Researchers at the University of Pennsylvania Perelman School of Medicine have found that yoga helps alleviate negative side effects of prostate cancer treatment.
The study found that men who attended a structured yoga class twice a week during prostate cancer radiation treatment reported less fatigue and better sexual and urinary function than those who didn’t.
It is the first randomized trial to look at the effect of twice-weekly yoga on the side-effects and quality of life issues caused by prostate cancer treatment. The phase II trial was designed to measure potential therapeutic effects of yoga on fatigue, erectile dysfunction, urinary incontinence and overall quality of life in patients undergoing external beam radiation therapy for prostate cancer.
Between October 2014 to January 2016, 50 prostate cancer patients who underwent between six and nine weeks of radiation were randomized into two groups, one arm participated in a yoga class that met twice a week and the other arm served as a control group. Patients who already practiced yoga on their own were not eligible for the study, nor were patients with a history of prior radiation therapy or those with metastatic disease.
“At their baseline, before patients started treatment, patients in both groups were on the lower end of the scale, meaning they reported lower amounts of fatigue,” Dr. Neha Vapiwala, associate professor of Radiation Oncology at Perelman, said in a press release. “But as treatment went on, we observed a difference in the two groups.”
Only two instructors led classes for this study, with the lead instructor teaching 75 percent of the classes. Each session lasted for 75 minutes, beginning with 5 minutes of breathing and centering techniques and ending with 5 minutes of Savasana. Typical sessions incorporated sitting, standing, and reclining positions that were modified using props to adapt to each patient’s needs and restrictions.
Patients were primarily evaluated on their level of fatigue. Each man filled out a nine-item questionnaire was given between two and three weeks before the start of radiotherapy, then twice a week while receiving radiotherapy, with a final survey filled out within a week of their last yoga class or last radiation treatment, depending on the assigned study arm.
“Levels of patient-reported fatigue are expected to increase by around the fourth or fifth week of a typical treatment course, but that did not happen in the yoga group,” Vapiwala said. “Both the severity of the fatigue as well as the patients’ ability to go about their normal lives appeared to be positively impacted in the yoga group.”
The study found patients in the non-yoga group not only did not report decreased fatigue, but instead reported increasing fatigue as treatment progressed.
The study utilized the International Index of Erectile Function (IIEF) questionnaire, in which scores range from 0-25. Scores greater than 21 are considered normal and scores below 12 indicate moderate to severe ED. Both groups started out with scores of around 11, and were balanced in terms of ADT exposure; but while the yoga group’s score ended up largely unchanged from baseline, the non-yoga group saw a decline over the course of treatment.
“Yoga is known to strengthen pelvic floor muscles, which is one of several postulated theories that may explain why this group did not demonstrate declining scores, as seen in the control group,” Vapiwala said. “That may also explain the yoga patients’ improved urinary function scores, another finding of this trial.” Vapiwala pointed out that the findings on improved or stable urinary function are consistent with other research on the effects of physical therapy on pelvic floor muscles.
The study appeared in International Journal of Radiation Oncology, Biology, Physics.