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Yoga: Benefits and Precautions for People With Breast Cancer
Vicki Flannery, RN
January 17, 2020

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Vicki Flannery wears a number of hats: She’s a nurse in the Kansas City area; she’s a yoga instructor at weBuild4Life, a nonprofit that focuses on functional fitness and nutritional programs for cancer survivors and people with chronic illnesses; and she is a breast cancer survivor.

Vicki’s yoga classes center around recovery, flexibility, and strengthening.

Listen to the podcast to hear Vicki talk about:

  • what yoga is and examples of different types of yoga
  • the benefits yoga can offer to people who’ve been diagnosed with breast cancer
  • precautions people who’ve been diagnosed with breast cancer may want to consider
  • how she modified her own yoga practice after being diagnosed with breast cancer

Running time: 29:58

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Show Full Transcript

Jamie DePolo: Hello, thanks for listening. Our guest today is Vicki Flannery. Vicki wears a number of hats. She’s a nurse in the Kansas City area, she’s a yoga instructor at weBuild4Life, a nonprofit that focuses on functional fitness and nutritional programs for cancer survivors and people with chronic illnesses, and she’s a breast cancer survivor. Vicki’s yoga classes center around recovery, flexibility, and strengthening.

Today, she’s joining us to talk about what yoga is and the benefits it can offer to people who have been diagnosed with cancer, with breast cancer specifically. Vicki, welcome to the podcast.

Vicki Flannery: Thank you.

Jamie DePolo: So if you’re comfortable, could you tell us a little bit about your breast cancer diagnosis and treatment?

Vicki Flannery: Sure. Last year, on May the 4th, I was diagnosed with estrogen-positive, progesterone-positive, HER2-negative breast cancer of which I went through bilateral mastectomy with spacer implants. I had like 15 lymph nodes removed in my left arm, and then I went through four cycles of Adriamycin, Cytoxan and then the four cycles of Taxol. And then rounded off my treatment with 6 full weeks of radiation.

Jamie DePolo: Yeah, it’s a pretty intense treatment. Did you find a lump? Do you have a history of breast cancer in your family?

Vicki Flannery: Absolutely none. No one in my family had any history of breast cancer. I had kind of felt something odd in my breast, but I had cystic breast disease, and then the next month it went away. And then one morning I woke up and I went to go take a shower and I had just this huge lump in my breast. And I was like, “Oh my God, it’s breast cancer.” You know, as a nurse I know all those… you think you know, “Oh I’m doing all the right stuff and doing my exams,” but then when that lump came I just automatically knew. And I looked at my husband and I’m like, “This is breast cancer. I’ve got to go get this looked at ASAP,” so then I did, and they confirmed that it was. And thankfully I was a nurse and I knew right away what it looked like and I knew to get in and do something about it.

Jamie DePolo: Sure. Sure. That’s great. And how long have you been out of treatment now?

Vicki Flannery: So I wrapped up radiation, I believe it was in March of this year.

Jamie DePolo: Okay. Okay, so a little while but not a huge long time. And you were practicing yoga when you were diagnosed, is that correct?

Vicki Flannery: I was. I’ve been doing yoga on and off for many years, like 12 years, and I would do it rarely wholeheartedly. It was just kind of my easy gym day. I hate to say it like that but it was. It was what I did when I had a hard week at work and I didn’t feel like lifting weights or doing my cardio. It was like, “Oh, I’m going to go do yoga and I’ll still get all those benefits but it will just be a lighter exercise for me.” It started off my week on a good note I always felt, so every Monday I tried to do yoga. And it just kind of set me and got me going for the good rest of the week. And if I didn’t do it then I just kind of felt like I was bumbling through. Something about it just kind of resonated with me.

Jamie DePolo: You were not an instructor at that time, is that right?

