Yoga
An ancient mind-body practice combining movement and stretches with meditation, yoga is used to manage symptoms and side effects and body terrain imbalances common in cancer.
How can yoga help you? What the research says
We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).
To see more details, click the plus sign to the right of any section.
Our assessments of evidence for each medical benefit fall into one of these categories:
- Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
- Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
- Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
- Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
- Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
- Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)
Learn more about how we research and rate therapies and practices in How We Rate Therapies ›
Improving treatment outcomes
Is yoga linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.
As with other mind-body approachesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body., assessing the effectiveness of yoga in addressing cancer symptoms can be challenging. Creating controls and placebo conditions is difficult.1Ruddy KJ, Stan DL, Bhagra A, Jurisson M, Cheville AL. Alternative exercise traditions in cancer rehabilitation. Physical Medicine and Rehabilitation Clinics of North America. 2017 Feb;28(1):181-192. However, because the risk of harm from yoga is relatively small, many oncology professionals are comfortable recommending it for people with cancer.
No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on a measure of cell health among people with breast cancer practicing Hatha yoga
- No evidence of an effect on a measure of cell health (phase anglea measure of cell health status; a low PA may suggest deterioration of the cell membrane, which in advanced cancer patients may result in reduced overall survival) among people with breast cancer practicing Hatha yoga twice a week for 10 weeks compared to no yoga in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects2Eyigör S, Apaydin S et al. Effects of yoga on phase angle and quality of life in patients with breast cancer: a randomized, single-blind, controlled trial. Complementary Medicine Research. 2021;28(6):523-532.
Optimizing your body terrain
Does yoga promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.
See Optimizing Your Body Terrain ›
Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›
Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of better body weight and waist circumference among people practicing yoga
- Better BMI and body weight among people practicing yoga compared to non-exercise controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 32 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects3Chu P, Gotink RA, Yeh GY, Goldie SJ, Hunink MG. The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology. 2016 Feb;23(3):291-307.
- Better body mass index and waist-to-hip ratio among adults with type 2 diabetes practicing yoga compared to controls in a meta-analysis of 23 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial4Thind H, Lantini R, Balletto B et al. The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis. Preventive Medicine. 2017 Dec;105:116-126.
- Lower BMI but no evidence of an effect on waist circumference or waist-to-hip ratio among people with type 2 diabetes practicing yoga compared to physical exercise in a meta-analysis of 8 controlled trials5Jayawardena R, Ranasinghe P, Chathuranga T, Atapattu PM, Misra A. The benefits of yoga practice compared to physical exercise in the management of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes & Metabolic Syndrome. 2018 Sep;12(5):795-805.
- Better waist circumference among people with metabolic syndrome participating in yoga compared to controls in a meta-analysis of 7 RCTs of low quality6Cramer H, Langhorst J, Dobos G, Lauche R. Yoga for metabolic syndrome: a systematic review and meta-analysis. European Journal of Preventive Cardiology. 2016 Dec;23(18):1982-1993.
- Better waist circumference and waist-to-hip ratio among healthy people, non-diabetic people with high risk for cardiovascular disease, or people with type 2 diabetes practicing yoga compared to usual care or no intervention in a meta-analysis of 44 RCTs of poor quality7Cramer H, Lauche R et al. Effects of yoga on cardiovascular disease risk factors: a systematic review and meta-analysis. International Journal of Cardiology. 2014 May 1;173(2):170-83.
Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better markers of blood sugar and insulin balance among people practicing yoga, mostly among people with prediabetes, diabetes, or metabolic syndrome
- Better blood sugar levels among people practicing yoga compared to active controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 42 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects8Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017 Dec;86:152-168.
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on markers of blood glucose among people practicing yoga compared to non-exercise controls in a meta-analysis of 32 RCTs9Chu P, Gotink RA, Yeh GY, Goldie SJ, Hunink MG. The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology. 2016 Feb;23(3):291-307.
- Better fasting blood glucose levels among people with pre-diabetes participating in yoga compared to controls in a meta-analysis of 14 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial10Ramamoorthi R, Gahreman D, Skinner T, Moss S. The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: a systematic review and meta-analysis. PLoS One. 2019 Oct 16;14(10):e0221067.
- Better blood sugar balance among people with type 2 diabetes practicing yoga compared to physical exercise in a meta-analysis of 8 controlled trials11Jayawardena R, Ranasinghe P, Chathuranga T, Atapattu PM, Misra A. The benefits of yoga practice compared to physical exercise in the management of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes & Metabolic Syndrome. 2018 Sep;12(5):795-805.
- Better of blood sugar balance among adults with type 2 diabetes practicing yoga compared to controls in a meta-analysis of 20 controlled trials12Thind H, Lantini R, Balletto B et al. The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis. Preventive Medicine. 2017 Dec;105:116-126.
- No evidence of an effect on fasting blood glucose among people with metabolic syndrome participating in yoga compared to controls in a meta-analysis of 7 RCTs of low quality13Cramer H, Langhorst J, Dobos G, Lauche R. Yoga for metabolic syndrome: a systematic review and meta-analysis. European Journal of Preventive Cardiology. 2016 Dec;23(18):1982-1993.
- Better markers of blood sugar and insulin resistance among people with type 2 diabetes practicing yoga compared to controls in a meta-analysis of 4 controlled trials14Venugopal V, Geethanjali S et al. Effect of yoga on oxidative stress in type 2 diabetes mellitus: a systematic review and meta-analysis. Current Diabetes Reviews. 2022;18(2):63-70.
- Lower markers of blood sugar among adults with type 2 diabetes participating in yoga compared to controls in a meta-analysis of 12 RCTs15Cui J, Yan JH et al. Effects of yoga in adults with type 2 diabetes mellitus: a meta‐analysis. Journal of Diabetes Investigation. 2017 Mar;8(2):201-209.
- Better markers of blood sugar regulation among people receiving treatment for type 2 diabetes practicing yoga compared to controls in a meta-analysis of 17 RCTs of low quality16Kumar V, Jagannathan A et al. Role of yoga for patients with type II diabetes mellitus: a systematic review and meta-analysis. Complementary Therapies in Medicine. 2016 Apr;25:104-12.
- Lower marker of blood sugar regulation (HbA1c levels) among people with type 2 diabetes participating in yoga compared to controls in a meta-analysis of 5 RCTs17Pai LW, Li TC et al. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: a systematic review and meta-analysis. Diabetes Research and Clinical Practice. 2016 Mar;113:77-85
- Better markers of blood sugar regulation and insulin resistance among healthy people, non-diabetic people with high risk for cardiovascular disease, or people with type 2 diabetes practicing yoga compared to usual care or no intervention in a meta-analysis of 44 RCTs of low quality18Cramer H, Lauche R et al. Effects of yoga on cardiovascular disease risk factors: a systematic review and meta-analysis. International Journal of Cardiology. 2014 May 1;173(2):170-83.
Changes in hormone levels seen in the studies here may not be beneficial in every situation. Your oncology team needs to determine whether any changes would be favorable for your condition.
Preliminary evidence of better cortisol levels among people with breast cancer participating in yoga
Modest evidence of better cortisol levels among healthy adults or with conditions other than cancer practicing yoga
Preliminary evidence of better levels of follicle-stimulating hormone, luteinizing hormone, adrenalin, or serotonin among people practicing yoga
Preliminary evidence of lower cortisol levels among people participating in laughter yoga
- Better cortisol rhythms during and 1 month after radiotherapy among people with stage 1–3 breast cancer participating in yoga compared to stretching or wait-list controls (no intervention) in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects19Chandwani KD, Perkins G et al. Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy. Journal of Clinical Oncology. 2014 Apr 1;32(10):1058-65.
- Lower morning waking cortisol among people with metastatic breast cancer participating in an integrated yoga based stress reduction program compared to education and supportive therapy sessions in a small RCT20Rao RM, Vadiraja HS et al. Effect of yoga on sleep quality and neuroendocrine immune response in metastatic breast cancer patients. Indian Journal of Palliative Care. 2017 Jul-Sep;23(3):253-260.
- Better cortisol levels among adults with type 2 diabetes practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 23 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial21Thind H, Lantini R, Balletto B et al. The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis. Preventive Medicine. 2017 Dec;105:116-126.
