Cancer will affect around one in two people and is one of the world’s major health conditions. The World Health Organisation estimates that 14.2 million people are diagnosed annually with cancer, and that figure is set to almost double over the next 20 years. Understandably, vast resources are being invested into researching the causes of cancer and possible cures, and certainly the prognosis for many cancers is significantly more positive than in the past. However, many people who are diagnosed with cancer will lose their lives to the disease, so being told you have cancer is one of the most traumatic health events you’re ever likely to encounter.
There are several recognised medical approaches to treating cancer, but many people also turn to other treatments and therapies, either in the hope of an alternative cure or to help them the manage the unpleasant side effects that conventional treatments can cause. Many non-conventional therapies are also popular to help patients manage other ‘side effects’ of cancer, such as stress and anxiety, caused by the serious nature of the diagnosis. Ultimately, every cancer patient faces the possibility that they may eventually die from the disease, which is traumatic enough in its own right, without the added stresses and strains of an ongoing treatment regime. And even if the cancer goes into remission, many patients will need to continue with drug regimens, together with their attendant side effects (e.g. fatigue), and regular check-ups, all of which can cause worry and stress.
Of course, any patient diagnosed with cancer wants to be sure they are doing everything possible to get well quickly and, at the end of the day, survive. This explains the rise in the use of non-conventional cancer therapies, but picking your way through the different alternatives, the terminology, and how the various treatments can best be applied to your individual situation, can be something of a minefield. So what kind of therapies are available, what are the different terminologies used, and last but not least, how scientifically valid are they?
Non-conventional medical treatments for cancer are often referred to with terms such as ‘alternative’, ‘complementary’,’natural’, traditional’ and so on. Very often these terms are used almost interchangeably, but in reality there is a significant difference between alternative and complementary therapies.
Alternative therapy is generally used instead of conventional treatment for cancer. There’s a bewildering range of different alternative therapies, but before opting to undergo them it’s essential to understand some basic facts. Conventional medical treatments are required to undergo rigorous testing before they can be used on people, and doctors are also acutely aware of the huge body of scientific research and medical trials attached to each form of treatment. This is often very detailed, and enables physician to devise a treatment regimen that not only makes use of the most effective approaches to treatments, but avoids unnecessary treatment. For example, studies show that for some breast cancers there’s no advantage in having a full mastectomy rather than a lumpectomy.
Alternative treatments are not tested scientifically in this way, and some make extremely spurious claims about their treatment being a ‘cure’ for cancer, without rigorous evidence to back this up. Alternative therapists do not need to be qualified at all. Some alternative treatments could actually cause harm rather than do good to a body already compromised from cancer.
Naturally, cancer patients often want to leave no stone unturned in their treatment, to give them the best chance of survival. But rejecting conventional medical treatments (which have a quantifiable success rate), in favour of untested alternative therapies could ultimately end in a patient dying from a cancer that may have been easily treatable. Sometimes patients who’ve been given a terminal diagnosis may feel they have nothing to lose by trying an alternative therapy, but as a rule, patients should think very carefully indeed before opting for an alternative treatment.
There is a vast range of alternative cancer treatments available, ranging from the relatively harmless to some which can have very severe consequences, in addition to the implications of refusing conventional treatment in favour of untested therapies.
Alternative therapies can include ingesting ‘natural’ products or foodstuffs, Gerson therapy (following a regimented diet), shark cartilage therapy, and hyperthermia (using high temperatures to ‘treat’ tumours). These are unproven treatments, which can have a detrimental effect on the health of cancer patients.
For example, laetrile is a form of the plant-based amygdalin, which can be found in nuts and fruit seeds.It has a number of alternative names, including vitamin B17, and can be taken orally, by injection, or via liquid which is applied to the skin or inserted into the rectum. Amygdalin is known to release cyanide, so ingesting laetrile can have serious side-effects and there’s no scientific evidence to show it’s effective in tackling cancer.
Unlike alternative therapies, complementary therapies are undertaken alongside conventional medical treatment, to manage the nasty side effects (such as nausea and fatigue), and also to help patients cope with the mental and physical aspects of dealing with a cancer diagnosis and undergoing treatment.