Vicki Flannery: No. No. I always wanted to be. I always thought, “Oh I like this, I would like to teach this to other people,” but it just never worked out with my schedule. Being a nurse I work on the weekends, and every single teacher training I had found was on the weekends, and I was like, “Oh I wish I could but I can’t.” Yeah, I always wanted to but I never did. And then I had kind of fallen off of yoga for a little bit because I wanted… Zumba kind of took over in my life, and I found that to be very fun. And so I did a lot of that, but then something just kind of pulled me back to it like it always does, I just kind of get off kilter. And I started… words in my head from a yoga teacher I had where she was talking about “in your home practice.” You know, “If you do this in your home practice then do this. If not, you know maybe find something else.”

And I was like, “Home practice, I should do that. I don’t do that and I should.” So, I’m like, “Every day I could do yoga.” I started picking up more of a home practice, and fortunately for me the home practice and the meditation piece that I put in with that just kind of was at the right time in my life, because I started doing that about a year before I got diagnosed with breast cancer. And that really helped carry me through that diagnosis and have a sense of well being, whereas I feel like you can easily get overwhelmed with the diagnosis. It really helped me stay grounded through all that.

Jamie DePolo: Excellent. Now, I do want to ask you about the benefits. You sort of touched on a couple there for people who have been diagnosed with breast cancer. But before we do that just in case someone’s listening and they’re not really clear, can you tell us what yoga is? And then sort of, I know there are a number of different types of yoga, so if you could talk about maybe some of the main ones, too.

Vicki Flannery: Oh, sure. It’s a funny question. When I started yoga teacher training, the yoga teacher said, “Okay, come write down a thing and tell us what yoga is.” And I was like, “Oh, I’ve read lots of yoga philosophy and books about yoga, I’ve got this, I’ve got a good one.” So I wrote all this stuff and then she looked at us, and she’s like, “All right, now I’m going to tell you what yoga is.” And I’m like, “Okay I’ve got this one, A+,” you know? And she was like, “Yoga is now, now is yoga.” And I was like, “What? That’s crazy. Yoga is now, what do you mean?” So then as we dived into more of the Yoga Sutras of Patanjali, he says that yoga is the restraint of the modifications of the mind stuff. Like, what is stuff in our minds? And that if you control the rising of the mind into ripples you’ll experience yoga. And I was like, “Oh, okay. So I’ve got to get rid of the mind stuff.” It’s just the getting rid of the mind stuff is what it is.

He says we have our projections such as the way we view the outside world. So an easy example of that, you see a person walking down the road and they’re walking at a fast pace and they have a grimace on their face, and their head is down and they don’t acknowledge you as you pass by. And you think, “Oh, unpleasant person.” They’re walking down the road, they don’t want to socialize, they’re grumpy, you start making all these labels for that person and creating a story around that person. Where the reality is, maybe he’s in pain and he’s just trying to get to the doctor’s appointment to find out why. Maybe you know someone down the road who says, “Oh, did you see my friend? He’s a really nice guy and he’s going to a doctor and I’m trying to catch up to him.” And you’re like, “Oh, I judged him,” and now you feel bad. And so all this projection that we had around this human being makes us feel bad. It brings an unpleasant feeling for ourselves.

So that’s one sense of getting rid of those modifications of our mind. Another one is feeling a sense of bondage to the outside world, meaning outside of your body. So an example of that would be feeling like you have to clean your house before company comes, “Oh, I’ve got to get this clean, it’s got to be spotless.” Whereas your company doesn’t really… they don’t mind if your house is clean, they’re coming to spend time with you. So, not that your company cares. It’s an internal thought of feeling bound to do something.

Yoga is freeing yourself of all these kinds of thoughts, all these processes, the labels, the conditioned thought processes, your misconceptions, the delusions or stories that we create in our head, we make up in our mind, our mental attitudes. And so if you come to being in the now and try to let those modifications of the mind go to the side, then you’ll experience yoga and a piece of being in a state of being in peace. The physical practice of yoga itself helps you prepare your body for meditation.

Jamie DePolo: That’s very interesting, because a lot of people just think about the physical practice of yoga, and they don’t think about the mental aspects of yoga.

Vicki Flannery: Absolutely. And you don’t have to physically practice a posture in order to practice yoga.

