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Cited by 74Cancer survivorship and careWomen's cancer prevention and managementComplementary and Alternative Medicine Studies

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

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O’Neill, Meagan, Samaroo, Dominic, Lopez, Christian, Tomlinson, George, Santa Mina, Daniel, Sabiston, Catherine, Culos-Reed, Nicole, Alibhai, Shabbir M. H.·2020·Integrative Cancer Therapies
DOI 10.1177/1534735420959882PMC PMC7580184
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Abstract

Background: Women with breast cancer (BC) are living longer with debilitating side effects such as cancer-related fatigue (CRF) that affect overall well-being. Yoga promotes health, well-being and may be beneficial in reducing CRF. Although there have been previous systematic reviews and meta-analyses, the effects of yoga on CRF and quality of life (QOL) remain unclear, particularly in comparison with other types of physical activity (PA). Our objective is to carry out a systematic review and meta-analysis of the effects of yoga on CRF and QOL in women with BC. Methods: Electronic databases were searched (MEDLINE, Embase Classic+Embase and EMB Reviews, Cochrane Central CT) from inception to May 2018. Randomized controlled trials were included if they were full text, in English, included a yoga intervention, a comparator (including non-PA usual care or alternate PA intervention), and reported on CRF or QOL. Effects of yoga were pooled using standardized mean difference (SMD) via a random effects model. Results: Of the 2468 records retrieved, 24 trials were included; 18 studies compared yoga to a non-PA comparator and 6 to a PA comparator. Yoga demonstrated statistically significant improvements in CRF over non-PA (SMD −0.30 [−0.51; −0.08]) but not PA (SMD −0.17 [−0.50; 0.17]) comparators. Additionally, yoga demonstrated statistically significant improvements in QOL over non-PA (SMD −0.27 [−0.46; −0.07]) but not PA (SMD 0.04 [−0.22; +0.31]) comparators. Discussion: This meta-analysis found that yoga provides small to medium improvements in CRF and QOL compared to non-PA, but not in comparison to other PA interventions.

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  • Mixed results have been reported for yoga's effect on QL.

    “and QL (in 18 RCTs with a nonphysical activity comparator, SMD = -0.27; in 6 RCTs with a physical activity comparator, SMD = 0.04; O'Neill et al. 2020).”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as O'Neill et al. 2020

    The Results (Quality of Life; page unavailable) support the mixed finding: yoga benefited quality of life versus non-active comparators but had a negligible effect versus active comparators. The cited SMDs match the paper’s reported values, but the sentence presents 18 and 6 RCTs as the quality-of-life comparison counts. Those are the counts of all included trials by comparator; the Quality of Life results specify 10 studies for the non-active comparison. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Mixed results have been reported for yoga's effect on fatigue.

    “fatigue (in 18 RCTs with a nonphysical activity comparator, SMD = -0.30; in 6 RCTs with a physical activity comparator, SMD = -0.17;O'Neill et al. 2020)”

