By Duke Medicine News and Communications

Durham, NC – Breast cancer survivors often have more severe hot flashes and other menopausal symptoms than other women, yet they have limited treatment choices. Hormone replacement therapy, for example, is not an option for cancer survivors because it may increase their risk for disease recurrence. Therapies widely used to prevent cancer recurrence, such as tamoxifen, also tend to induce or exacerbate menopausal symptoms.

However, new research from Duke University Medical Center and Oregon Health and Science University offers an untraditional source of relief: a tailored yoga program.

"These women have suffered through the difficulties of breast cancer and are left to cope with these daily, extremely disruptive symptoms with few options for relief," said Duke assistant professor Laura Porter, Ph.D., co-author of the study presented at the International Association of Yoga Therapists Symposium for Yoga Therapy and Research. "We knew that some data found yoga helped reduce hot flashes among healthy women but no one had studied the effects among cancer survivors."

The study, supported through a grant from the Susan G. Komen Breast Cancer Foundation, included 37 survivors of early stage breast cancer who reported experiencing hot flashes. Women were randomized to either participate in an eight-week program called "Yoga of Awareness" or to a wait-list group which served as an experimental control.

The researchers describe "Yoga of Awareness" as an innovative program that is specifically tailored to address patients' hot flashes and other menopausal symptoms. During the two-hour sessions, yoga therapists lead their classes through gentle physical stretching postures, breathing exercises, meditation techniques, study of yoga principles and group discussions. Women were also instructed to supplement in-class sessions with use of the techniques at home.

"This program is not what you'd find at your local fitness center," Porter said. "'Yoga of Awareness' is based on traditional yoga techniques that go beyond the teaching of specific postures to incorporate practices aimed at reducing stress and creating a heightened sense of awareness and acceptance about one's physical and mental state."

Study participants' reported their menopausal symptoms prior to the program, immediately following the program and three months later.

The women who participated in the yoga program not only showed significant declines in the frequency and severity of their hot flashes but also experienced decreased fatigue, joint pain, sleep disturbance, and symptom-related distress, Porter said. They also reported increased vigor. These improvements continued to be seen in the yoga group compared to the wait-listed group even three months after the sessions concluded.

"While this is a specific pilot program, women seeking similar results could consult with an experienced yoga instructor to learn some of the same techniques," Porter said. "In addition to the traditional yoga postures, a well-trained yoga instructor or other mind-body practitioner may be able to provide instruction in breathing and meditation techniques to help manage stress and alleviate bothersome menopausal symptoms."

The research team plans to conduct additional studies to better understand the effects of the "Yoga of Awareness" program on breast cancer patients. They also plan to teach the concepts to yoga instructors nationwide.

Co-authors on the study include Francis J. Keefe of Duke University Medical Center and Kimberly M. Carson and James W. Carson of Oregon Health and Science University.