Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials

Laurien M Buffart; Jannique GZ van Uffelen; Ingrid I Riphagen; Johannes Brug; Willem van Mechelen; Wendy J Brown; Mai JM Chinapaw

doi:10.1186/1471-2407-12-559

BMC Cancer

Table 1 Description of study populations in alphabetical order of first author

From: Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials

Author, year	Diagnosis; treatment	number of participants (n); gender (%women); mean age (sd) and/or range	eligibility criteria
Banasik, 2011 [56]	Breast cancer, (>2 mo) post-treatment	n = 18 (9Y, 9C) % women: 100% Age: 62.9 (7.1) years	Inclusion women with stages II-IV breast cancer at least 2 months post-treatment.
Banasik, 2011 [56]	Breast cancer, (>2 mo) post-treatment	n = 18 (9Y, 9C) % women: 100% Age: 62.9 (7.1) years	Exclusion receiving Herceptin therapy, pregnant or lactating, had past or current history of other neoplasm, active serious infection or immune deficiency; history of psychiatric disorders or alcohol or drug abuse; steroid therapy or physical condition preventing yoga.
Banerjee, 2007 [51]	Breast cancer, during radiotherapy	n = 58 (35Y, 23C) % women: 100% Age: 44 (1.3) years	Inclusion Recently operated breast cancer, age between 30 and 70 years, Zubrod’s performance status 0–2 (ambulatory >50% of the time), high school education, treatment plan of radiotherapy or both radiotherapy and chemotherapy, consent to participate in the study.
Banerjee, 2007 [51]	Breast cancer, during radiotherapy	n = 58 (35Y, 23C) % women: 100% Age: 44 (1.3) years	Exclusion Having any concurrent medical condition likely to interfere with the treatment; major psychiatric, neurological illness, or autoimmune disorders; cardiovascular illness; any known metastases. No exposure to other mutagens, smoking or alcohol for at least 3 months prior to pre-radiation blood donation.
Blank, 2003 [31]	Breast cancer stage I-III receiving antiestrogen or aromatase inhibitor hormonal therapy	N = 18 (9Y, 9C) % women: 100% Age: 48 – 69 years	Inclusion minimum of eight weeks post chemotherapy, estrogen receptor positive status, surgery for lumpectomy, modified mastectomy or full mastectomy (with/without reconstruction), a life expectancy greater than six months, adequate blood cell counts and kidney, liver, and cardiac function, physical and mental ability to attend all the Yoga training sessions.
Blank, 2003 [31]		N = 18 (9Y, 9C) % women: 100% Age: 48 – 69 years	Exclusion women on Herceptin therapy, current steroid therapy, or other known immunomodulating medications, pregnancy or current lactation, a past or current history of another neoplasm, active serious infection or immune deficiency, documented alcohol or drug abuse, history of psychiatric disorders requiring use of psychotropic medication.
Bower, 2012 [58]	Breast cancer state 0 – II, at least 6 months after adjuvant cancer therapy.	n = 31 (16Y, 15C) % women: 100% Age: 54.4 (5.7) years	Inclusion originally diagnosed with stage 0 to II breast cancer; completed local and/or adjuvant cancer therapy (with the exception of hormone therapy) at least 6 months previously; ages 40 to 65 years; postmenopausal; no other cancer in last 5 years; experiencing persistent cancer-related fatigue.
Bower, 2012 [58]		n = 31 (16Y, 15C) % women: 100% Age: 54.4 (5.7) years	Exclusion chronic medical conditions or regular use of medications associated with fatigue; evidence that fatigue was driven primarily by a medical or psychiatric disorder other than cancer; evidence that fatigue was driven primarily by other noncancer-related factors; physical problems or conditions that could make yoga unsafe; a body mass index (BMI) >31 kg/m2.
Carson, 2009 [32]	Breast cancer; no current treatment (4.9 ± 2.4 years since diagnose)	n = 37 (17Y, 20C) % women: 100% Age: 54.4 (7.5) years	Inclusion Experiencing at least one hot flash per day on 4 or more days per week; no signs of active breast cancer; no current cytotoxic chemotherapy; diagnosed with breast cancer at stages IA-IIB ≥ 2 years before; no hormone replacement therapy currently or within prior 3 months; stabilized on constant regime of menopausal symptom medications and supplements for at least 3 weeks; if taking antidepressants, stabilized at a fixed dose for at least 3 months.
