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Arthralgia affects postmenopausal breast cancer survivors (BCSs) receiving aromatase inhibitors (AIs). This study aims to establish the feasibility of studying the impact of yoga on objective functional outcomes, pain, and health-related quality of life (HR-QOL) for AI-associated arthralgia (AIAA). Postmenopausal women with stage I to III breast cancer who reported AIAA were enrolled in a single-arm pilot trial. A yoga program was provided twice a week for 8 weeks. The Functional Reach (FR) and Sit and Reach (SR) were evaluated as primary outcomes. Pain, as measured by the Brief Pain Inventory (BPI), self-reported Patient Specific Functional Scale (PSFS), and Functional Assessment of Cancer Therapy-Breast (FACT-B) were secondary outcomes. Paired t tests were used for analysis, and 90% provided data for assessment at the end of the intervention. Participants experienced significant improvement in balance, as measured by FR, and flexibility, as measured by SR. The PSFS improved from 4.55 to 7.21, and HR-QOL measured by FACT-B also improved; both P < .05. The score for the Pain Severity subscale of the BPI reduced. No adverse events nor development or worsening of lymphedema was observed. In all, 80% of participants adhered to the home program. Preliminary data suggest that yoga may reduce pain and improve balance and flexibility in BCSs with AIAA. A randomized controlled trial is needed to establish the definitive efficacy of yoga for objective functional improvement in BCSs related to AIAA.
OBJECTIVE: Emerging research suggests that yoga may be beneficial for reducing symptoms and improving quality of life among breast cancer patients. However, very little is known about the characteristics of breast cancer patients who use yoga; thus, this study seeks to identify the sociodemographic and clinical characteristics of yoga users among this population.DESIGN: A cross-sectional survey study was conducted.
SETTING: The study was conducted at an outpatient breast oncology clinic at a large university hospital.
PARTICIPANTS: Three hundred postmenopausal breast cancer patients currently receiving aromatase inhibitors were included in this study.
MAIN OUTCOME MEASUREMENT: Self-reported use of yoga following the cancer diagnosis was collected along with sociodemographic and clinical data. Multivariate logistic regression was used to identify independent predictors of yoga use among breast cancer patients.
RESULTS: Of 300 participants, 53 (17.7%) reported having used yoga following cancer diagnosis. White patients were significantly more likely to use yoga than nonwhite patients (P = .02). Higher education level, lower BMI (body mass index), part-time employment status, previous chemotherapy, and radiation therapy were all associated with greater yoga use (all P < .05). Controlling for other factors, greater yoga use was independently associated with higher education level (adjusted odds ratio [AOR] 2.72, 95% confidence interval [CI], 1.15-6.46), and lower BMI (AOR 0.25, 95% CI, 0.09-0.66).
CONCLUSION: Yoga use following breast cancer diagnosis was substantially higher for white patients and those with lower BMI and higher education levels. Considering its potential benefits for symptom management in cancer, more research is needed to understand the attitudes and barriers to yoga use among individuals with nonwhite race, lower education, and higher BMI level. Such investigation will help design yoga programs that are aligned to the needs of these populations.
RESEARCH QUESTION: Arthralgia affects postmenopausal breast cancer survivors (BCS) receiving aromatase inhibitors (AI), which may result in reduced function and long-term well-being. This is an exploratory, qualitative investigation of BCS who participated in a yoga-based program to understand impact on joint pain and various aspects of quality of life (QOL) through a yoga program.THEORETICAL FRAMEWORK: Social cognitive theory was used and provided the foundation for developing a yoga intervention through sources of efficacy information: (1) performance accomplishment, (2) structured experience, (3) verbal support from instructor and group, and (4) physical feedback.
METHODOLOGY: Ten postmenopausal women with stage I-III breast cancer and AI associated arthralgia (AIAA) received yoga twice a week for eight weeks for 90 minutes and were instructed to continue in a home-based yoga program. We used social cognitive theory (SCT) to structure a yoga intervention as an ongoing physical activity to manage joint pain and function. Participants completed journal reflections on their experience and received weekly phone calls.
ANALYSIS: Data was collected and analyzed using qualitative methods. Member checks were completed and emergent themes were explored and agreed upon by the research team to ensure reliability and validity of data. Several emergent themes were discovered: Empowerment: Importance of Camaraderie, Community, and Sharing; Pain Relief; Increased Physical Fitness (Energy, Flexibility, and Function); Relieved Stress/Anxiety and Transferability of Yoga through Breathing. These themes were identified through instructor observation, participant observation, and weekly phone call documentation.
INTERPRETATION: Participants experienced an eight-week yoga intervention as an effective physical activity and support group that fostered various improvements in quality of life (QOL) and reduction in AIAA. Participants were highly motivated to improve physical fitness levels and reduce pain. This study revealed benefits from alternative forms of exercise such as yoga to provide a structure, which is transferable in other situations. Information, structured physical guidance in yoga postures, support, and feedback are necessary to foster physical activity for BCS experiencing pain.
IMPLICATIONS FOR CANCER SURVIVORS: Results of this qualitative analysis indicate that interventions to support BCS with AIAA are warranted. Yoga appears to positively impact these side effects of hormonal therapies. Additional research would aid in the development of other interventions.