Jamie DePolo: Okay. So how do the different types of yoga fit into that? Is it that each is sort of preparing the body to meditate in a different way? Is that how it works?

Vicki Flannery: A lot of them originate from different people who have set up their own specific style. Hot yoga is very much like Bikram where he, in a warm environment, set up a series of postures that he believed were beneficial, but it was a set sequence. Hot yoga is very similar, but they can’t use that specific set sequence without calling themselves Bikram. So if they modify away from that specific set then they have to call themselves by a different name, which is usually hot yoga. Power yoga is very similar to them, but it’s very strength-focused so it’s, in essence, a more strength-oriented practice. So most of them are just from different lineages, I guess you could say.

Jamie DePolo: Are there any others that you’d like to go over before we move on?

Vicki Flannery: Ashtanga is based mostly on your ancient teachings. It has a set sequence of postures that are done in a row, each one builds onto the next one and that’s a very set practice. In Ashtanga you usually do the same series — and there are several — and once you master one then you can move onto the next level. And then there’s Vinyasa. The sequence of postures can change in Vinyasa, but they flow very smoothly together. Hatha is another one and it can tend to be more gentle. So if you have a class that says that they’re Hatha, you might get a more basic intro class. And then you have Iyengar, and that’s a school of practice that’s very alignment-oriented. They will use a lot of props. It’s very physical and mentally challenging, but it’s really about making sure your body is in the right posture and the right alignment. And it can really help cultivate strength, flexibility, and endurance.

And then you have others, like your restorative classes that really is a more passive style of yoga where you’re not going to exert any effort, and they’re going to use lots of props to bring the floor up to your body just to help the body totally relax. And another type is Kundalini. It can be pretty intense, your muscles will burn. The exercises can use different postures, different breathing techniques. They’ll do mantras. They could use mudras, body locks. Those are all designed to help open your energy channels and to help still and calm your mind. So those are some of the top most, I would say, probably the most popular ones.

Jamie DePolo: Okay. Now, you touched on a couple of them as far as benefits of yoga for somebody who has been diagnosed with breast cancer, and I’m wondering if you could talk a little bit more about that. And then for you personally, were there certain aspects of yoga that really helped you when you were in treatment?

Vicki Flannery: Benefits of yoga, there’s so many. It’s so beneficial in so many ways. Some of the more slow-moving, rhythmic movements that we do can actually help prevent lymphedema. So if lymphedema is a problem, a lot of the rhythmic movements help get the lymph moving throughout your system, and that’s very beneficial for you. Of course weight management as we go through breast cancer treatment. The one thing that I looked forward to was, “Oh, well, at least I’m going to lose a little weight.” And my doctor’s like, “No, you’re probably going to gain.” And I was like, “Oh.” Yoga can help in that of course, because you’re moving, and studies show that people who perform yoga tend to be more mindful about what they eat. So as like menopause, you’re put into that or you’re already there, and you’re just not burning as many calories. You’re going to want to be more mindful about what you eat, so it can help in that aspect. And of course you’re going to get improved strength because you’re strengthening all these core muscles and your legs and hopefully your arms and chest and back.

So those are some of the improvements that you can see in yourself. You might find that you start sleeping better, because with yoga it can help bring an inner calm and an overall better sense of well being to your soul. So as you’re feeling calmer, especially going through a diagnosis, as you try to alleviate any anxiety and stress that you have around that, it can help you sleep better. It will help you feel less fatigued. I guess studies have shown that physical exercise during treatment and moving helps alleviate those feelings of fatigue and exhaustion during treatment.

It can stimulate your immune system, because as you’re moving, you are moving that lymph out and through, which is a good part of helping your immune system rid itself of the toxins and whatever might be building up inside you as far as viruses and whatnot. But it will decrease the inflammation as you destress. It decreases your cortisol, so as that cortisol decreases your levels of inflammation decrease. So it can also help the efficacy of your chemo and radiation treatments. And that’s pretty much, that’s my top benefits.