Although it’s helpful to discuss any complementary therapy with your team of physicians, complementary therapies are unlikely to conflict with medical treatment. Indeed some health providers offer complementary therapies, such as meditation or movement therapies, as part of their programme. Complementary therapies can include acupuncture, Reiki, meditation, yoga, and creative arts therapies.
Yoga is an extremely popular complementary therapy for cancer, and there’s some scientific evidence to show that it can bring immense benefits to those suffering from cancer.
Yoga has its roots in Eastern tradition, originating in India around 5,000 years ago. Over the centuries, different branches and practices have developed, often adapted to suit the countries in which they were used. Yoga is promoted as an activity that stimulates the nervous system, enhances flexibility in the joints, tones muscles, and brings relaxation to the body and mind. The focus on effective breathing also brings great cardio-vascular benefits. Ultimately, yoga is a fabulous overall way to boost your health and promote mental and physical well-being.
In the west, yoga is often viewed as a spiritual activity, only for slim, fit and healthy people, adherents to a hippie lifestyle, and best suited to tree-hugging vegans. However, nothing could be further from the truth. It’s true that yoga can involve breathing techniques, cleansing techniques (kriyas), visualisations, chanting and mantras, and more, but nowadays, especially in Western practice, the emphasis is on holding poses to help develop focus and concentration and to strengthen the body. Breathing techniques (pranayama) and a set series of flowing postures (vinyasa) done in between poses are also important. Of course, many people derive great satisfaction from the more spiritual aspects of yoga, but even practising yoga for the physical benefits can bring superb benefits for the whole body and mind.
There are many different branches of yoga, each with its own specific focus, routines, and theory behind it that can hardly be summarized properly in a couple of words. However, here is an attempt to give clarity to a couple of the main ones:
Hatha yoga is considered to be the ‘mother’ form of postural yoga, from which all other practices stem – Western yoga is generally considered to be hatha yoga. The term ‘hatha’ can be variously translated as ‘forceful’ or ‘wilful’, referring to the how we manipulate our the body and breath to influence our mind into meditation’s strongest experiences. However, nowadays in the West it is usually associated with a gentle and slow practice.
Iyengar Yoga is a form of Hatha Yoga, which emphasises on detail, precision and alignment in the performance of posture (Asana) and breath control (pranayama). The developmental strength, mobility and stability is gained through the Asanas.
Iyengar Yoga often makes use of props, such as belts, blocks, and blankets, as aids in performing asanas (postures). The props enable students to perform the asanas correctly, minimising the risk of injury or strain, and making the postures accessible to both young and old.
Perhaps one of the best forms of Yoga for people with cancer is Yoga Nidra. Yoga Nidra is designed for relaxation. As Tantra Yoga India explains ” Yoga Nidra is a powerful technique from the Tantra Yoga tradition. It is both a name of a state and of a practice which creates an altered state of consciousness allowing the practitioner to relax and heal their being, expand their faculty of imagination, enter the realm of subconscious & superconscious, effectively manifest seemingly magical changes in their life, certain karmic debris in their life clear (if you believe in Karma) and assist in reaching a state called by some “enlightenment.”
Some of the benefits of Yoga Nidra are;
#1 Everyone can practice. Even beginners who have no experience with meditation.
#2 Physical stresses and tensions are removed.
#3 Mental stresses and unwanted impressions are removed.
#4 Emotional balance is restored.
#5 The faculties of imagination and visualization are practiced and enhanced.
Is yoga always good for you?
With so much positive vibe surrounding the practice of yoga, you’d be forgiven for thinking that yoga is some kind of cure-all that only has a good effect on our well-being. But, as often happens, many misconceptions have sprung up about yoga, and it pays to have a good knowledge of these before embarking on yoga practice.
There are many myths about yoga which. Some are relatively harmless, but others, if not properly understood, can actually cause you mental and physical harm.