- Lower evening and waking cortisol among people practicing yoga compared to active controls in a meta-analysis of 42 RCTs22Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017 Dec;86:152-168.
- Lower salivary cortisol reactivity after an acute psychological stressor among healthy young adults participating in a single video-instructed session of hatha yoga compared to controls watching television in a small RCT23Benvenutti MJ, Alves EDS et al. A single session of hatha yoga improves stress reactivity and recovery after an acute psychological stress task—a counterbalanced, randomized-crossover trial in healthy individuals. Complementary Therapies in Medicine. 2017 Dec;35:120-126.
- Lower cortisol response after cognitive testing among sedentary older adults participating in an 8-week yoga intervention compared to a stretching control group in a mid-sized RCT24Gothe NP, Keswani RK, McAuley E. Yoga practice improves executive function by attenuating stress levels. Biological Psychology. 2016 Dec;121(Pt A):109-116.
- Lower hormone levels (follicle-stimulating hormone and luteinizing hormone) among postmenopausal women practicing hatha yoga for 12 weeks compared to controls in a small RCT25Jorge MP, Santaella DF et al. Hatha yoga practice decreases menopause symptoms and improves quality of life: a randomized controlled trial. Complementary Therapies in Medicine. 2016 Jun;26:128-35.
- Lower plasma levels of adrenalin and higher plasma levels of serotonin among healthy young adult volunteers participating in a regular yoga intervention for 12 weeks compared to no yoga in a small RCT26Lim SA, Cheong KJ. Regular yoga practice improves antioxidant status, immune function, and stress hormone releases in young healthy people: a randomized, double-blind, controlled pilot study. Journal of Alternative and Complementary Medicine. 2015 Sep;21(9):530-8.
- Lower levels of leptin (“the hunger hormone) and lower levels of adiponectin (which is linked to obesity) among adults with metabolic syndrome participating in a 12-week yoga-based lifestyle intervention compared to a dietary intervention in a mid-sized RCT27Yadav R, Yadav RK, Khadgawat R, Pandey RM. Comparative efficacy of a 12 week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: a randomized controlled trial. Translational Behavioral Medicine. 2019 Jul 16;9(4):594-604.
- Lower cortisol stress response to a stressful task among healthy people participating in laughter yoga for 30 minutes compared to relaxation breathing or no intervention in a small RCT28Meier M, Wirz L, Dickinson P, Pruessner JC. Laughter yoga reduces the cortisol response to acute stress in healthy individuals. Stress. 2021 Jan;24(1):44-52.
- Lower cortisol levels but no evidence of an effect on DHEA levels among healthy university students participating in laughter yoga compared to controls reading a book in a mid-sized RCT29Fujisawa A, Ota A et al. Effect of laughter yoga on salivary cortisol and dehydroepiandrosterone among healthy university students: a randomized controlled trial. Complement Ther Clin Pract. 2018 Aug;32:6-11.
Increased immune system activation is not always beneficial, so your oncology team needs to determine whether immune activation would be favorable in your situation.
Preliminary evidence of higher markers of immune activation among people with cancer or healthy adults practicing yoga
- A higher marker of immune activation (natural killer cells) among people with metastatic breast cancer participating in an integrated yoga based stress reduction program compared to education and supportive therapy sessions in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects30Rao RM, Vadiraja HS et al. Effect of yoga on sleep quality and neuroendocrine immune response in metastatic breast cancer patients. Indian Journal of Palliative Care. 2017 Jul-Sep;23(3):253-260.
- Higher markers of immune activation among men with newly diagnosed localized prostate cancer participating in yoga for 6 weeks compared to standard of care in a small RCT31Kaushik D, Shah PK et al. Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer and Prostatic Diseases. 2021 Nov 23.
- Higher serum levels of immune-related cytokines (interleukin-12 and interferon-γ) among healthy young adult volunteers participating in a regular yoga intervention for 12 weeks compared to no yoga in a small RCT32Lim SA, Cheong KJ. Regular yoga practice improves antioxidant status, immune function, and stress hormone releases in young healthy people: a randomized, double-blind, controlled pilot study. Journal of Alternative and Complementary Medicine. 2015 Sep;21(9):530-8.
Modest evidence of lower inflammation among people with cancer practicing yoga
- A larger decline in inflammatory cytokines among adults with gastrointestinal cancer participating in a yoga skills training intervention compared to attention controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects33Sohl SJ, Tooze JA et al. A randomized controlled pilot study of yoga skills training versus an attention control delivered during chemotherapy administration. Journal of Pain and Symptom Management. 2022 Jan;63(1):23-32.
- Lower plasma cytokine levels among people with breast cancer with aromatase inhibitor-associated knee joint pain participating in a 6-week yoga intervention compared to massage in a small RCT34Tsai CL, Liu LC et al. Yoga versus massage in the treatment of aromatase inhibitor-associated knee joint pain in breast cancer survivors: a randomized controlled trial. Scientific Reports. 2021 Jul 21;11(1):14843.
- Lower inflammatory cytokine levels among men with newly diagnosed localized prostate cancer participating in yoga for 6 weeks compared to standard of care in a small RCT35Kaushik D, Shah PK et al. Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer and Prostatic Diseases. 2021 Nov 23.
- Markers of less inflammation among people with breast cancer with persistent fatigue participating in a 12-week Iyengar yoga intervention compared to controls in a 12-week health education intervention in a small RCT36Bower JE, Greendale G et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial. Psychoneuroendocrinology. 2014 May;43:20-9.
- A lower marker of inflammation (TNF-α) among people with myeloproliferative neoplasm participating in an online yoga intervention compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design37Huberty J, Eckert R et al. Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC Complementary and Alternative Medicine. 2019 Jun 7;19(1):121.
Modest evidence of lower markers of oxidationa process in which molecules combine with oxygen or lose electrons; losing an electron creates unstable free radicals that can damage cells, causing illness and aging among healthy people or people with diabetes, pre-diabetes, or metabolic syndrome participating in yoga
- A lower marker of oxidation (malondialdehyde) among people with type 2 diabetes practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 4 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial38Venugopal V, Geethanjali S et al. Effect of yoga on oxidative stress in type 2 diabetes mellitus: a systematic review and meta-analysis. Current Diabetes Reviews. 2022;18(2):63-70.
- A better marker of oxidation (reduced glutathionethe active form of glutathione that is able to neutralize all free radicals in the body), but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on oxidative stress, among people with type 2 diabetes participating in yoga compared to controls doing nonaerobic stretching exercise in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects39Hegde SV, Adhikari P, Kotian SM, Shastry R. Effects of yoga versus sham yoga on oxidative stress, glycemic status, and anthropometry in type 2 diabetes mellitus: a single-blinded randomized pilot study. International Journal of Yoga Therapy. 2020 Jan 1;30(1):33-39.
- Lower marker of oxidative stress (thiobarbituric acid reactive substances and superoxide dismutase) among adults with metabolic syndrome participating in a 12-week yoga-based lifestyle intervention compared to a dietary intervention in a mid-sized RCT40Yadav R, Yadav RK, Khadgawat R, Pandey RM. Comparative efficacy of a 12 week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: a randomized controlled trial. Translational Behavioral Medicine. 2019 Jul 16;9(4):594-604.
- Lower oxidative stress and better antioxidant levels among healthy young adult volunteers participating in a regular yoga intervention for 12 weeks compared to no yoga in a small RCT41Lim SA, Cheong KJ. Regular yoga practice improves antioxidant status, immune function, and stress hormone releases in young healthy people: a randomized, double-blind, controlled pilot study. Journal of Alternative and Complementary Medicine. 2015 Sep;21(9):530-8.
- A lower marker of oxidative stress (malondialdehyde) among people with prediabetes participating in a 3-month yoga intervention compared to controls in a small RCT42Hegde SV, Adhikari P, Shetty S, Manjrekar P, D’Souza V. Effect of community-based yoga intervention on oxidative stress and glycemic parameters in prediabetes: a randomized controlled trial. Complementary Therapies in Medicine. 2013 Dec;21(6):571-6. 2013.
Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly less DNA damage during radiotherapy among people with breast cancer participating in yoga
- Slightly less DNA damage to healthy white blood cells (lymphocytes) during radiotherapy among people with breast cancer participating in yoga compared to controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects43Banerjee B, Vadiraj HS et al. Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integrative Cancer Therapies. 2007 Sep;6(3):242-50.
Mindfulness meditation and gentle yoga: preliminary evidence of better daily cortisol rhythms among people with breast cancer participating in mindfulness meditation and gentle yoga
- Better daily cortisol rhythms among people with breast cancer participating in mindfulness-based cancer recovery comprising training in mindfulness meditation and gentle yoga compared to controls receiving 1-day stress management in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects44Carlson LE, Doll R et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer. Journal of Clinical Oncology. 2013 Sep 1;31(25):3119-26.
Managing side effects and promoting wellness
Is yoga linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.
Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety, usually only for a short time after practice, among people with cancer practicing yoga
- Less anxiety immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects45Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Short-term lower anxiety among people with breast cancer practicing yoga compared to controls in a meta-analysis of 5 RCTs of moderate quality46Yi LJ, Tian X, Jin YF, Luo MJ, Jiménez-Herrera MF. Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Feb;10(2):1961-1975.
- Less anxiety among women with breast cancer practicing yoga for longer than three months compared to controls in a meta-analysis of 16 RCTs47Pan Y, Yang K, Wang Y, Zhang L, Liang H. Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis. Asia-Pacific Journal of Clinical Oncology. 2017 Apr;13(2):e79-e95.
- Large reductions in anxiety among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality48Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Short-term improvements in anxiety among people with breast cancer practicing yoga compared to controls in a meta-analysis of 12 RCTs of low or moderate quality49Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012 Sep 18;12:412.
- Moderately less anxiety among people with cancer practicing yoga compared to controls in a meta-analysis of 16 RCTs50Gonzalez M, Pascoe MC et al. Yoga for depression and anxiety symptoms in people with cancer: a systematic review and meta-analysis. Psycho-oncology. 2021 Aug;30(8):1196-1208.
- A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less anxiety among women with breast cancer practicing yoga compared to no intervention in a meta-analysis of 6 RCTs of very low quality51Cramer H, Lauche R et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017 Jan 3;1(1):CD010802.
- Lower anxiety among people with myeloproliferative neoplasma type of disease in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells participating in an online yoga intervention compared to wait-list controls in a small RCT52Huberty J, Eckert R et al. Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC Complementary and Alternative Medicine. 2019 Jun 7;19(1):121.
- A weak trend toward less anxiety at 8 weeks, but significantly less at 12 weeks, among people with breast or gynecologic cancer with persistent moderate to severe chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to wait-list controls in a small RCT53Zhi WI, Baser RE et al. Yoga for cancer survivors with chemotherapy-induced peripheral neuropathy: health-related quality of life outcomes. Cancer Medicine. 2021 Aug;10(16):5456-5465.
Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less breathlessness during cancer treatment among women with breast cancer participating in Iyengar yoga
- Less breathlessness (dyspnea) during (neo)adjuvanttherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery chemotherapy and endocrine therapy among women with breast cancer participating in Iyengar yoga compared to baseline at the completion of yoga and 3 months later in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design54Lötzke D, Wiedemann F et al. Iyengar-yoga compared to exercise as a therapeutic intervention during (neo)adjuvant therapy in women with stage I-III breast cancer: health-related quality of life, mindfulness, spirituality, life satisfaction, and cancer-related fatigue. Evidence-based Complementary and Alternative Medicine. 2016;2016:5931816.
Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better appetite among people with cancer or caregivers participating in yoga
- Better appetite during adjuvant chemotherapy among people with breast cancer practicing specific yoga techniques (diaphragmatic breathing techniques, systematic relaxation, alternate nostril breathing, and Joints and Glands neck and shoulder exercises) supervised during chemotherapy sessions and twice a day at home compared to routine care in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects55Prakash K, Saini SK, Pugazhendi S. Effectiveness of yoga on quality of life of breast cancer patients undergoing chemotherapy: a randomized clinical controlled study. Indian Journal of Palliative Care. 2020 Jul-Sep;26(3):323-331.
- Better appetite among people with cancer and caregivers participating in at least one yoga session compared to baseline in a mid-sized uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design56Lopez G, Chaoul A et al. Group yoga effects on cancer patient and caregiver symptom distress: assessment of self-reported symptoms at a comprehensive cancer center. Integrative Cancer Therapies. 2018 Dec;17(4):1087-1094.
- Less appetite loss during (neo)adjuvanttherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery chemotherapy and endocrine therapy among women with breast cancer participating in Iyengar yoga compared to baseline, both at the completion of yoga and 3 months later, in a small uncontrolled trial57Lötzke D, Wiedemann F et al. Iyengar-yoga compared to exercise as a therapeutic intervention during (neo)adjuvant therapy in women with stage I-III breast cancer: health-related quality of life, mindfulness, spirituality, life satisfaction, and cancer-related fatigue. Evidence-based Complementary and Alternative Medicine. 2016;2016:5931816.
Modest evidence of fewer cognitive difficulties among people with cancer practicing yoga
- Fewer cognitive complaints 3 months, but not immediately, after the intervention among people with breast cancer who had completed treatment participating in Hatha yoga twice a week for 12 weeks compared to wait-list controls, and fewer complaints among those practicing yoga more frequently compared to less frequently in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects58Derry HM, Jaremka LM et al. Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Psycho-oncology. 2015 Aug;24(8):958-66.
- Less memory difficulty among people with cancer receiving standard care practicing YOCAS©® yoga (Yoga for Cancer Survivors)—breathing exercises, postures, and meditation—compared to standard care alone, with improvements influenced by sleep quality in a mid-sized RCT59Janelsins MC, Peppone LJ, Heckler CE, Kesler SR, Sprod LK, Atkins J, Melnik M, Kamen C, Giguere J, Messino MJ, Mohile SG, Mustian KM. YOCAS©® yoga reduces self-reported memory difficulty in cancer survivors in a nationwide randomized clinical trial: investigating relationships between memory and sleep. Integrative Cancer Therapies. 2016 Sep;15(3):263-71.
Good evidence of less depression among people with cancer practicing yoga
- Moderately less depression among people with cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects60Gonzalez M, Pascoe MC et al. Yoga for depression and anxiety symptoms in people with cancer: a systematic review and meta-analysis. Psycho-oncology. 2021 Aug;30(8):1196-1208.
- Less depression immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysis of 26 RCTs61Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Less depression among women with breast cancer practicing yoga compared to controls in a meta-analysis of 16 RCTs62Pan Y, Yang K, Wang Y, Zhang L, Liang H. Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis. Asia-Pacific Journal of Clinical Oncology. 2017 Apr;13(2):e79-e95.
- Short-term lower depression among people with breast cancer practicing yoga compared to controls in a meta-analysis of 6 RCTs of moderate quality63Yi LJ, Tian X, Jin YF, Luo MJ, Jiménez-Herrera MF. Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Feb;10(2):1961-1975.
- A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less depression among women with breast cancer practicing yoga compared to no intervention in a meta-analysis of 7 RCTs of low quality64Cramer H, Lauche R et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017 Jan 3;1(1):CD010802.
- Fewer depressive symptoms among people with breast cancer practicing yoga compared to controls in a meta-analysis of a subset of 41 RCTs65Coutiño-Escamilla L, Piña-Pozas M, Tobías Garces A, Gamboa-Loira B, López-Carrillo L. Non-pharmacological therapies for depressive symptoms in breast cancer patients: systematic review and meta-analysis of randomized clinical trials. Breast. 2019 Apr;44:135-143.
- Large reductions in depression among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality66Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Short-term improvements in depression among people with breast cancer practicing yoga compared to controls in a meta-analysis of 12 RCTs of low or moderate quality67Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012 Sep 18;12:412.
- A larger decline in depressive symptoms among adults with gastrointestinal cancer participating in a yoga skills training intervention compared to attention controls in a small RCT68Sohl SJ, Tooze JA et al. A randomized controlled pilot study of yoga skills training versus an attention control delivered during chemotherapy administration. Journal of Pain and Symptom Management. 2022 Jan;63(1):23-32.
- Lower depression among people with myeloproliferative neoplasma type of disease in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells participating in an online yoga intervention compared to wait-list controls in a small RCT69Huberty J, Eckert R et al. Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC Complementary and Alternative Medicine. 2019 Jun 7;19(1):121.
