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Oncologists see benefits for cancer patients in yoga

Wes Venteicher
| Monday, Sept. 12, 2016, 7:51 p.m.
Judy Richard, of Canonsburg, practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Andrew Russell | Tribune-Review
Judy Richard, of Canonsburg, practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Wendy Addis, 68, of McDonald practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Andrew Russell | Tribune-Review
Wendy Addis, 68, of McDonald practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Deb Warren, 55, of Mt. Lebanon practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Andrew Russell | Tribune-Review
Deb Warren, 55, of Mt. Lebanon practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Lori Heinecke 60 of South Park, practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Andrew Russell | Tribune-Review
Lori Heinecke 60 of South Park, practices yoga at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
A group of people practice restorative yoga poses at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.
Andrew Russell | Tribune-Review
A group of people practice restorative yoga poses at St. Clair Hospital, in Mt. Lebanon, Tuesday, Sept. 6, 2016.

Standing in front of a group of shoeless, mostly middle-age cancer patients and caregivers seated on yoga mats one recent weeknight at St. Clair Hospital, instructor Holly Koenig discussed the health benefits of focused relaxation.

“If your mind is calm, your body will actually release chemicals to help promote that,” Koenig told the group, beginning an hourlong session of breathing exercises, stretches and meditation.

As medical studies increasingly show yoga's health benefits, and patients more often inquire about alternative medicine, more hospitals are incorporating yoga into treatment.

Koenig leads a monthly restorative yoga session at St. Clair in Mt. Lebanon. Paid for by the St. Clair Hospital Foundation, the class is free for people affected by cancer. At Allegheny Health Network, integrative care specialists are looking for ways to incorporate yoga into treatment in the coming months. UPMC is continuously expanding a 3-year-old integrative oncology program that includes recommending specific patients enroll in therapeutic yoga sessions and using yoga techniques during chemotherapy infusions.

“Cancer is a disease where people have a lot of challenges, physically and mentally, and yoga can be helpful because of all of these challenges,” said Dr. Lanie Francis, director of integrative oncology at UPMC CancerCenter.

Studies suggest yoga can help patients sleep better, manage stress, decrease pain and reduce inflammation, along with other benefits.

And those benefits come without many of the unpleasant side effects and costs of more conventional treatments, said Dr. Vincent Reyes, an oncologist who launched the St. Clair program.

“What resounded with me is that it's nonpharmaceutical,” Reyes said.

Lori Heineke, 60, of South Park said she has attended all four sessions that have been held so far at St. Clair. She said yoga helps her manage the aching joints and weight gain that come with taking a hormone blocker to help keep her breast cancer in remission. A strong believer in alternative medicine, she said she started doing yoga alone on her porch in the days between chemotherapy treatments.

“I did yoga to make me calmer and to feel good — as good as I could anyways,” Heineke said.

Reyes asked participants at St. Clair's latest yoga session, held Sept. 6, to fill out forms before and afterward estimating their level of distress. Among 27 people, many of whom were his patients, the average distress level decreased to 1.7 from 5.4, he said.

Similar forms have been used in some of the randomized controlled trials on yoga, asking participants to estimate things like fatigue and vitality.

Surveys used in an Ohio State University study published in 2014 in the Journal of Clinical Oncology showed improvements in fatigue and vitality but not in depression.

That study also measured inflammation, a condition of the immune system associated with a host of health problems that doctors often target in clinical and research settings. Researchers measured levels of three biological compounds associated with inflammation in the bodies of 200 breast cancer survivors before and after they did hatha yoga and compared those levels to patients in the study who didn't do yoga.

The researchers found that the levels of the inflammatory agents decreased in participants who did two 90-minute yoga sessions per week. Moreover, women who practiced yoga most often showed the highest response rate, strengthening the quality of the evidence for yoga's benefits.

“The idea that something as relatively benign as yoga could have downstream effects was particularly impressive,” said Janice Kiecolt-Glaser, a study co-author and director of the Institute for Behavioral Medicine Research at Ohio State University College of Medicine.

Another study in the journal the same year, from the University of Texas MD Anderson Cancer Center, compared simple stretching to yoga practices that incorporate breathing, meditation and relaxation techniques.

The study, which tracked 191 women with breast cancer during radiation therapy, found that fatigue decreased both in those who practiced yoga and those who stretched. Women who practiced yoga had the biggest drop in the stress hormone cortisol — which has been linked to worse breast cancer outcomes — compared to women who just stretched and those who did neither, according to study results. The study found no difference in mental health or sleep quality, although a separate study in the journal found benefits from yoga for sleep.

Despite the benefits documented in medical literature, many patients require a little convincing to try something new, Reyes said.

“They come from a world of pills, IV, meds, feeling miserable — they don't have time for these type of things,” he said.

Ron Ponist, 71, of Bethel Park was diagnosed in 2010 with lymphoma after noticing pain in his groin. He said he initially was reserved about complementary medical treatments.

“It seems like this is so low-tech. It doesn't cost anything. It doesn't seem like it will work,” he said.

But he found that tai chi, which he learned about during a 2011 Lymphoma Research Foundation conference, helped him manage stress, improved his balance and helped with breathing. He mentioned tai chi to Reyes, who suggested yoga.

Because his lymphoma is in a quiescent stage, he chose an approach known as active surveillance, which involves monitoring the disease without treating it unless something changes.

“I can't say that what I'm doing is keeping it at bay, but if there's any chance that what I'm doing can keep it in this inactive stage, then that's what I'm doing,” he said.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.

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