Alberta Cancer Foundation

A Peaceful Practice

Two years ago, there wasn’t a part of Gail McCombie that didn’t hurt. “I’d just finished breast cancer treatment and the chemotherapy was very hard on me,” she remembers. “My muscles ached and I felt like I had arthritis in every joint. I couldn’t get off the floor by myself.”

Then, while waiting for a medical appointment, she noticed a brochure about yoga classes in Calgary for cancer patients. Although McCombie didn’t know a downward facing dog from a happy baby pose, she was intrigued. Two months later, she completed her first Yoga Thrive course.

She didn’t notice changes initially, but her instructor did. “By the end of the course she couldn’t believe how far I’d come,” McCombie says. Soon after, McCombie returned to work part time. She continued taking yoga and, in April 2009, resumed her busy executive assistant responsibilities full time at Statoil Canada. “It’s not a miracle, but yoga’s done wonders for me,” McCombie says, without hesitation. “My flexibility is back and I feel good.”

Skeptics who dismiss yoga as a trendy fitness fad don’t have to take McCombie’s word for it; Alberta research backs her up. Dr. Nicole Culos-Reed, a University of Calgary kinesiology associate professor and an oncology adjunct associate professor, has examined the benefits of the Yoga Thrive program since 2002.
This program uses gentle, specifically modified yoga for

cancer patients. In Edmonton, Dr. Amy Speed-Andrews, a post-doctorate fellow in exercise oncology at the University of Alberta, recently analysed data dating back to 2005 from cancer participants in the university’s special yoga classes. She also conducts ongoing research with the Edmonton Family Yoga Centre’s “Living with Breast Cancer” classes.

As avid yoga practitioners, both women were keen to test whether the benefits they personally experience would translate to yoga modified for cancer patients. The good news: gentler yoga gives the same benefits. Their research contains significant statistical proof that yoga is highly beneficial in minimizing, or improving, the treatment-related side effects of cancer, for both the body and the mind.

A comparison of questionnaires completed by cancer patients before and after therapeutic yoga session reveals reduced levels of stress, pain and fatigue, along with improvements in strength, flexibility and stamina. As well, empirical physical testing for core strength, balance and physical range of movement backs up their feedback. The studies show numerous positive findings compared to a no-yoga control group, broadly summarized as “improved QofL (quality of life).” Or, to put it more simply, just like Gail McCombie, cancer patients found yoga makes them feel better.

Warrior Pose: University of Calgary researcher Nicole Culos-Reed has developed the Yoga Thrive program, which uses gentle poses adapted for cancer survivors.

“Participants love it,” says Speed-Andrews. “Some have done yoga before, but many haven’t. They’re apprehensive at first, but quickly gain confidence when they see they don’t have to twist themselves into pretzels, a common misconception.” Speed-Andrews credits yoga for building strength in surgery sites and for pain relief, but she believes yoga’s stress-busting properties are equally important for cancer patients. “Tension melts away,” she explains. “As your breathing and body relax, your mind relaxes too.”

To date, Speed-Andrews’ research has focused on using yoga to help breast cancer patients, while Nicole Culos-Reed’s research with Yoga Thrive is broader, and includes kidney, brain, prostrate and gynecological cancer patients. “It’s not about doing this pose for this cancer,” Culos-Reed explains. “It’s modified yoga, a gentle physical activity that would help anyone with a chronic disease, whether it’s cancer or arthritis. If you do regular yoga, you’d find the pace slow, but our focus is relaxation. By slowing down, breathing deeply and focusing on their bodies, participants rediscover how to feel good about themselves, instead of feeling sick.”

Culos-Reed feels yoga offers unique benefits for cancer patients that other physical activities don’t. In yoga, participants work on mind-body balance and creating a sense of well being, while strengthening and stretching. “There’s a mindfulness to yoga, a living in the moment that enhances one’s mood and helps diminish distress about treatment or other health concerns,” Culos-Reed says. “We validated that now with our research, and interest in the program is strong.”

Participants range from those in their mid-20s to an 80-year-old, with most in the mid-40s to early 50s segment. “We’ve had grannies and bikers taking the same classes, and instructors report they had a fabulous time together,” Culos-Reed says. “It’s the whole gamut. Some are quite sick, others are five years out of treatment, but still working on fatigue or other issues. Everyone benefits and drop-outs are rare.”

That’s an important point for Speed-Andrews. She’s noticed that although the benefits of physical activity for cancer patients are now widely recognized, participation rates remain low. Many simply aren’t attracted to the aerobics or resistance exercise programs traditionally offered. And cancer patients who weren’t active before diagnosis aren’t all that likely to get active after a diagnosis. “They might not want to take up weight lifting, but they’re willing to try low-impact, gentle yoga,” says Speed-Andrews. “It’s a more accessible option, and more sustainable, too. After trying yoga, they’ll stick with it.”

McCombie’s is a perfect case in point. “Before, me and the TV remote were best friends,” McCombie admits. “Vigorous exercise was not my favourite thing, so I decided to try yoga.” Now a convert, McCombie’s “graduated” to Yoga Thrive’s newly-developed advanced program. As a spin-off effect, she’s also become more active in other areas of her life and recently joined a local fitness centre. In addition to the physical benefits of yoga, she says that shavasana, a relaxation pose at the end of any yoga practice, allows her to find a new sense of calm.

“You feel so alone with your cancer,” says McCombie. “My mind was always going a thousand miles-a-minute. I couldn’t shut it down. Now, when I do shavasana at the end of a session, I can let go and relax.”

Downward Dog: Participants in the Yoga Thrive program have reported improvements in overall mood, stress levels, physical strength and quality of life.

Another unexpected benefit for McCombie was finding a strong support group in her classmates. “It’s a comfortable environment, and many have become friends outside classes too. We’re all at different stages of our cancer journey and I constantly learn from them.”

Still, McCombie doesn’t consider her journey over yet. “I’m on a six-month regime of seeing a doctor. I try not to think about that,” she says. Instead, she focuses on feeling good, which includes continuing her yoga. She’s recruited her 75-year-old mother to join her yoga class and even introduced noon-hour yoga into her workplace. “I continue to see improvements. I can’t say enough about how yoga’s helped me,” McCombie says.