Jamie DePolo: Okay. And you mentioned, too, earlier, it helped you mentally sort of be centered and be focused, if I’m remembering correctly what you said, when you were in treatment and dealing with your diagnosis.

Vicki Flannery: Yes, it did. It did. I felt like during that, if I didn’t get my daily practice in I just didn’t feel as calm or as centered. And during my practice when I was going through all the testing and the waiting, the waiting for the test results and the waiting for the biopsies and dealing with the fact that I had this diagnosis over me and I didn’t know what was exactly going to happen, it helped me find a level of acceptance. Because as you do the yoga practice and you center and you bring some of your subconscious fears to your conscious and deal with them and you sit in your body for a little bit and accept what’s going on, it helps you just find that level of acceptance. Like, okay, this is going on and this is going to be what it is and I’m going to roll with it, and it’s going to be okay one way or another.

Jamie DePolo: Now, you mentioned, too, that some of the postures can be pretty intense. Are there any precautions that somebody who’s been diagnosed and treated for breast cancer should take when they’re doing yoga? I know some people are worried about the downward dog posture as far as their arms if they had a lot of lymph nodes removed, or shoulder stands, head stands, things like that.

Vicki Flannery: So far as precautions, I would always suggest, number one, talk to your doctors. Ask them, “Hey, what can I do and what should I avoid?” Because they know your treatment, what you’ve done, and what they’ve done to you. And so they might have some suggestions of, you know, “Avoid this but it’s okay to do this.” And then if you see a therapist or a lymphedema specialist, check with them as well, because they may have ways and suggestions for you to modify your practice to fit you. Lymphedema is a huge concern for almost everybody I talk to, and you can modify your down dog and try to avoid weight-bearing exercises on your arms. But you can also wear your sleeves, you know, get fitted for a compression sleeve. You may want to use that while you’re working out to help alleviate some of that.

Chest strength is a concern. So for some, after breast cancer, modify push ups on the knees until you build up the strength and you know how your body’s going to respond to having extra pressure on your arms. Slowly build up to arm balances if that’s something you want to try. Be careful with poses, though, that put too much weight on your arms or your full body weight, especially at the beginning. Introduce them to your routine slowly. Don’t try to strain yourself to look like the instructor because, well, of course we all have bones, muscles, and tendons, we’re not all the same and our body shapes are different. So some people are more hypermobile and can move into positions better than other people, so respect your body.

Jamie DePolo: Okay. And I assume the same thoughts would go toward anybody who’s doing a home practice or using an app or a video. They may not be able to talk to the instructor as much, but they would have to kind of think through the various poses and see, “Can I do that? Does that hurt? Am I straining myself?” Something like that.

Vicki Flannery: So if you are using an app or a video, I would suggest using a high quality one. There’s really good instructors out there on the internet and there are some that might not be as good for basic stuff. I would really suggest maybe getting into a class and actually doing an intro to yoga, really, before you dive into any app or online video, just so you can have that kind of personalized one-on-one. But I understand that’s not always accessible to everybody to have that. I think, personally, Yoga With Adriene, I think she’s a good video. She runs through the basics really well and explains them in very good detail. So her basics through her video courses are great if you’re wanting a free online video.

Jamie DePolo: Okay. Okay, thank you for that recommendation. Now, since you personally have been diagnosed, are there certain poses that you don’t do or that you modify because of your treatments?

Vicki Flannery: I’ve never really been able to do a full wheel, so I will never do a full wheel. Since I’ve had breast surgery I don’t think my body is capable. I don’t know if anyone else’s is but certainly mine is not, so that is not something I will teach or do.

Jamie DePolo: Okay. And just in case anybody doesn’t know, a wheel is basically a backbend where you’re kind of in an arch and your hands are on the floor behind your head and your feet are on the floor and then you arch up so your back is off the ground.