- Less depression among people with chronic chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to controls in a small RCT70Knoerl R, Giobbie-Hurder A et al. Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled trial. Journal of Cancer Survivorship. 2021 Sep 15:1–10
- Better mood after yoga class among people with prostate cancer and their support persons participating in a 7-week class-based yoga program followed by 7 weeks of self-selected physical activity in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design71Ross Zahavich AN, Robinson JA, Paskevich D, Culos-Reed SN. Examining a therapeutic yoga program for prostate cancer survivors. Integrative Cancer Therapies. 2013 Mar;12(2):113-25.
Good evidence of less cancer-related fatigue among people practicing yoga
- Less cancer-related fatigue among people practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 16 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects72Song J, Wang T et al. The effectiveness of yoga on cancer-related fatigue: a systematic review and meta-analysis. Oncology Nursing Forum. 2021 Mar 1;48(2):207-228.
- Substantially less cancer-related fatigue after treatment, but slightly less fatigue during treatment, among people practicing yoga compared to controls in a meta-analysis of 17 RCTs73Dong B, Xie C, Jing X, Lin L, Tian L. Yoga has a solid effect on cancer-related fatigue in patients with breast cancer: a meta-analysis. Breast Cancer Research and Treatment. 2019 Aug;177(1):5-16.
- Short-term lower fatigue among people with breast cancer practicing yoga compared to controls in a meta-analysis of 5 RCTs of moderate quality74Yi LJ, Tian X, Jin YF, Luo MJ, Jiménez-Herrera MF. Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Feb;10(2):1961-1975.
- Moderately less fatigue both during and after cancer treatment, with the greatest benefit after treatment, among people with cancer participating in yoga compared to controls in a meta-analysis of 10 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial75Hilfiker R, Meichtry A et al. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. British Journal of Sports Medicine. 2018;52(10):651-658.
- Less cancer-related fatigue among women with breast cancer practicing yoga compared to usual care and comparable to other forms of physical activity in meta-analyses of 24RCTs76O’Neill M, Samaroo D et al. The effect of yoga interventions on cancer-related fatigue and quality of life for women with breast cancer: a systematic review and meta-analysis of randomized controlled trials. Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420959882.
- Moderate reductions in fatigue among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality77Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Less fatigue immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysis of 26 RCTs78Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Less fatigue among women with breast cancer practicing yoga compared to no intervention in a meta-analysis of 11 RCTs79Cramer H, Lauche R et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017 Jan 3;1(1):CD010802.
- A larger decline in fatigue among adults with gastrointestinal cancer participating in a yoga skills training intervention compared to attention controls in a small RCT80Sohl SJ, Tooze JA et al. A randomized controlled pilot study of yoga skills training versus an attention control delivered during chemotherapy administration. Journal of Pain and Symptom Management. 2022 Jan;63(1):23-32.
- Less fatigue among elderly people (ages 65-70) with breast cancer participating in 8 sessions of yoga compared to 8 sessions of exercise in a small RCT81Yagli NV, Ulger O. The effects of yoga on the quality of life and depression in elderly breast cancer patients. Complementary Therapies in Clinical Practice. 2015 Feb;21(1):7-10.
- Less cancer-related fatigue at the end of the intervention among people with cancer participating in a standardized, 4-week yoga therapy program (Yoga for Cancer Survivors, or YOCAS) and standard care compared to standard care alone, with some of the benefit coming from better sleep quality and less daytime dysfunction, in a mid-sized RCT82Lin PJ, Kleckner IR et al. Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: a nationwide, multicenter randomized controlled trial of yoga in cancer survivors. Integrative Cancer Therapies. 2019 Jan-Dec;18:1534735419855134.
- Less fatigue during external beam radiation therapy among people with prostate cancer practicing yoga compared to no yoga in a small RCT83Ben-Josef AM, Chen J et al. Effect of Eischens yoga during radiation therapy on prostate cancer patient symptoms and quality of life: a randomized phase II trial. International Journal of Radiation Oncology, Biology, Physics. 2017 Aug 1;98(5):1036-1044.
- Less fatigue among people with chronic chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to controls in a small RCT84Knoerl R, Giobbie-Hurder A et al. Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled tria. Journal of Cancer Survivorship. 2021 Sep 15:1–10
- Less fatigue after yoga class among people with prostate cancer and their support persons participating in a 7-week class-based yoga program followed by 7 weeks of self-selected physical activity in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design85Ross Zahavich AN, Robinson JA, Paskevich D, Culos-Reed SN. Examining a therapeutic yoga program for prostate cancer survivors. Integrative Cancer Therapies. 2013 Mar;12(2):113-25.
People with cancer practicing yoga have experienced less constipation or nausea and vomiting in several studies, and one study also found less diarrhea.
Gastrointestinal symptoms as a whole: good evidence of fewer gastrointestinal symptoms related to treatment among women with breast cancer practicing yoga
- Fewer gastrointestinal symptoms related to treatment among women with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 16 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects86Pan Y, Yang K, Wang Y, Zhang L, Liang H. Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis. Asia-Pacific Journal of Clinical Oncology. 2017 Apr;13(2):e79-e95.
Constipation: preliminary evidence of less constipation during adjuvant chemotherapy among people with breast cancer practicing yoga
- Less constipation during adjuvanttherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery chemotherapy among people with breast cancer practicing specific yoga techniques (diaphragmatic breathing techniques, systematic relaxation, alternate nostril breathing, and Joints and Glands neck and shoulder exercises) supervised during chemotherapy sessions and twice a day at home compared to routine care in a mid-sized RCT87Prakash K, Saini SK, Pugazhendi S. Effectiveness of yoga on quality of life of breast cancer patients undergoing chemotherapy: a randomized clinical controlled study. Indian Journal of Palliative Care. 2020 Jul-Sep;26(3):323-331.
- Less constipation during (neo)adjuvant chemotherapy and endocrine therapy among women with breast cancer participating in Iyengar yoga compared to baseline, both at the completion of yoga and 3 months later, in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design88Lötzke D, Wiedemann F et al. Iyengar-yoga compared to exercise as a therapeutic intervention during (neo)adjuvant therapy in women with stage I-III breast cancer: health-related quality of life, mindfulness, spirituality, life satisfaction, and cancer-related fatigue. Evidence-based Complementary and Alternative Medicine. 2016;2016:5931816.
Diarrhea: weak evidence of less diarrhea during (neo)adjuvant chemotherapy and endocrine therapy among women with breast cancer practicing yoga
- Less diarrhea during (neo)adjuvant chemotherapy and endocrine therapy among women with breast cancer participating in Iyengar yoga compared to baseline, both at the completion of yoga and 3 months later, in a small uncontrolled trial89Lötzke D, Wiedemann F et al. Iyengar-yoga compared to exercise as a therapeutic intervention during (neo)adjuvant therapy in women with stage I-III breast cancer: health-related quality of life, mindfulness, spirituality, life satisfaction, and cancer-related fatigue. Evidence-based Complementary and Alternative Medicine. 2016;2016:5931816.
Nausea and vomiting: preliminary evidence of less nausea and vomiting during chemotherapy among people practicing yoga
- Less vomiting and severe nausea during a chemotherapy regimen causing vomiting (emetogenic) among people treated with standard antinausea (antiemetic) therapy and practicing yoga and compared to standard antiemetic therapy alone in a mid-sized RCT90Kothari TO, Jakhar SL et al. Prospective randomized trial of standard antiemetic therapy with yoga versus standard antiemetic therapy alone for highly emetogenic chemotherapy-induced nausea and vomiting in South Asian population. Journal of Cancer Research and Therapeutics. 2019 Jul-Sep;15(5):1120-1123.
- Less nausea and vomiting during chemotherapy at 6 months but not 3 months after starting the intervention among women with breast cancer receiving standard care and participating in Dru yoga once a week for 12 weeks compared to standard care alone in a small RCT91Jong MC, Boers I et al. A randomized study of yoga for fatigue and quality of life in women with breast cancer undergoing (neo) adjuvant chemotherapy. Journal of Alternative and Complementary Medicine. 2018 Sep/Oct;24(9-10):942-953.
