Monday, 14 April 2008
Yoga helps breast cancer patients
April 14, 2008
By Syed Akbar
Simple Yoga exercises help in fast recovery of breast cancer patients, who undergo surgery. Pre- and post-operative distress in breast cancer patients can cause complications and delay recovery from surgery. But Yoga has beneficial effect on such patients.
"Our research results suggest benefits of yoga in reducing postoperative complications in breast cancer patients. After surgery, breast cancer patients experience particularly high levels of distress manifested as anxiety, depression and anger due to the effects of surgery and the disease itself on life expectancy, physical appearance and sexual identity. Furthermore, concerns regarding one's physical condition, postoperative recovery, hospital admissions, anticipating painful
procedures, image problems, confronting cancer diagnosis and worries about
survival and recovery can contribute to the already prevailing distress and psychological reactions," says senior scientist M Raghavendra Rao.
His team at the department of Yoga Research, Swami Vivekananda Yoga Anusandhana Samsthana, conducted studies on 98 people diagnosed with stage II and III breast cancer. The team compared the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery.
According to him, the results suggest a significant decrease in the duration of hospital stay, days of drain retention and days for suture removal in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF (tumour necrosis factor) alpha levels following surgery in the yoga group, as compared to the controls.
Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels."Distress is known to impede wound healing in early phases of wound repair. Wound healing is important in this
current context of breast surgery as exaggerated inflammation, infections and collection of seroma at the wound site lengthen hospital stay, warrant more medical attention, cause distress and lead to delayed wound closure.
Although the use of anaesthetics and opioids for effective postoperative pain management has been shown to reduce plasma cortisol levels related to poorer wound healing, they nevertheless cause distressing side effects such as headache, nausea and gastrointestinal distress and are not cost-effective," the study pointed out.
He said since Yoga is a psychotherapeutic intervention, it helps in giving relief from stress. It consists of a series of breathing exercises or Pranayama, postures, relaxation and meditative techniques. These techniques are known to alter certain physiological functions that are known to reduce the effects of stress.
The study found that these functional alterations include bringing about a
stable autonomic balance, improvement of physical efficiency, increase in cardiopulmonary functions, improved immunological tolerance, improved neuro-endocronine functions, improved mood states and a tranquil state of mind to combat stress.
"This could be particularly useful in the current context where apart from reducing psychological distress, yoga could be used to alter endocrine and immune function to lower the risk of infections and enhance wound healing.
Distress could also impede recovery by reducing compliance, for example, it is known that breathing exercises reduce the risk of pneumonia following surgery and incorporating yoga interventions that use breathing, stretching and relaxation interventions could help hasten the recovery process following breast surgery," he said.
The research team invited subjects and their caretakers to participate in an introductory session before surgery where they were given information about surgery and the management of its related side effects, taught shoulder exercises and mobilisation by the physiotherapist and provided the answers to a variety of common questions.
He said both the interventions were imparted at the patient's bedside by trained personnel during the pre- and postoperative periods and subjects underwent four such in-person sessions in the hospital.
Following their discharge, subjects were asked to practise their respective interventions at home daily (for half an hour) during the next three weeks.
"The results showed that our intervention was effective in reducing postoperative complications. The type of surgery (mastectomy vs breast conservation) did not affect postoperative outcomes in our study which is consistent with earlier findings. We propose several mechanisms for action for our yoga intervention. The internal awareness and relaxation associated with these practices are known to alter perceptible thoughts and emotions and reduce reactivity to stressful situations or stimuli thereby altering stress responses and reducing distress," the study
The effects could be attributed primarily to the reduction in distress in the immediate postoperative period that could have buffered the effects of stress hormones, facilitated recruitment of inflammatory cells at the wound site and reduced the rate of infections and the sustained elevated levels of proinflammatory cytokines at a later period. Secondly, various yogic breathing practices are known to increase oxygen consumption that could hasten wound repair.
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