05/15/2011 08:45 pm ET Updated Jul 16, 2011

Enhancing Cancer Treatment With Yoga And Tai Chi

This blog is a continuation of a series that looks at what have come to be called "Alternative and Complementary Treatments" or ACTs. These treatments have existed for a long time -- in some cases for centuries. Their increased popularity as complements to cancer treatment is in large part a consequence of medical advances that have the power to extend life and even put once fatal illnesses into remission. These medical treatments, however, often have pernicious side effects. Also, as we discuss in depth in "Saying Goodbye: How Families Can Find Renewal through Loss," having to cope with a terminal or potentially terminal illness is increasingly a prolonged process that time exposes both patients and their caregivers to chronic stress.

After reviewing the research on ACTs, I prefer to call them complementary treatments, as I have yet to find convincing evidence, aside from personal testimonials, that would lead me to encourage people to pursue these treatments instead of medical treatments for cancer. On the other hand, I think there is good reason to consider and include many complementary treatments in a holistic approach to treatment. Moreover, many ACTs may be beneficial to caregivers as well as the loved ones they care for.

Yoga and Tai Chi are two more popular complementary treatments. What they share is that they combine movement, posture and breathing to help people relax and achieve a "balance" between body, mind and spirit. Let's look at each one.

Yoga was originally developed as a discipline intended to help people achieve spiritual enlightenment. The Yoga Sutras, written some 2,000 years ago, describe eight foundations of yoga practice:
· Yama -- moral behavior.
· Niyama -- healthy habits
· Asana -- physical postures
· Pranayama -- breathing exercises
· Dharana -- concentration
· Dhyana -- contemplation
· Samadhi -- higher consciousness

There are several schools of yoga that incorporate the above in various proportions. The most popular school of yoga, Hatha, emphasizes postures and breathing exercises. Yoga can be self-taught but many people prefer to sign up for group classes taught by experienced yoga instructors. Many personal growth centers around the country also offer yoga workshops and weekend retreats.

Is Yoga Effective?
Researchers in the Department of Psychology at Queen's University in Ontario, Canada conducted a systematic review of the use of yoga as a complementary treatment for patients with cancer. They were looking specifically at how yoga might affect overall psychological functioning. They were able to identify 10 studies that qualified as "random clinical trials," meaning that the results obtained were objective and not reflective solely of the biases of the researchers.

The majority of the participants in these studies were women, and the most common diagnosis was breast cancer. Several different schools of yoga were involved. The researchers concluded that yoga can have a beneficial effect, particularly in reducing stress and anxiety. They also recommend that future research seek to determine which components of yoga seem to be the most beneficial.

Researchers at Ohio State University reported in the Journal Psychosomatic Medicine on a study that compared 25 "experts" who had been practicing yoga weekly for at least two years to a group of yoga "novices" -- people who'd had only six to 12 yoga sessions. When they compared blood tests of the two groups, they found that the novices' blood had much higher levels of a chemical that has been found to be associated with increased risk for cardiovascular disease and Type 2 diabetes. In addition, the expert group had significantly lower heart rates. In both groups, yoga practice boosted participants' overall mood. These women were not cancer patients, but there is no reason to believe that women with cancer would not respond similarly.

Tai Chi
Tai Chi is another popular discipline that involves repeating a series of movements -- some slowly, others quickly -- in a precise manner. Like yoga, Tai Chi involves low-impact, weight-bearing exercises. Also like yoga, its roots are Oriental, having been practiced in China, in particular, for thousands of years. Tai Chi is graceful to watch. It is also fairly gentle on the body -- even more so that yoga -- and is therefore gaining popularity among older adults as well as those who suffer from chronic illnesses that compromise their strength.

Tai Chi is based on the idea that a life force -- chi -- flows through the body along energy pathways known as meridians. The goal of Tai Chi exercises is to free up "blocked" and/or "unbalanced" chi.

Can Tai Chi Help?
A study conducted at the Oregon Research Institute found that, after six months, Tai Chi participants were twice as likely as nonparticipants to be able to perform moderate physical activities. This would tend to support the use of Tai Chi by older people or people whose physical condition has limited their activities. These same researchers found that Tai Chi participants had improved sleep, both in terms of quantity and quality. It has long been known by mental health professionals that poor sleep contributes to stress and depression.

Researchers at Deakin University in Australia examined 15 studies of Tai Chi. Thirteen of these studies concluded that Tai Chi had significant and beneficial results, particularly with respect to reducing depression and anxiety. However, the reviewers point out that only six of these studies were deemed to be of high quality, and two of those reported no such effects for Tai Chi.

In another comprehensive review, researchers at Tufts University School of Medicine identified 40 studies. These also varied in quality. Nevertheless, the Tufts group was convinced that there was sufficient objective data to support the idea that regular practice of Tai Chi leads to improved mental health, particularly with respect to anxiety, depression, and reported stress.

Is Yoga or Tai Chi Right for You?
The evidence cited above suggests that regular and sustained practice of either yoga or Tai Chi can benefit your mental health. In particular, they may help to reduce stress and ameliorate anxiety and depression. Respondents to interviews we conducted in preparing to write our book convinced Dr. Barbara Okun and I that cancer patients -- as well as their caregivers -- must cope not only with their terminal illness but also with the prolonged stress that a terminal diagnosis creates as well as the side effects of medical treatments. Surely that would mean that giving ACTs a closer look could well be in your interest.

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