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on chemotherapy-induced nausea and vomiting among adults with breast cancer treated with standard care and participating in an 8-week yoga program compared to standard care alone in a small RCT92Anestin AS, Dupuis G, Lanctôt D, Bali M. The effects of the Bali yoga program for breast cancer patients on chemotherapy-induced nausea and vomiting: results of a partially randomized and blinded controlled trial. Journal of Evidence-based Complementary and Alternative Medicine. 2017 Oct;22(4):721-730.
Weak evidence of fewer breast cancer-related lymphedema symptoms among people with cancer practicing yoga
- Less tissue hardening (induration) after 8 weeks of yoga, and smaller arm circumference after 12 weeks, among people with breast cancer with lymphedema practicing yoga compared to no intervention, although swelling returned after the intervention ended in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects93Loudon A, Barnett T, Piller N, Immink MA, Williams AD. Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial. BMC Complementary and Alternative Medicine. 2014 Jul 1;14:214.
- No change in swelling (edema volume) among women with breast cancer-related lymphedema practicing yoga for 8 weeks compared to controls in a small RCT94Pasyar N, Barshan Tashnizi N, Mansouri P, Tahmasebi S. Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: a pilot study. European Journal of Oncology Nursing. 2019 Oct;42:103-109.
- Smaller arm volume but no significant improvements in quality of life, self-reported arm function, or hand grip strength among people with breast cancer practicing yoga for 8 weeks compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design95Fisher MI, Donahoe-Fillmore B et al. Effects of yoga on arm volume among women with breast cancer related lymphedema: a pilot study. Journal of Bodyworks and Movement Therapies. 2014 Oct;18(4):559-65.
Preliminary evidence of less neurotoxicity among people with chemotherapy-induced peripheral neuropathy (CIPN) practicing yoga
- Lower neurological symptom scores after chemotherapy among people with breast or gynecologic cancer and persistent moderate-to-severe pain, numbness, or tingling from chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to usual care in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects96Bao T, Zhi I et al. Yoga for chemotherapy-induced peripheral neuropathy and fall risk: a randomized controlled trial. JNCI Cancer Spectrum. 2020 Jun 4;4(6):pkaa048.
- Lower neurotoxicity scores and a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less pain among people with breast or gynecologic cancer with chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to usual care in a small RCT97Bao T, Zhi I et al. Yoga for chemotherapy-induced peripheral neuropathy and fall risk: a randomized controlled trial. JNCI Cancer Spectrum. 2020 Jun;pkaa048.
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on worst pain from chronic CIPN or sensory CIPN among people with chronic CIPN practicing yoga for 8 weeks compared to controls in a small RCT98Knoerl R, Giobbie-Hurder A et al. Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled tria. Journal of Cancer Survivorship. 2021 Sep 15:1–10
Modest evidence of less pain among people with cancer practicing yoga
- Less pain severity immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects99Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Lower pain levels among people with breast cancer with aromatase inhibitor-associated knee joint pain participating in a 6-week yoga intervention compared to massage in a small RCT100Tsai CL, Liu LC et al. Yoga versus massage in the treatment of aromatase inhibitor-associated knee joint pain in breast cancer survivors: a randomized controlled trial. Scientific Reports. 2021 Jul 21;11(1):14843.
- Less pain among women with metastatic breast cancer with relatively more time practicing yoga across two consecutive previous days compared to less time in a small RCT; researchers note that “meditation practice showed the strongest association with lower daily pain”101Carson JW, Carson KM et al. Yoga practice predicts improvements in day-to-day pain in women with metastatic breast cancer. Journal of Pain and Symptom Management. 2021 Jun;61(6):1227-1233.
- Lower pain intensity among people with myeloproliferative neoplasma type of disease in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells participating in an online yoga intervention compared to wait-list controls in a small RCT102Huberty J, Eckert R et al. Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC Complementary and Alternative Medicine. 2019 Jun 7;19(1):121.
- Less pain among women with breast cancer-related lymphedema practicing yoga for 8 weeks compared to controls in a small RCT103Pasyar N, Barshan Tashnizi N, Mansouri P, Tahmasebi S. Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: a pilot study. European Journal of Oncology Nursing. 2019 Oct;42:103-109.
- Less pain severity at least 3 months after treatment among people with head and neck cancer participating in an 8-week tailored Hatha yoga intervention compared to wait-list controls in a small RCT104Adair M, Murphy B et al. Feasibility and preliminary efficacy of tailored yoga in survivors of head and neck cancer: a pilot study. Integrative Cancer Therapies. 2018 Sep;17(3):774-784.
Good evidence of better quality of life among people with cancer practicing yoga
Preliminary evidence of better quality of life scores among women with breast cancer-related lymphedema practicing yoga
Modest evidence of higher quality of life during cancer treatment among people with cancer practicing yoga
Preliminary evidence of better general health, quality of life, role functioning and social functioning after breast cancer surgery among women practicing yoga
Preliminary evidence of better range of motion, reach, strength, or arm symptoms—including after surgery or among people with peripheral neuropathy—among people with cancer practicing yoga
Preliminary evidence of a higher rate of return to work 6 months after starting chemotherapy among people with breast cancer practicing yoga
Preliminary evidence of beneficial changes in meridian energy—the qi energy that travels along the meridian pathways in the body—among people with breast cancer participating in yoga
Weak evidence of better quality of life (mental component score) among caregivers for people with cancer practicing yoga
Quality of life without regard to treatment phase
Good evidence of better quality of life among people with cancer practicing yoga
- Better quality of life immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects105Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Better health-related quality of life among women with breast cancer practicing yoga compared to controls in a meta-analysis of 16 RCTs106Pan Y, Yang K, Wang Y, Zhang L, Liang H. Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis. Asia-Pacific Journal of Clinical Oncology. 2017 Apr;13(2):e79-e95.
- Short-term improvements in global health-related quality of life and functional, social, and spiritual well-being among people with breast cancer practicing yoga compared to controls in a meta-analysis of 12 RCTs of low or moderate quality107Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012 Sep 18;12:412.
- Better health-related quality of life among women with breast cancer practicing yoga compared to no intervention in a meta-analysis of 10 RCTs108Cramer H, Lauche R et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017 Jan 3;1(1):CD010802.
- Short-term better health-related quality of life among people with breast cancer practicing yoga compared to controls in a meta-analysis of 3 RCTs of moderate quality109Yi LJ, Tian X, Jin YF, Luo MJ, Jiménez-Herrera MF. Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Feb;10(2):1961-1975.
- A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward better quality of life immediately after practice, but comparable effects at follow up, among women with breast cancer practicing yoga compared to other physical exercise interventions in a meta-analysis of 8 RCTs110El-Hashimi D, Gorey KM. Yoga-specific enhancement of quality of life among women with breast cancer: systematic review and exploratory meta-analysis of randomized controlled trials. Journal of Evidence-Based Integrative Medicine. 2019 Jan-Dec;24:2515690X19828325.
- Moderate increases in general quality of life, emotional function, and social function, and a small increase in functional well-being among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality111Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Better quality of life among people with breast cancer practicing yoga compared to controls in a meta-analysis of 6 RCTs112Zhang J, Yang KH, Tian JH, Wang CM. Effects of yoga on psychologic function and quality of life in women with breast cancer: a meta-analysis of randomized controlled trials. Journal of Alternative and Complementary Medicine. 2012 Nov;18(11):994-1002.
- Higher quality of life among men with newly diagnosed localized prostate cancer participating in yoga for 6 weeks compared to standard of care in a small RCT113Kaushik D, Shah PK et al. Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer and Prostatic Diseases. 2021 Nov 23.
- Better emotional well-being among people with non-metastatic colorectal cancer practicing yoga for 10 weeks compared to wait-list controls in a small RCT114Cramer H, Pokhrel B et al. A randomized controlled bicenter trial of yoga for patients with colorectal cancer. Psycho-oncology. 2016 Apr;25(4):412-20.
Preliminary evidence of better quality of life scores among women with breast cancer-related lymphedema practicing yoga
- Better quality of life scores among women with breast cancer-related lymphedema practicing yoga for 8 weeks compared to controls in a small RCT115Pasyar N, Barshan Tashnizi N, Mansouri P, Tahmasebi S. Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: a pilot study. European Journal of Oncology Nursing. 2019 Oct;42:103-109.
