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Yoga promotes survivor well being

It was a combination of foresight plus opportunity. Inspired by her own commitment to the practice of yoga, Sally Blank — together with a team of researchers at WSU Spokane — has demonstrated that breast cancer survivors who practice Iyengar yoga show enhanced psychological well-being and possible immune system benefits as well.

“It really bridges the gap between personal philosophy and professional scholarship,” said Blank, associate professor and director of the Program of Health Sciences.

“It also says a lot about what Sally and (fellow researcher) Mel Haberman have done to develop working relationships with the Spokane medical community,” said Deborah Haberman, research development coordinator for the Cancer Prevention and Research Center at WSU Spokane, www.cancer.wsu.edu.  (Wife of Mel Haberman.)

In the beginning Blank had been told by a member of the medical community that yoga research would be opposed in Spokane – and that she should go to southern California if she wanted to pursue it. But today, Blank is seeing increased acceptance and interest, particularly because of the support from Dr. Joni Nichols, who encouraged her patients at Cancer Care Northwest (affiliated with U.S. Oncology) to participate in the research studies. For her latest pilot study, Blank and her team were able to identify 600 eligible women from the Spokane area. Though only 20 were needed for the research, over 140 had volunteered.

Pamela Schultz, Sally Blank and Nicole Munoz (l-r), with Sharon White, demonstrating equipment. Photo by Bob Hubner, WSU Photo Service

Pilot study

The study, presented at the American Psychological Association on April 30, included women, with an average age of 61, who had been diagnosed with stage I – III breast cancer and were currently receiving antiestrogen or aromatase inhibitor hormonal therapy. None of the women had previous experience with Iyengar yoga and were randomly divided into either a yoga group or wait list control group.

Beginning level Iyengar yoga classes were conducted twice a week for eight weeks with instructions to also practice once a week at home. Yoga poses included standing poses, chest and shoulder openers and inversions.

Typically, breast cancer survivors are offered gentle, restorative exercises. In contrast, Iyengar yoga can incorporate cardiovascular endurance, muscular strength, flexibility and balance. There is careful attention to body alignment and symmetry and the use of props is allowed to help participants achieve the poses — or asanas. Sequences of asanas are individually chosen for each class — including poses, such as inversions, that yoga philosophy suggests will benefit the immune system.

Named for its creator, the 89 year old B. K. S. Iyengar, this method of yoga has been said to reduce fatigue, anxiety and depression, see ONLINE @ www.bksiyengar.com.

Before and after the study, both groups of women were given surveys concerning the demands of their illness (stress levels) and blood was drawn to check NF-kB activation. NF-kB (nuclear factor-kappa B) is a protein complex found in all cells which acts as a transcription factor in controlling the expression of genes involved in the immune response. In essence, it is a marker for stress and inflammation in the body.

Results of the study clearly showed that the women who participated in yoga experienced a drop in lymphocyte NF-kB activation compared to the control group. The demands of illness scores also decreased for these women. Lower demands of illness were associated with decreased NF-kB activation in yoga participants only.

Stress and inflammation.

Mel Haberman

Mel Haberman, professor, College of Nursing, and associate director of the Cancer Prevention and Research Center, studies quality of life issues in cancer survivors. He agreed that women who participated in the yoga study — compared to those who received standard medical care — reported a significant decline in stress symptoms.  Specifically, they were less worried about the spread or recurrence of the disease. They believed the cancer was controllable and showed very high confidence in their medical caregivers.

“Our overall hypothesis is that the progression of cancer can be related to inflammation,” said Blank. “When lymphocytes are activated, it could increase inflammation and possibly contribute to the progression of the disease. We also know that meditation during yoga induces a relaxation response which affects neurological pathways and can decrease NF-kB levels,” she said. “At this point we are asking if the results are more related to a dysregulation of the inflammatory response or if we are potentiating a relaxation response,” Blank said. “We don’t have the data yet, but will be exploring it further with our next grant.”

The Iyengar yoga studies were funded by grants from WSU Spokane, WSU Cancer Prevention and Research Center and by the University of Washington Center for Women’s Health and Gender Research.

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