Vicki Flannery: Correct. That one won’t happen for me. Another one that I like to modify is when you’re on all fours in a tabletop. You’re on your hands and your knees, which is a tabletop position with a flat back. When you go to reach your arm up for a twist in that position, I like to take whatever arm is going up, be it my left or my right, I take that same leg and I just move it back about 3 inches. And in doing that it allows me to open up and actually feel like I’m getting into the twist where my body’s probably not twisting any more than it would if I just raised my arm up, but it feels like I get a better twist. And I can get my arm up higher and it feels good. So that’s one modification.

I try to avoid down dog. I know a lot of people like it so I want to provide it to them if that’s something that’s in their practice and they feel comfortable doing. But I try to do it after everybody’s really good and warmed up because I don’t want anyone to have any spinal injuries or have any injuries related to that for fear of the lymphedema coming because they’re in that arm position where they’re putting a lot of weight on their hands and their arms.

And forward folds, I try to teach it with bent knees where you’re resting your torso more on your thighs, again, because a lot of people have concerns of fragile bones and loss of bone density after treatment. And so to alleviate maybe some of the strain, bending your knees and resting on your lap feels good, and I feel like it’s a safer way to do a forward fold.

Jamie DePolo: So it definitely sounds like there are modifications for just about any pose. And if someone isn’t comfortable with a pose, maybe they talk to the instructor about what she or he can do instead.

Vicki Flannery: Absolutely.

Jamie DePolo: Yeah, okay. Okay. And again that would be harder with an app or a video. But I do like your suggestion of maybe taking a basics class first so then if you are using an app or a video you can know which poses you kind of can’t do and modify them.

Now, I know you teach yoga at a gym that really focuses on people who have been diagnosed with cancer or people with chronic illness. Are there other instructors or is there sort of a specialized yoga training to teach people who have been diagnosed with cancer? I guess I’m wondering how somebody, if they’re out there listening and they want to try yoga for the first time, how do they go about finding a good instructor for them or a good class for them? Do instructors specialize in teaching people who have been diagnosed?

Vicki Flannery: Yeah, there’s some special training out there that can be achieved so that… Your normal yoga instruction is usually a 200-hour course, but it doesn’t usually have the time to go into all the intricacies of what is going on with a person during a cancer treatment. That is something that usually you can get through specialized yoga therapy programs that teach you how to modify and incorporate poses that will energize and be beneficial for people with cancer.

Most of them, I find, are affiliated with hospitals. So any hospital site that you go to and search for yoga classes will have, somewhere in their list, they will have yoga classes for cancer patients. And then some individual yoga studios may have therapists that work within their studio that offer specialized classes, specifically for people with cancer.

Jamie DePolo: Okay, that all sounds good. So to wrap up, I’m wondering, if somebody wanted to try yoga for the first time, somebody who had been diagnosed and treated for breast cancer, what two or three things would you tell them to think about or do first?

Vicki Flannery: I would say start slow and see how your body feels. Progress at your own pace. Go to your edge, which means go to that point that takes you out of your comfort zone, but then ease up a little bit. You don’t want to go too over the edge of feeling uncomfortable while you’re practicing. We all have different bodies, so finding respect for yours and listening to it. Any chance you get use a prop. If it doesn’t feel good then just don’t do it. Take rests. Ask for help when you need it. If you’re in a yoga studio and something’s just not feeling right, flag someone down, “Help me out, this doesn’t feel good.” Yoga instructors love to help everybody feel like the pose will work for them or finding a modification to make something work for the individual.

And advocate for yourself. If you don’t want adjustments, let the instructor know. There’s some yoga, like Ashtanga — in that yoga teaching, they often do physical adjustments to the students, so if you’re going into an Ashtanga or a Vinyasa and you don’t want an adjustment, just let the instructor know. Because sometimes they could push you into a pose, like if you are in down dog, push you down. And depending on some of the medications and treatments, your joints and your muscles might be more tight than the average Joe out on the street. So knowing that if you’re forced into a position it could cause damage, advocate for yourself and let them know that you don’t want certain things done.

Jamie DePolo: Great. Thank you so much, Vicki. I really appreciate your time and your insights. I think this will be very helpful for our listeners.

Vicki Flannery: Oh, good.

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