Guidelines recommend that we should all be doing at least 150 minutes of aerobic activity each week to keep our body in optimum health. However, although yoga gives us a physical workout, it doesn’t raise our VO2 intake enough to count as serious aerobic exercise. In his books The Science of Yoga: The Risks and the Rewards, William Broad (himself an experienced yoga practitioner), investigates a number of claims about the benefits of yoga, including whether or not it can be counted as aerobic exercise. He believes that with the huge rise in the popularity of yoga in the 70s and 80s, people were perhaps over-keen to stress the supposed health benefits, without checking whether these claims could be validated scientifically. As an example, yoga was praised as an aerobic activity because it raised the VO2 level by up to seven percent, but in reality this was significantly lower than the increase of fifty percent noted in endurance athletes. As Broad put it: the facts “rapidly sank into the void of cultural forgetfulness.” Even working at speed or in hot conditions, yoga can’t really be counted as aerobic exercise.
Some of the yoga positions are cited as being good for the body, whereas they could actually cause significant damage. Performing maximum extensions in poses such as the Cobra, in which the head is tilted back ‘as far as possible’ causing extreme curvature, can cause huge damage to muscles and tendons in the area, and in the case of some conditions (e.g. osteoporosis), can even lead to fractures. Headstands can be equally as dangerous. In severe cases, challenging poses like this can lead to nerve damage, strokes, paralysis and even death.
Whilst it may be true that, with time and careful practice, it’s possible to extend the mobility and flexibility of joints and muscles, which can help the body to become stronger and healthier, attempting to achieve extreme poses (especially if you’re not used to them), could be dangerous. Always aim to build up your yoga moves carefully and with full control, making sure you don’t push your body too far.
It’s also been suggested that yoga is good for our health because it helps the body sweat away toxins from the body, leaving us cleaner and healthier inside. However, when we sweat, we don’t really get rid of toxins – that’s done by organs like the liver, kidneys and digestive system.
Bikram yoga is renowned for conducting ‘hot’ yoga sessions, in the belief that working in such warm temperatures helps to burn more calories. However, scientific evidence shows that any increase in calories burned is unlikely to have any real impact – a higher intensity workout would be far more effective.
Injuries from practising yoga
As part of his research for his book, Broad extrapolated worldwide figures on the number of yoga injuries incurred each year, and the results showed that yoga injuries had risen hugely since 2000. There are various theories as to why this might be. Certainly, more people are becoming involved in yoga, but other factors could be the inexperience of some teachers, and an increase of the competitive element in yoga, where people are more concerned with how they look and what their neighbour is doing, rather than concentrating carefully on listening to their own body.
Benefits of using Yoga
However, despite all this myth-busting, it would be a mistake to think that yoga doesn’t have any health benefits. In fact, it has many, and these benefits have been scientifically verified rather than relying on hearsay and word-of-mouth. Yoga can be a wonderful way to improve and maintain a whole range of physical and mental issues, many of which can be thrown into sharp relief when you’re diagnosed with cancer.
We’ve already seen how cancer can play havoc with both our physical and mental health. Surgery can be painful and sometimes disfiguring, as well as bringing all the attendant physical problems associated with recovering from an operation. Radiotherapy and chemotherapy require great stamina to attend appointment regularly, and cause some very unpleasant side effects in their own right. And of course, a cancer diagnosis can be very frightening and distressing, causing all kinds of emotional and mental problems. Yoga has been shown to bring significant relief in many of these areas.
Many people find that practising yoga helps them to feel more in control of their situation at a frightening time in their lives, when much ‘control’ has been taken away from them by medical practitioners, a failing body, and the cancer itself. They often find they feel more relaxed and energised after a yoga session, as well as enjoying a lifting of mood and an enhanced sense of well-being. In themselves, these benefits have positive longer term mental effects for patients.
Focusing on controlling breathing and getting the maximum benefit out of deep breathing techniques have been proven to have a beneficial effect on stress, anxiety, the general immune system, and some psychological issues. It enables our heart rate to slow, inhibits stress hormones like cortisol, and boosts ‘feel-good’ hormones like dopamine and oxytocin.
Research has also shown that yoga can increase the level of gamma-amino butyric acid in our bodies. This important neurotransmitter helps regulate the nervous system, leading to a better balanced mood and outlook on life. The gradual improvement in our physical state, such as becoming leaner and more toned, or losing excess weight, can also help us feel better mentally
Whether physical pain is caused by the cancer itself, or by side effects from medical treatment, pain management is one of the most crucial aspects of cancer care. Patients suffering constant pain become tense, stressed and unhappy, and in time this can cause lethargy, fatigue and depression. Conversely, anxiety and other associated mental issues can manifest themselves as pain, and whilst there may not be a physical cause, the actual suffering experienced by patients is very real. Yoga, done at an appropriate level, can help tackle physical pain by enabling greater mobility and flexibility, but it’s also been shown to alter the mental attitude to pain. For example, women who practised yoga during their recovery period from cancer reported less pain and stress than those who didn’t.
