The award is the largest ever made to study Tibetan yoga in cancer patients, say the researchers, who published a 2004 study in Cancer that found the practice led to significant sleep improvements in patients with lymphoma. Another small study of Tibetan yoga also found improvements in cancer-related symptoms and intrusive thoughts in women with breast cancer.
With this grant support, the research team will conduct a large randomized trial that will compare Tibetan yoga versus simple stretching or usual care in women who will be undergoing chemotherapy to treat their breast cancer. Lorenzo Cohen, Ph.D., an associate professor in the Departments of Behavioral Science and Palliative Care and Rehabilitation Medicine, and the director of the Integrative Medicine Program at M. D. Anderson is the study's principal investigator.
Most of what is known about yoga in the West comes from the Indian tradition, but Cohen has chosen to study yogic practices from Tibet. His team was the first to design pilot studies that examined the benefits of these techniques to cancer patients.
"Cancer and its treatment are associated with considerable distress, impaired quality of life, poor mental health and reduced physical function. This is particularly true for women with breast cancer who receive multi-modality treatment over an extended period of time," he says. "For thousands of years, Tibetans have been employing a form of yoga that we think could help ameliorate the treatment-related morbidity that accumulates over time in cancer patients."
The study's yoga instructor and co-investigator is Argentinean Alejandro Chaoul, Ph.D., one of few individuals in the United States trained in Tibetan yoga. "Like other types of yoga, Tibetan yoga involves breathing, physical movements and meditation, but it puts greater emphasis on meditation and visualization," he says. The program that Chaoul created to study in cancer patients has been closely supervised by his Tibetan teachers to make sure the yoga will be taught as much as possible in the original tradition. One such advisor, Tenzin Wangyal Rinpoche, a trained Tibetan yoga master, says, "These practices have long been considered beneficial for health, well-being and spiritual development, and we have always been interested in bringing this ancient knowledge into the area of modern scientific proof."
In the newly funded study, women with breast cancer who are scheduled to undergo chemotherapy will be randomly assigned to either a Tibetan yoga group, a control group that does simple stretching or to a group that receives standard care. The participants will practice their assigned techniques for seven weeks during chemotherapy, and then will have five booster sessions over the next six months.
The study will assess the physical and psychological benefits of the yoga program, and will specifically examine such patient lifestyle factors as fatigue and sleep, mental health and distress. Additionally, the study will evaluate cognitive and emotional processing, social networking and interactions, coping and other psychosocial factors, Cohen says.
Although the study is designed to look at improvements in quality of life, it could be that Tibetan yoga offers health benefits as well, Cohen says.
"Theoretically, if the Tibetan yoga intervention is found to decrease the patient's stress level, it could have an impact on their immune system," Cohen says. "There is extensive evidence showing that stress suppresses cell-mediated immunity, a component of the immune system involved in tumor surveillance. Tibetan yoga also might have an impact on patients' hormonal activity."
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