During treatment: modest evidence of higher quality of life during cancer treatment among people with cancer practicing yoga
- Better quality of life including physical function, role function, and emotional function during adjuvant chemotherapy among people with breast cancer practicing specific yoga techniques (diaphragmatic breathing techniques, systematic relaxation, alternate nostril breathing, and Joints and Glands neck and shoulder exercises) supervised during chemotherapy sessions and twice a day at home compared to routine care in a mid-sized RCT116Prakash K, Saini SK, Pugazhendi S. Effectiveness of yoga on quality of life of breast cancer patients undergoing chemotherapy: a randomized clinical controlled study. Indian Journal of Palliative Care. 2020 Jul-Sep;26(3):323-331.
- Higher quality of life scores during radiotherapy among women with breast cancer and with high baseline sleep disturbance practicing yoga compared to wait-list controls in a small RCT117Ratcliff CG, Milbury K et al. Examining mediators and moderators of yoga for women with breast cancer undergoing radiotherapy. Integrative Cancer Therapies. 2016 Sep;15(3):250-62.
- A weak trend toward higher quality of life scores during radiotherapy among women with breast cancer and with high baseline depressive symptoms practicing yoga compared to wait-list controls in a small RCT118Ratcliff CG, Milbury K et al. Examining mediators and moderators of yoga for women with breast cancer undergoing radiotherapy. Integrative Cancer Therapies. 2016 Sep;15(3):250-62.
- Better quality of life on emotional, physical, and social scores but not on functional scores during external beam radiation therapy among people with prostate cancer practicing yoga compared to no yoga in a small RCT119Ben-Josef AM, Chen J et al. Effect of Eischens yoga during radiation therapy on prostate cancer patient symptoms and quality of life: a randomized phase II trial. International Journal of Radiation Oncology, Biology, Physics. 2017 Aug 1;98(5):1036-1044.
After treatment
Preliminary evidence of better functional reach after chemotherapy among people with breast or gynecologic cancer and persistent moderate-to-severe chemotherapy-induced peripheral neuropathy practicing yoga
- Better functional reach after chemotherapy among people with breast or gynecologic cancer and persistent moderate-to-severe pain, numbness, or tingling from chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to usual care in a small RCT120Bao T, Zhi I et al. Yoga for chemotherapy-induced peripheral neuropathy and fall risk: a randomized controlled trial. JNCI Cancer Spectrum. 2020 Jun 4;4(6):pkaa048.
Preliminary evidence of better general health, quality of life, role functioning and social functioning after breast cancer surgery among women practicing yoga
- Better general health, quality of life, role functioning and social functioning after breast cancer surgery among women practicing yoga in 90-minute lessons once a week compared to no yoga in a small RCT121Andysz A, Merecz D et al. Effect of a 10-week yoga programme on the quality of life of women after breast cancer surgery. Przeglad Menopauzalny. 2014 Jun;13(3):186-93.
Physical function
Preliminary evidence of better range of motion, reach, strength, or arm symptoms—including after surgery or among people with peripheral neuropathy—among people with cancer practicing yoga
Preliminary evidence of beneficial changes in meridian energy—the qi energy that travels along the meridian pathways in the body—among people with breast cancer participating in yoga
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on physical function among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality122Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Better shoulder range of motion at least 3 months after treatment among people with head and neck cancer participating in an 8-week tailored Hatha yoga intervention compared to wait-list controls in a small RCT123Adair M, Murphy B et al. Feasibility and preliminary efficacy of tailored yoga in survivors of head and neck cancer: a pilot study. Integrative Cancer Therapies. 2018 Sep;17(3):774-784.
- Greater functional reach among people with breast or gynecologic cancer with chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to usual care in a small RCT124Bao T, Zhi I et al. Yoga for chemotherapy-induced peripheral neuropathy and fall risk: a randomized controlled trial. JNCI Cancer Spectrum. 2020 Jun;pkaa048.
- Better range of motion and strength after surgery among women with breast cancer at high risk for breast cancer-related lymphedema practicing yoga twice a week for 8 weeks compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design125Mazor M, Lee JQ et al. The effect of yoga on arm volume, strength, and range of motion in women at risk for breast cancer-related lymphedema. Journal of Alternative and Complementary Medicine. 2018 Feb;24(2):154-160.
- Better physical functioning and arm symptoms after breast cancer surgery among women practicing yoga in 90-minute lessons once a week compared to no yoga in a small RCT126Andysz A, Merecz D et al. Effect of a 10-week yoga programme on the quality of life of women after breast cancer surgery. Przeglad Menopauzalny. 2014 Jun;13(3):186-93.
- Beneficial meridian energy changes among people with breast cancer with aromatase inhibitor-associated knee joint pain participating in a 6-week yoga intervention compared to massage in a small RCT;127Tsai CL, Liu LC et al. Yoga versus massage in the treatment of aromatase inhibitor-associated knee joint pain in breast cancer survivors: a randomized controlled trial. Scientific Reports. 2021 Jul 21;11(1):14843. stimulation of meridian energy channels is used in traditional Chinese medicine, and meridian electrical conductance is used to tailor acupuncture treatments to specific needs
Return to work: preliminary evidence of a higher rate of return to work 6 months after starting chemotherapy among people with breast cancer practicing yoga
- Higher rate of return to work 6 months after starting chemotherapy among women with breast cancer receiving standard care and participating in Dru yoga once a week for 12 weeks compared to standard care alone in a small RCT128Jong MC, Boers I et al. A randomized study of yoga for fatigue and quality of life in women with breast cancer undergoing (neo) adjuvant chemotherapy. Journal of Alternative and Complementary Medicine. 2018 Sep/Oct;24(9-10):942-953.
Among caregivers: weak evidence of better quality of life (mental component score) among caregivers for people with cancer practicing Vinyasa yoga
- Better quality of life (mental component score) among caregivers for people with cancer practicing Vinyasa yoga compared to baseline in a small uncontrolled trial129Martin AC, Keats MR. The impact of yoga on quality of life and psychological distress in caregivers for patients with cancer. Oncology Nursing Forum. 2014 May;41(3):257-64.
Preliminary evidence of better sexual health scores during external beam radiation therapy among people with prostate cancer practicing yoga
- Better sexual health scores (International Index of Erectile Function Questionnaire) during external beam radiation therapy among people with prostate cancer practicing yoga compared to no yoga in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects130Ben-Josef AM, Chen J et al. Effect of Eischens yoga during radiation therapy on prostate cancer patient symptoms and quality of life: a randomized phase II trial. International Journal of Radiation Oncology, Biology, Physics. 2017 Aug 1;98(5):1036-1044.
Good evidence of less sleep disruption among people with cancer practicing yoga
- Better sleep quality immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects131Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward small reductions in sleep disturbances among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality132Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Less short-term sleep disturbance among women with breast cancer practicing yoga compared to no intervention in a meta-analysis of 6 RCTs133Cramer H, Lauche R et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database of Systematic Reviews. 2017 Jan 3;1(1):CD010802.
- Short-term less sleep disturbance among people with breast cancer practicing yoga compared to controls in a meta-analysis of 3 RCTs of moderate quality134Yi LJ, Tian X, Jin YF, Luo MJ, Jiménez-Herrera MF. Effects of yoga on health-related quality, physical health and psychological health in women with breast cancer receiving chemotherapy: a systematic review and meta-analysis. Annals of Palliative Medicine. 2021 Feb;10(2):1961-1975.
- Better sleep quality and less daytime dysfunction among people with cancer participating in a standardized, 4-week yoga therapy program (Yoga for Cancer Survivors, or YOCAS) and standard care compared to standard care alone in a mid-sized RCT135Lin PJ, Kleckner IR et al. Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: a nationwide, multicenter randomized controlled trial of yoga in cancer survivors. Integrative Cancer Therapies. 2019 Jan-Dec;18:1534735419855134.
- A larger decline in sleep disruption among adults with gastrointestinal cancer participating in a yoga skills training intervention compared to attention controls in a small RCT136Sohl SJ, Tooze JA et al. A randomized controlled pilot study of yoga skills training versus an attention control delivered during chemotherapy administration. Journal of Pain and Symptom Management. 2022 Jan;63(1):23-32.
