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CONTEXT AND AIM: Complementary and alternative therapies (CAM) are gaining popularity amongst patients as add on to conventional medicine. Yoga stands third amongst all CAM that is being used by cancer patients today. Different schools of yoga use different sets of practices, with some using a more physical approach and many using meditation and/or breathing. All these modules are developed based on the needs of the patient. This paper is an attempt to provide the basis for a comprehensive need based integrative yoga module for cancer patients at different stages of treatment and follow up. In this paper, the holistic modules of the integrated approach of yoga therapy for cancer (IAYTC) have been developed based on the patient needs, as per the observations by the clinicians and the caregivers. Authors have attempted to systematically create holistic modules of IAYTC for various stages of the disease and treatment. These modules have been used in randomized trials to evaluate its efficacy and have shown to be effective as add-on to conventional management of cancer. Thus, the objective of this effort was to present the theoretical basis and validate the need based holistic yoga modules for cancer patients.MATERIALS AND METHODS: Literature from traditional texts including Vedas, Ayurveda, Upanishads, Bhagavat Gita, Yoga Vasishtha etc. and their commentaries were looked into for references of cancer and therapeutic directives. Present day scientific literature was also explored with regards to defining cancer, its etiopathology and its management. Results of studies done using CAM therapies were also looked at, for salient findings. Focused group discussions (FGD) amongst researchers, experienced gurus, and medical professionals involved in research and clinical cancer practice were carried out with the objectives of determining needs of the patient and yoga practices that could prove efficient. A list of needs at different stages of conventional therapies (surgery, chemotherapy and radiation therapy) was listed and yoga modules were developed accordingly. Considering the needs, expected side effects, the energy levels and the psychological states of the participants, eight modules evolved. RESULTS: The results of the six steps for developing the validated module are reported. Step 1: Literature review from traditional yoga and ayurveda texts on etiopathogenesis and management of cancer (arbuda), and the recent literature on cancer stem cells and immunology of cancer. Step 2: Focused group discussions and deliberations to compile the needs of patients based on the expected side effects, energy levels and the psychological state of the patient as observed by the caregivers and the clinicians. Step 3: Content validation through consensus by the experts for the eight modules of IAYTC that could be used as complimentary to conventional management of cancer at different stages during and after the diagnosis was created. Step 4: Field testing for safety and feasibility of the modules through pilot studies. Step 5: Compilation of the results of efficacy trials through RCTs and step 6: A review of our studies on mechanisms to offer evidence for action of IAYTC on psycho-neuro-immunological pathways in cancer. CONCLUSION: The evidence from the traditional knowledge and recent scientific studies validates eight modules of integrated approach of yoga therapy for cancer that can be used safely and effectively as complimentary during all conventional cancer therapies.
AIMS: The aim of this study is to compare the effects of yoga program with supportive therapy counseling on mood states, treatment-related symptoms, toxicity, and quality of life in Stage II and III breast cancer patients on conventional treatment.METHODS: Ninety-eight Stage II and III breast cancer patients underwent surgery followed by adjuvant radiotherapy (RT) or chemotherapy (CT) or both at a cancer center were randomly assigned to receive yoga (n = 45) and supportive therapy counseling (n = 53) over a 24-week period. Intervention consisted of 60-min yoga sessions, daily while the control group was imparted supportive therapy during their hospital visits. Assessments included state-trait anxiety inventory, Beck's depression inventory, symptom checklist, common toxicity criteria, and functional living index-cancer. Assessments were done at baseline, after surgery, before, during, and after RT and six cycles of CT. RESULTS: Both groups had similar baseline scores. There were 29 dropouts 12 (yoga) and 17 (controls) following surgery. Sixty-nine participants contributed data to the current analysis (33 in yoga, and 36 in controls). An ANCOVA, adjusting for baseline differences, showed a significant decrease for the yoga intervention as compared to the control group during RT (first result) and CT (second result), in (i) anxiety state by 4.72 and 7.7 points, (ii) depression by 5.74 and 7.25 points, (iii) treatment-related symptoms by 2.34 and 2.97 points, (iv) severity of symptoms by 6.43 and 8.83 points, (v) distress by 7.19 and 13.11 points, and (vi) and improved overall quality of life by 23.9 and 31.2 points as compared to controls. Toxicity was significantly less in the yoga group (P = 0.01) during CT. CONCLUSION: The results suggest a possible use for yoga as a psychotherapeutic intervention in breast cancer patients undergoing conventional treatment.