    From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as O'Neill et al. 2020

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  1. [1]Bray F Ferlay J Soerjomataram I Siegel RL Torre LA Jemal A Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394- 424. 30207593
  2. [3]Ewertz M Jensen AB Late effects of breast cancer treatment and potentials for rehabilitation. Acta Oncol. 2011; 50: 187- 193. 21231780
  3. [4]Luctkar-Flude MF Groll DL Tranmer JE Woodend K Fatigue and physical activity in older adults with cancer. Cancer Nurs. 2007; 30: e35- e45. 17876176
  4. [5]Brown JC Huedo-Medina TB Pescatello LS Pescatello SM Ferrer RA Johnson BT Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011; 20: 123- 133. 21051654
  5. [6]Haas BK Fatigue, self-efficacy, physical activity, and quality of life in women with breast cancer. Cancer Nurs. 2011; 34: 322- 334. 21116178
  6. [7]Mortimer JE Barsevick AM Bennett CL, et al Studying cancer-related fatigue: report of NCCN scientific research committee. J Natl Compr Canc Netw. 2010; 8: 1131. 21147900
  7. [8]Husebo AM Dyrstad SM Mjaaland I Soreide JA Bru E Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer. Sci World J. 2014; 2014: 271828. PMC3915861 24563628
  8. [9]Berger AM Gerber LH Mayer DK Cancer-related fatigue: implications for breast cancer survivors. Cancer. 2012; 118: 2261- 2269. 22488700
  9. [10]Cramp F Daniel J Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012;(2): CD006145. 23152233 PMC8480137
  10. [11]Velthuis MJ Agasi-Idenburg SC Aufdemkampe G Wittink HM The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomized controlled trials. Clinical Oncology. 2010; 22: 208- 221. 20110159
  11. [12]Edwardson CL Gorely T Davies MJ, et al Association of sedentary behaviour with metabolic syndrome: a meta-analysis. PLoS ONE. 2012; 7: e34916. 22514690 PMC3325927
  12. [13]Humpel N Iverson DC Sleep quality, fatigue and physical activity following a cancer diagnosis. Eur J Cancer Care. 2010; 19: 761- 768. 19832890
  13. [14]Tomlinson D Diorio C Beyene J Sung L Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil. 2014; 93: 675- 686. 24743466
  14. [15]Oberoi S Robinson PD Cataudella D, et al Physical activity reduces fatigue in patients with cancer and hematopoietic stem cell transplant recipients: a systematic review and meta-analysis of randomized trials. Crit Rev Oncol Hemat. 2018; 122: 52- 59. 29458789
  15. [16]Smith SG Chagpar AB Adherence to physical activity guidelines in breast cancer survivors. Am Surgeon. 2010; 76: 962. 20836343
  16. [17]Ottenbacher A Yu M Moser RP Phillips SM Alfano C Perna FM Population estimates of meeting strength training and aerobic guidelines, by gender and cancer survivorship status: findings from the Health Information National Trends Survey (HINTS). J Phys Act Health. 2015; 12: 675- 679. 24834485
  17. [18]Brunet J Taran S Burke S Sabiston CM A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer. Disabil Rehabil. 2013; 35: 2038- 2045. 23772995
  18. [19]Blaney J Lowe-Strong A Rankin J Campbell A Allen J Gracey J The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Phys Ther. 2010; 90: 1135- 1147. 20558566
  19. [22]Littman AJ Bertram LC Ceballos R, et al Randomized controlled pilot trial of yoga in overweight and obese breast cancer survivors: effects on quality of life and anthropometric measures. Support Care Cancer. 2012; 20: 267- 277. 21207071 PMC3188686
  20. [23]Ross A Thomas S The health benefits of yoga and exercise: a review of comparison studies. J Altern Complem Med. 2010; 16: 3- 12. 20105062
  21. [24]Bower JE Woolery A Sternlieb B Garet D Yoga for cancer patients and survivors. Cancer Control. 2005; 12: 165- 171. 16062164
  22. [25]Sadja J Mills PJ Effects of yoga interventions on fatigue in cancer patients and survivors: a systematic review of randomized controlled trials. Explore. 2013; 9: 232- 243. 23906102 PMC3781173
  23. [26]Harder H Parlour L Jenkins V Randomised controlled trials of yoga interventions for women with breast cancer: a systematic literature review. Support Care Cancer. 2012; 20: 3055- 3064. 23052917
  24. [27]Morgan SJ Does yoga decrease cancer-related fatigue in women with breast cancer? Systematic review of randomized controlled trials. Int J Res Med Sci. 2017; 5: 1180.
  25. [28]Sharma M Lingam VC Nahar VK A systematic review of yoga interventions as integrative treatment in breast cancer. J Cancer Res Clin Oncol. 2016; 142: 2523- 2540. 27630024 PMC11819344
  26. [29]Buffart LM van Uffelen JGZ Riphagen II, 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; 12: 559. 23181734 PMC3571972
  27. [30]Lin KY Hu YT Chang KJ Lin HF Tsauo JY Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. Evid Based Complement Alternat Med. 2011; 2011: 659876. 21437197 PMC3062158
  28. [33]Pan 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 Pac J Clin Oncol. 2017; 13: e79- e95. 25560636
  29. [34]Moher D Liberati AM Tetzlaff J Altman DG Group P Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med. 2009; 151: 264- 269. 19622511
  30. [35]Higgins JP Cochrane handbook for systematic review of interventions version 5.0.1 (updated March 2011). The Cochrane Collaboration Website. Published 2010.
  31. [36]Higgins JP Altman DG Gotzsche PC, et al The Cochrane collaboration’s tool for assessing risk of bias in randomized trials. BMJ. 2011; 343: d5928. 22008217 PMC3196245
  32. [37]Viechtbauer W Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010; 36: 1- 48. https://www.jstatsoft.org/article/view/v036i03.