- Less insomnia among women with breast cancer-related lymphedema practicing yoga for 8 weeks compared to controls in a small RCT137Pasyar N, Barshan Tashnizi N, Mansouri P, Tahmasebi S. Effect of yoga exercise on the quality of life and upper extremity volume among women with breast cancer related lymphedema: a pilot study. European Journal of Oncology Nursing. 2019 Oct;42:103-109.
- Lower sleep disturbance among people with myeloproliferative neoplasma type of disease in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells participating in an online yoga intervention compared to wait-list controls in a small RCT138Huberty J, Eckert R et al. Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC Complementary and Alternative Medicine. 2019 Jun 7;19(1):121.
- Fewer sleep disturbances among people with non-metastatic colorectal cancer practicing yoga for 10 weeks compared to wait-list controls in a small RCT139Cramer H, Pokhrel B et al. A randomized controlled bicenter trial of yoga for patients with colorectal cancer. Psycho-oncology. 2016 Apr;25(4):412-20.
- A weak trend toward less sleep impairment among people with chronic chemotherapy-induced peripheral neuropathy practicing yoga for 8 weeks compared to controls in a small RCT140Knoerl R, Giobbie-Hurder A et al. Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled trial. Journal of Cancer Survivorship. 2021 Sep 15:1–10
Good evidence of less psychological stress or distress among people with cancer practicing yoga
Preliminary evidence of less stress before chemotherapy among people with cancer participating in laughter yoga
Weak evidence of less psychological distress among caregivers for people with cancer practicing yoga
- Less stress immediately after practice among people with breast cancer practicing yoga compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 26 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects141Hsueh EJ, Loh EW, Lin JJ, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer. 2021 Mar;28(2):264-276.
- Large reductions in distress among people with cancer—mostly breast cancer, but also lymphoma—practicing yoga compared to controls in a meta-analysis of 13 RCTs of moderate quality142Buffart LM, van Uffelen JG et al. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012 Nov 27;12:559.
- Short-term improvements in perceived stress and psychological distress among people with breast cancer practicing yoga compared to controls in a meta-analysis of 12 RCTs of low or moderate quality143Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012 Sep 18;12:412.
- Lower symptom distress among people with metastatic breast cancer participating in an integrated yoga based stress reduction program compared to education and supportive therapy sessions in a small RCT144Rao RM, Vadiraja HS et al. Effect of yoga on sleep quality and neuroendocrine immune response in metastatic breast cancer patients. Indian Journal of Palliative Care. 2017 Jul-Sep;23(3):253-260.
- A larger decline in psychological stress among adults with gastrointestinal cancer participating in a yoga skills training intervention compared to attention controls in a small RCT145Sohl SJ, Tooze JA et al. A randomized controlled pilot study of yoga skills training versus an attention control delivered during chemotherapy administration. Journal of Pain and Symptom Management. 2022 Jan;63(1):23-32.
- Less stress after yoga class among people with prostate cancer and their support persons participating in a 7-week class-based yoga program followed by 7 weeks of self-selected physical activity in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design146Ross Zahavich AN, Robinson JA, Paskevich D, Culos-Reed SN. Examining a therapeutic yoga program for prostate cancer survivors. Integrative Cancer Therapies. 2013 Mar;12(2):113-25.
- Lower stress before chemotherapy among people with cancer participating in laughter yoga compared to no intervention in a small RCT147Farifteh S, Mohammadi-Aria A, Kiamanesh A, Mofid B. The impact of laughter yoga on the stress of cancer patients before chemotherapy. Iranian Journal of Cancer Prevention. 2014 Fall;7(4):179-83.
Among caregivers: weak evidence of less psychological distress among caregivers for people with cancer practicing yoga
- Less psychological distress among caregivers for people with cancer practicing Vinyasa yoga compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design148Martin AC, Keats MR. The impact of yoga on quality of life and psychological distress in caregivers for patients with cancer. Oncology Nursing Forum. 2014 May;41(3):257-64.
- Less stress after yoga class among people with prostate cancer and their support persons participating in a 7-week class-based yoga program followed by 7 weeks of self-selected physical activity in a small uncontrolled trial149Ross Zahavich AN, Robinson JA, Paskevich D, Culos-Reed SN. Examining a therapeutic yoga program for prostate cancer survivors. Integrative Cancer Therapies. 2013 Mar;12(2):113-25.
These symptoms are common among people with cancer, but these studies did not investigate the symptoms exclusively among people with cancer
Good evidence of better blood pressure, heart rate, and respiratory rate among people practicing yoga
Preliminary evidence of less constipation among elderly people (aged 60 to 75) practicing yoga
Modest evidence of substantially fewer or less severe hot flashes among perimenopausal or postmenopausal women practicing yoga
Preliminary evidence of less psychological stress or depression, better sleep, and better quality of life among people practicing yoga
Preliminary evidence of fewer and less severe hot flashes; less joint pain, fatigue, sleep disturbance, and symptom-related bother; and better vigor among disease-free women experiencing hot flashes participating in a program of gentle yoga poses, meditation, and breathing exercises
Cardiovascular symptoms
Cardiovascular health is of special concern among people with cancer, especially people receiving treatments that can damage the heart.
Good evidence of better blood pressure, heart rate, and respiratory rate among people practicing yoga
- Better systolic and diastolic blood pressure and heart rate among people practicing yoga compared to non-exercise controls in a meta-analysis of 32 RCTs150Chu P, Gotink RA, Yeh GY, Goldie SJ, Hunink MG. The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology. 2016 Feb;23(3):291-307.
- Better blood pressure among adults with type 2 diabetes practicing yoga compared to controls in a meta-analysis of 23 controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial151Thind H, Lantini R, Balletto B et al. The effects of yoga among adults with type 2 diabetes: a systematic review and meta-analysis. Preventive Medicine. 2017 Dec;105:116-126.
- Better systolic and diastolic blood pressure, heart rate, and respiratory rate among healthy people, non-diabetic people with high risk for cardiovascular disease, or people with type 2 diabetes practicing yoga compared to usual care or no intervention in a meta-analysis of 44 RCTs of poor quality152Cramer H, Lauche R et al. Effects of yoga on cardiovascular disease risk factors: a systematic review and meta-analysis. International Journal of Cardiology. 2014 May 1;173(2):170-83.
- Lower ambulatory systolic blood pressure and resting heart rate among people practicing yoga compared to active controls in a meta-analysis of 42 RCTs153Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017 Dec;86:152-168.
- Lower systolic blood pressure among people with pre-diabetes participating in yoga compared to controls in a meta-analysis of 14 controlled trials154Ramamoorthi R, Gahreman D, Skinner T, Moss S. The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: a systematic review and meta-analysis. PLoS One. 2019 Oct 16;14(10):e0221067.
- A larger decrease in systolic and diastolic blood pressures and heart rate, and better Reynolds Risk Scoresa predictive score of risk of having a future heart attack, stroke, or other major heart disease in the next 10 years among people with diagnosed hypertension performing 30 minutes of aerobic exercise training 5 times weekly and adding 15 minutes of yoga compared to adding stretching in a small RCT155Pandey A, Pandey A et al. Impact of yoga on global cardiovascular risk as an add-on to a regular exercise regimen in patients with hypertension. Canadian Journal of Cardiology. 2022 Dec.
- No evidence of an effect on blood pressure among people with type 2 diabetes practicing yoga compared to physical exercise in a meta-analysis of 8 controlled trials156Jayawardena R, Ranasinghe P, Chathuranga T, Atapattu PM, Misra A. The benefits of yoga practice compared to physical exercise in the management of type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes & Metabolic Syndrome. 2018 Sep;12(5):795-805.
- Better systolic but not diastolic blood pressure among people with metabolic syndrome participating in yoga compared to controls in a meta-analysis of 7 RCTs of low quality157Cramer H, Langhorst J, Dobos G, Lauche R. Yoga for metabolic syndrome: a systematic review and meta-analysis. European Journal of Preventive Cardiology. 2016 Dec;23(18):1982-1993.
- Lower diastolic blood pressure among healthy adults or those at high risk of cardiovascular disease practicing yoga at least 3 months compared to controls in a review of RCTs of low to moderate quality158Hartley L, Dyakova M et al. Yoga for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews. 2014 May 13;(5):CD010072.