Although yoga isn’t considered to be aerobic exercise, in many other ways it brings the same benefits as alternative forms of physical activity. When we practise yoga, the hormone serotonin is released into the blood stream. Increased levels of serotonin in the brain lead to improved emotional well-being, making yoga a good choice for patients with cancer.
#5 Yoga can diminish sleep problems and insomnia
Insomnia and sleep problems can be conditions in their own right, but are often made worse by factors such as anxiety, stress, and depression, all of which can be present in cancer patients. Although studies into the effects of yoga on sleep problems are limited, some have shown that it can help aid restful sleep. This includes one for female cancer patients who reported better sleep patterns after practising yoga each evening.
Gentle controlled stretching, moving, balancing and breathing can all produce physical benefits too. Improved flexibility, stronger muscles, and better balance are all good outcomes from doing yoga, and go a long way towards helping those with cancer feel better about their situation.
Coping with cancer is not only about the patients themselves. The love, understanding and support from others around them can be a crucial factor in how well people recover following cancer treatment, both emotionally and physically. Practising yoga with others provides a ‘built-in’ support network, especially if the class is run by healthcare professionals as part of their treatment regime – everyone is in the same boat, so to speak. The importance of enabling family and friends to feel supported shouldn’t be underestimated either – yoga is a great coping strategy for many who are anxious about a friend or relative battling cancer, and allows them to offer better support because their own physical and emotional needs are being met,
Naturally, no-one can say for certain whether or not you will survive cancer. Much depends on factors such as the form of cancer and how advanced it is. However, there is evidence to show that those with a more positive outlook tend to have a better survival rate than those with more pessimistic attitudes. For example, the stress hormone cortisol is at its highest level in the morning, tailing off throughout the day. One study found that women whose cortisol level dropped off more slowly had lower survival rates. A further study then looked at how yoga impacted on cortisol decline, finding that those who practised yoga had a more significant drop, implying that yoga may have a possible impact on cancer survival rates.
Understandably, there’s an increasing amount of research into whether or not yoga can have a measurable benefit for cancer patients, with some interesting findings.
At the 2003 Annual Meeting of the American Society of Clinical Oncology (ASCO), delegates heard a report of a study based on 126 women who’d recently been diagnosed with Stage I or II breast cancer and were about to undergo chemotherapy or hormonal therapy. A random group were chosen to do yoga for a three-month period. Afterwards, this group reported a 12% improvement in fatigue, physical functioning and quality of life over those who didn’t do yoga.
Similarly, in 2006 another study by the M.D. Anderson Cancer Center involved a group of 61 women undergoing a 6-week course of radiotherapy for breast cancer. Half the women practised yoga during this time and half did not. Those who did yoga reported less daytime fatigue, improved night-time sleep and better quality of life.
A study (Cancer Care, July 2005), drew together findings from a variety of studies (including the above named study), into the impact of practising yoga on cancer patients and survivors, looking for quantifiable evidence that yoga can truly make a difference and why. One study covered in this publication was conducted in 2004. It was a randomised, controlled study on a group of Tibetan cancer patients, in which the 39 participants were assigned to a yoga study group or required to wait . All patients had Stages I-IV lymphoma and were either receiving chemotherapy or had undergone it in the past year. The patients completed baseline questionnaires, with further questionnaires issued after one week, one month and three months. The yoga participants reported much better sleep patterns, including falling asleep, length of sleep and less need for sleep medications than the other group.
The Cancer Care 2005 report also included feedback on studies done in Canada into combining yoga with Mindfulness Based Stress Reduction techniques. 109 participants with a wide range of cancers were randomly distributed between an intervention group (61 participants), or a control group (48). Features such as overall mood, and stress indicators, were assessed at the start and again after the seven-week intervention. Following the interventions, 65% of the practising group reported lower levels of stress and a better overall mood, compared with 12% in the control group.