  33. [38]Andysz A Merecz D Wojcik A Swiatkowska B Sierocka K Najder A Effect of a 10-week yoga programme on the quality of life of women after breast cancer surgery. Prz Menopauzalny. 2014; 13: 186- 193. 26327853 PMC4520362
  34. [39]Banasik J Williams H Haberman M Blank SE Bendel R Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract. 2011; 23: 135- 142. 21355946
  35. [41]Chandwani KD Perkins G Nagendra HR, et al Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy. J Clin Oncol. 2014; 32: 1058- 1065. 24590636 PMC3965260
  36. [42]Chandwani KD Thornton B Perkins GH, et al Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol. 2010; 8: 43- 55. 20388445
  37. [44]Culos-Reed SN Carlson LE Daroux LM Hately-Aldous S A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psycho-Oncol. 2006; 15: 891- 897. 16374892
  38. [45]Danhauer SC Mihalko SL Russell GB, et al Restorative yoga for women with breast cancer: findings from a randomized pilot study. Psycho-Oncol. 2009; 18: 360- 368. PMC3930083 19242916
  39. [46]Gregoire C Bragard I Jerusalem G, et al Group interventions to reduce emotional distress and fatigue in breast cancer patients: a 9-month follow-up pragmatic trial. Br J Cancer. 2017; 117: 1442- 1449. 28926526 PMC5680472
  40. [47]Kiecolt-Glaser JK Bennett JM Andridge R, et al Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol. 2014; 32: 1040- 1049. 24470004 PMC3965259
  41. [48]Lotzke D Wiedemann F Rodrigues Recchia D, 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. Evid-Based Compl Alt. 2016; 2016: 5931816. PMC4785257 27019663
  42. [49]Loudon A Barnett T Piller N Immink MA Williams AD Yoga management of breast cancer-related lymphoedema: a randomized controlled pilot-trial. BMC Altern Med. 2014; 14: 214. PMC4083036 24980836
  43. [50]Moadel AB Shah C Wylie-Rosett J, et al Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol. 2007; 25: 4387- 4395. 17785709
  44. [51]Pruthi S Stan D Jenkins SM, et al A randomized controlled pilot study assessing feasibility and impact of yoga practice on quality of life, mood, and perceived stress in women with newly diagnosed breast cancer. Glob Adv Health Med. 2012; 1: 30- 35. PMC4890104 27257529
  45. [52]Siedentopf F Utz-Billing I Gairing S Schoenegg W Kentenich H Kollak I Yoga for patients with early breast cancer and its impact on quality of life – a randomized controlled trial. Geburtshilfe Frauenheilkd. 2013; 73: 311- 317. 24771916 PMC3864467
  46. [53]Stan DL Croghan KA Croghan IT, et al Randomized pilot trial of yoga versus strengthening exercises in breast cancer survivors with cancer-related fatigue. Support Care Cancer. 2016; 24: 4005- 4015. 27129840
  47. [54]Taso CJ Lin HS Lin WL Chen SM Huang WT Chen SW The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. J Nurs Res. 2014; 22: 155- 164. 25111109
  48. [55]Taylor TR Barrow J Makambi K, et al A restorative yoga intervention for African-American breast cancer survivors: a pilot study. J Racial Ethn Health Disparities. 2018; 5: 62- 72. 28411330
  49. [56]Vardar Yağlı N Şener G Arıkan H, et al Do yoga and aerobic exercise training have impact on functional capacity, fatigue, peripheral muscle strength, and quality of life in breast cancer survivors? Integ Cancer Ther. 2015; 14: 125- 132. 25567329
  50. [57]Winters-Stone KM Moe EL Perry CK, et al Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial. Support Care Cancer. 2018; 26: 905- 912. 28965138
  51. [58]Vardar Yağlı N Ulger O The effects of yoga on the quality of life and depression in elderly breast cancer patients. Complement Ther Clin Pract. 2015; 21: 7- 10. 25697379
  52. [59]Vadiraja H Rao R Nagarathna R Nagendra H Patil S Diwakar R Effects of yoga in managing fatigue in breast cancer patients: a randomized controlled trial. Indian J 2017; 23: 247. PMC5545948 28827926
  53. [60]Banasik J Williams H Haberman M Blank SE Bendel R Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Prac. 2011; 23: 135- 142. 21355946
  54. [62]Minton O Stone P A systematic review of the scales used for the measurement of cancer-related fatigue (CRF). Ann Oncol. 2009; 20: 17- 25. 18678767
  55. [63]Boehm K Ostermann T Milazzo S Bussing A Effects of yoga interventions on fatigue: a meta-analysis. Evid Based Complement Alternat Med. 2012; 2012: 124703. 22991569 PMC3443845

Cited by

Sorted by citations

Authors
O’Neill, M., Samaroo, D., Lopez, C., Tomlinson, G., Santa Mina, D., Sabiston, C., Culos-Reed, N., & Alibhai, S. M. H.
Affiliations
  • University Health Network (CA)
  • University of Toronto, Toronto, ON, Canada
  • University of Toronto (CA)
  • University of Calgary (CA)
Corresponding author
O’Neill, Meagan
ORCID
Venue
Integrative Cancer Therapies
Publisher
SAGE Publications
Published
2020-01
Volume
19
Pages
1534735420959882-1534735420959882
ISSN
  • 1534-7354 (ISSN-L)
  • 1552-695X
DOI
10.1177/1534735420959882
PMC
PMC7580184
OpenAlex
W3093370396
Cited by
74
References
7
Citations by year
2026: 11 · 2025: 7 · 2024: 16 · 2023: 22 · 2022: 16 · 2021: 2
FWCI
1.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Integrative Cancer Therapies (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Keywords
yoga, cancer-related fatigue, quality of life, breast cancer, physical activity interventions, complementary therapy, women with cancer
MeSH terms
Breast Neoplasms, Fatigue, Female, Humans, Quality of Life, Yoga, Randomized Controlled Trials as Topic

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