with a pose, an experienced instructor will design an easier posture for you. Many teachers use props such as blocks or cushions to make the practice more comfortable.
  • If you find even basic classes to be too difficult, ask your teacher if there is a "restorative" yoga class you could try. These gentle classes are beneficial when recovering from illness or surgery and involve a minimum of physical work, concentrating on breathing while being supported by pillows and other props.

Yoga practitioner requirements

In the United States, a yoga instructor has the option to train for 2 or more years or to be certified after only taking a weekend-long course. As a result, there is a wide gap in experience from teacher to teacher. Inexperienced teachers can increase the risk for student injuries, so it's important to find a seasoned instructor. Ask your doctor for recommendations on yoga instructors who have worked with breast cancer patients. Another way to find an experienced instructor is to check with an organization requiring at least 200 hours of training to gain certification as a yoga instructor.

The Yoga Alliance sets guidelines for teacher training and registers yoga schools according to these standards. The Yoga Alliance website offers a searchable U.S. database of qualified teachers and schools, as well as information on how to choose a teacher.

For more information about finding a qualified complementary medicine practitioner, see our Finding a Practitioner section.

Here are questions to ask a potential yoga instructor:

• Where did you receive your training?
• How many hours have you trained?
• Are you continuing your study of yoga? Do you still attend classes and seminars?
• How many years have you been teaching yoga?
• Do you regularly work with people who have had breast cancer?

Research on yoga in women with breast cancer

In studies of women with breast cancer, yoga has been shown to reduce fatigue and improve quality of sleep, physical vitality, and overall quality of life.

At the 2003 annual meeting of the American Society of Clinical Oncology (ASCO), results were reported from a yoga study involving 126 women recently diagnosed with Stage I or II breast cancer. The women were about to receive chemotherapy or hormonal therapy. Some of the women were assigned to yoga classes over a 3-month period. The women taking yoga had a 12% improvement in fatigue, physical functioning, and quality of life compared with those in the program who did not take the yoga classes.

In 2006, results of a yoga study were reported from an M.D. Anderson Cancer Center study. The study followed 61 women receiving 6 weeks of radiation treatment for breast cancer. Half the women took a yoga class twice a week; the other half did not. Compared with the women who did not take yoga, the women in the yoga group reported having more energy and less daytime sleepiness, better physical functioning, and better overall quality of life.

Important things to consider before trying yoga

Like all practices, yoga comes with some risks:

• Risk of inexperienced instructors: Because of the variation in certification requirements for yoga teachers, it's possible to take a class with a yoga teacher who has very little experience. This is not always safe and can result in injuries. Ask your oncologist or cancer center staff to recommend highly experienced yoga instructors who regularly work with cancer patients.
• Risk of lymphedema: In people who have had lymph nodes removed, some of the more strenuous yoga types and poses may present a risk for lymphedema. A yoga instructor who has experience with breast cancer patients will know which yoga types and poses are safe.
• Risk of fracture in people with bone metastasis: In people with breast cancer that has metastasized to the bone, some types of yoga may carry a risk of fractures. If you have bone metastasis, ask your doctor whether yoga is right for you, or if there is a gentle form of yoga or another practice that might work better, such as meditation or guided imagery. Always check with your doctor before you begin a yoga practice.

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