- Quicker systolic and diastolic blood pressure recovery, but no change in blood pressure or heart rate, after an acute psychological stressor among healthy young adults participating in a single video-instructed session of Hatha yoga compared to controls watching television in a small RCT159Benvenutti MJ, Alves EDS et al. A single session of hatha yoga improves stress reactivity and recovery after an acute psychological stress task—a counterbalanced, randomized-crossover trial in healthy individuals. Complementary Therapies in Medicine. 2017 Dec;35:120-126.
- Better resting blood pressure, heart rate, and heart rate variability among sedentary volunteers practicing yoga for 12 weeks compared to baseline in a small uncontrolled trial160Sawane MV, Gupta SS. Resting heart rate variability after yogic training and swimming: a prospective randomized comparative trial. International Journal of Yoga. 2015 Jul-Dec;8(2):96-102.
Gastrointestinal symptoms: preliminary evidence of less constipation among elderly people (aged 60 to 75) practicing yoga
- Less constipation among elderly people practicing yoga compared to wait-list controls in a small RCT161Shree Ganesh HR, Subramanya P, Rao M R, Udupa V. Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: a randomized controlled trial. Journal of Bodywork and Movement Therapies. 2021 Jul;27:692-697.
Hot flashes: good evidence of substantially fewer or less severe hot flashes among perimenopausal or postmenopausal women practicing yoga
- Fewer menopausal vasomotor symptoms among people practicing yoga compared to controls in a meta-analysis of 13 RCTs162Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms—a systematic review and meta-analysis. Maturitas. 2018 Mar;109:13-25.
- Substantially fewer or less severe hot flashes (vasomotor symptoms) among perimenopausal or postmenopausal women practicing yoga compared to controls in a meta-analysis of 8 RCTs163Shepherd-Banigan M, Goldstein KM et al. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: an umbrella systematic review and meta-analysis. Complementary Therapies in Medicine. 2017 Oct;34:156-164.
Yoga combined with other therapies
Preliminary evidence of fewer and less severe hot flashes; less joint pain, fatigue, sleep disturbance, and symptom-related bother; and better vigor among disease-free women experiencing hot flashes participating in a program of gentle yoga poses, meditation, and breathing exercises
- Fewer and less severe hot flashes; less joint pain, fatigue, sleep disturbance, and symptom-related bother; and better vigor among disease-free women experiencing hot flashes participating in Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) for 8 weeks compared to wait-list controls in a small RCT; the benefits persisted at 3 months follow-up164Carson JW, Carson KM, Porter LS, Keefe FJ, Seewaldt VL. Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial. Supportive Care in Cancer. 2009 Oct;17(10):1301-9.
Yoga and mindfulness meditation, sometimes with other therapies: preliminary evidence of less depression, fatigue, pain, stress, and sleep disturbance, fewer hot flashes, and better quality of life and cognitive function among people with cancer practicing yoga
Laughter yoga and comedy performance: preliminary evidence of better cognitive function and less pain for a short time among people with cancer participating in laughter therapy sessions
Breathe Easier, a program encompassing meditation, two levels of mindful Hatha yoga, breathing exercises, and participant interaction: weak evidence of better exercise capacity, improved sleep and stress scores among people with non-small-cell lung cancer practicing Breathe Easier
Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on breathlessness or fatigue
Pelvic floor muscle training with counseling and yoga or core exercises: modest evidence of better sexual function and health-related quality of life among people with cervical cancer participating in pelvic floor muscle training with counseling and yoga or core exercises
Yoga and mindfulness meditation, sometimes with other therapies: preliminary evidence of less depression, fatigue, pain, stress, and sleep disturbance, fewer hot flashes, and better quality of life and cognitive function among people with cancer practicing yoga
- Fewer symptoms of stress over time among people with breast cancer participating in mindfulness-based cancer recovery comprising training in mindfulness meditation and gentle yoga compared to either supportive-expressive group therapy (SET) or controls receiving 1-day stress management, and also better quality of life compared to controls, and better social support compared to SET in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects165Carlson LE, Doll R et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer. Journal of Clinical Oncology. 2013 Sep 1;31(25):3119-26.
- Less fatigue interference and severity, greater vitality, less depression, and less sleep disturbance, and less disability and anxiety after 1 month, among people with cancer receiving training in mindfulness meditation, yoga, and self-regulatory responses to stress compared to wait-list controls in a small RCT166Johns SA, Brown LF et al. Randomized controlled pilot study of mindfulness-based stress reduction for persistently fatigued cancer survivors. Psycho-oncology. 2015 Aug;24(8):885-93.
- Fewer hot flashes and other typical menopausal symptoms among people with breast cancer participating in a 12-week yoga and meditation intervention compared to usual care in a small RCT167Cramer H, Rabsilber S, Lauche R, Kümmel S, Dobos G. Yoga and meditation for menopausal symptoms in breast cancer survivors—a randomized controlled trial. Cancer. 2015 Jul 1;121(13):2175-84.
- Better overall quality of life; role, cognitive, emotion, and social functions; and fewer pain and fatigue symptoms in global life quality among people with breast cancer participating in a mindfulness-based stress reduction program and conscious yoga compared to controls in a small RCT168Rahmani S, Talepasand S. The effect of group mindfulness-based stress reduction program and conscious yoga on the fatigue severity and global and specific life quality in women with breast cancer. Medical journal of the Islamic Republic of Iran. 2015 Feb 8;29:175.
Laughter yoga and comedy performance: preliminary evidence of better cognitive function and less pain for a short time among people with cancer participating in laughter therapy sessions
- Better cognitive function and less pain for a short time among people with cancer participating in 4 laughter therapy sessions involving a laughter yoga routine followed by Rakugo or Manzai traditional Japanese verbal comedy performances, 1 session every second week, compared to no laughter therapy in a small RCT169Morishima T, Miyashiro I et al. Effects of laughter therapy on quality of life in patients with cancer: An open-label, randomized controlled trial. PLoS One. 2019 Jun 27;14(6):e0219065.
Breathe Easier, a program encompassing meditation, two levels of mindful Hatha yoga, breathing exercises, and participant interaction: weak evidence of better exercise capacity, improved sleep and stress scores among people with non-small-cell lung cancer practicing Breathe Easier
Insufficient (conflicting) evidence of an effect on breathlessness or fatigue
- Less breathlessness (dyspnea), fatigue, and better exercise capacity, sleep, and stress scores among people with non-small-cell lung cancer practicing Breathe Easier with level 1 yoga compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design170McDonnell KK, Gallerani DG et al. A prospective pilot study evaluating feasibility and preliminary effects of Breathe Easier: a mindfulness-based intervention for survivors of lung cancer and their family members (dyads). Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420969829.
- Slightly increased breathlessness (dyspnea) and fatigue, but improved sleep, stress, and exercise capacity among people with non-small-cell lung cancer practicing Breathe Easier with level 2 yoga compared to baseline in a small uncontrolled trial171McDonnell KK, Gallerani DG et al. A prospective pilot study evaluating feasibility and preliminary effects of Breathe Easier: a mindfulness-based intervention for survivors of lung cancer and their family members (dyads). Integrative Cancer Therapies. 2020 Jan-Dec;19:1534735420969829.
Pelvic floor muscle training with counseling and yoga or core exercises: modest evidence of better sexual function and health-related quality of life among people with cervical cancer participating in pelvic floor muscle training with counseling and yoga or core exercises
- Better sexual function and health-related quality of life among people with cervical cancer participating in pelvic floor muscle training with counseling and yoga or core exercises compared to controls in a systematic review of 5 RCTs and 2 retrospective cohort studies172Brennen R, Lin KY, Denehy L, Frawley HC. The effect of pelvic floor muscle interventions on pelvic floor dysfunction after gynecological cancer treatment: a systematic review. Physical Therapy. 2020 Aug 12;100(8):1357-1371.
Helpful links
What Is Yoga? What Is Yoga Therapy? ›
From the Executive Committee of the Society for Integrative Oncology Yoga Special Interest Group
Keep reading about yoga
Authors
Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.
Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.
For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.
Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.
Last update: October 22, 2024
Last full literature review: January 2022
CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.
Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.
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