Other studies indicated similar results, as well as improved outcomes depending on how long patients had followed routines at home as well.
Conclusions and recommendations for future research
Of course, research into the impact of yoga on cancer sufferers is continuing and widening day by day. Scientists have investigated a range of cancers, together with other factors such as the aggressiveness of the tumour, the location, the stage of cancer at diagnosis and many more, as well as factors such as whether or the patient is undergoing treatment, and if so, what kind or combination. The main body of evidence seems to indicate that yoga may well prove to have significant benefits for cancer patients, but more detailed research is need into how that is best conducted. For example, is it better to offer yoga before, during or after treatment? Which cancers respond best to yoga?
Early evidence points to a positive outcome in terms of tackling associated problems like fatigue, depression, sleep issues, overall mood and quality of life, and this kind of evidence is backed up through studies of others who don’t have cancer. Yoga appears to have a positive effect on the general population as well.
The more general aspects of providing support to patients through yoga is another useful area for further study. For example, breast cancer patients who were left to manage without support showed a 33% lower rate of optimism, 34% reported higher stress levels, with 35% most likely to benefit from group therapy.
It’s also worth investigating some of the more anecdotal evidence about cancer patients and the benefits of practising yoga. In one study, medical practitioners noticed a marked difference in the general demeanour and posture of patients as their interventions progressed, which did not seem to be mirrored in the control group.
If you decide that practising yoga could be beneficial to you, you must first take into account all the matters that have been discussed so far. However, once your decision is made, you should investigate possible groups or classes where you can begin to practise.
Larger medical facilities often offer yoga classes to patients, perhaps as part of a wider package of complementary therapy, which is a great way to start because everything will be geared towards supporting those who are ill. Routines and poses will be adapted to ensure that you are safe when practising whereas in a general class (e.g. at a health centre), you may not receive such specialist instruction. For example, some poses may put you at greater risk of developing lymphedema, or may not be recommended for those with a metastatic condition. Overly hot conditions could cause you to feel faint, especially if you’re undergoing debilitating treatment, or some may put too much strain on specific areas of the body which may be weaker due to your cancer.
But before taking on any yoga class, communicate first with the teacher and explain your condition exactly, so they understand what’s safe for you and what’s not. Try and visit a class to see what goes on, and perhaps note the poses used, so you can check an expert source for safety. And always be sure to discuss your yoga with the medical team who are treating your cancer.
It goes without saying that you should choose a teacher that is properly qualified, ideally to treat specific health conditions such as cancer. Although there are professional yoga instructor organisations there’s no legal requirement to join one, and theoretically anyone can set themselves up as a yoga teacher with no qualifications or experience. If your sessions are run by a health facility, then it’s more likely their instructors will be familiar with appropriate routines for cancer patients, with a clear understanding of the science behind healthy body movement, how different cancer treatments affect the body, and how yoga can be used safely to alleviate symptoms.
However, if your local healthcare centre doesn’t offer yoga sessions, it’s not impossible to find a teacher who is trained in managing particular health conditions – you just need to check carefully before you start. Keep your instructor and your medical team fully informed on an ongoing basis about the progress of your treatment, so everyone can work together to support your treatment and recovery.
It is possible to follow your own yoga routine at home, perhaps by watching YouTube videos or DVDs. Again, there can be problems here. Firstly, there is no control over the expertise and safety of those who produce instructional videos, so there’s no way you can be sure the teacher is properly skilled and the routine is safe. Secondly, if you’re a beginner, you need very careful management to be sure you carry out moves safely, so you don’t get injured. If you’re a beginner, trying to learn without direct instruction is at best difficult and at worst, could be dangerous.
It’s clear that there’s plenty of evidence to support the view that yoga can be a very beneficial complementary therapy for treating cancer, both because of its direct physical effects and also because of the wider mental and emotional impact. Whilst, there’s no evidence that it can provide a cure, or even slow the progress of cancer, practising yoga to help manage physical, mental and emotional side-effects of both the cancer diagnosis itself and the side effects of the treatment can make a huge difference to how someone ultimately approaches their illness. And having a positive mental attitude towards beating cancer is half the battle.
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