Carson, 2009 [32]		n = 37 (17Y, 20C) % women: 100% Age: 54.4 (7.5) years	Exclusion resided ≥ 70 miles from research site; unavailable to attend the intervention on the day and at the time offered; currently engaged in intensive yoga practice (> 3 days/week); having received treatment for serious psychiatric disorders (e.g. schizophrenia) in the previous 6 months; not English speaking
Chandwani, 2010 [55]	Breast cancer, during radiotherapy	N = 61 % women: 100% Age: 51.4 (8.0) range 37–68 years	Inclusion Women with stage 0-III breast cancer; ≥ 18 years; able to read, write and speak English; scheduled to undergo radiotherapy.
Chandwani, 2010 [55]	Breast cancer, during radiotherapy	N = 61 % women: 100% Age: 51.4 (8.0) range 37–68 years	Exclusion Patients who had any major psychiatric diagnosis or physical limitations that would prohibit participation in the yoga program.
Cohen, 2004 [44]	Lymphoma (18% Hodgkin), 61,5% active treatment	n = 39 % women: 61.5% Age: 51 years	Inclusion Patients with lymphoma who were either receiving chemotherapy or had received it within the past 12 months; ≥ 18 years; able to read and speak English.
Cohen, 2004 [44]	Lymphoma (18% Hodgkin), 61,5% active treatment	n = 39 % women: 61.5% Age: 51 years	Exclusion Patients with major psychotic illnesses.
Culos-Reed, 2006 [52]	Breast cancer (85%); no current treatment (> 3 mo post-treatment)	n = 38 % women: 95% Age: 51.2 (10.3) years	Inclusion Cancer survivors who were currently not undergoing active treatment; no additional health concerns; ≥ 18 years; minimum 3 months post-treatment.
Danhauer, 2009 [53]	Breast cancer; 34% actively undergoing treatment	n = 44 % women: 100% Age: 55.8 (9.9) years	Inclusion Women ≥ 18 years; diagnosed with breast cancer; 2 to 24 months post-primary treatment (surgery) following initial diagnosis and/or had a recurrence of breast cancer within the past 24 months (regardless of treatment status); physically able to attend restorative yoga; able to understand English; free of medical contraindications reported by their physician.
Littman, 2011 [57]	Breast cancer; > 3 mo post-treatment	n = 63 % women: 100% Age: 60 (7.9) years	Inclusion Age between 21 and 75 years; completion of breast cancer treatment (stage 0-III) at least 3 months prior, BMI ≥24 kg/m² (or ≥23 kg/m² if of Asian descent).
Littman, 2011 [57]	Breast cancer; > 3 mo post-treatment	n = 63 % women: 100% Age: 60 (7.9) years	Exclusion Myocardial infarction or stroke in the previous 6 months, diabetes, current yoga practice, pregnancy or plans to become pregnant, factors that might lead to poor retention and yoga practice.
Moadel, 2007 [54]	Breast cancer; 48% medical treatment	n = 128 % women: 100% Age: 54.8 (9.9) range 28–75 years	Inclusion Age ≥ 18 years; new/recurrent breast cancer (stages I-III) diagnosis within previous 5 years; high performance status (Eastern Cooperative Oncology Group performance status of < 3); ability to speak English or Spanish; not actively practicing yoga.
Raghavendra, 2007 [49]	Breast cancer, during chemotherapy	n = 62 % women: 100% Age: n = 33 < 50 yrs; n = 29 > 50 yrs	Inclusion Recently diagnosed with operable breast cancer; aged between 30 and 70 years; Zubrod’s performance status 0–2; high school education; having a treatment plan with surgery followed by adjuvant chemotherapy or by both adjuvant radiotherapy and chemotherapy; consenting to participate in the study.
Raghavendra, 2007 [49]	Breast cancer, during chemotherapy	n = 62 % women: 100% Age: n = 33 < 50 yrs; n = 29 > 50 yrs	Exclusion history of intestinal obstruction and any known sensitivity to any class of antiemetics.
Rao, 2009 [50]	Breast cancer, during adjuvant chemotherapy and radiotherapy	n = 98; % women: 100% Age: ?	Inclusion Recently diagnosed with operable breast cancer; aged between 30 and 70 years; Zubrod’s performance status 0–2; high school education; having a treatment plan with surgery followed by adjuvant radiotherapy and chemotherapy; consenting to participate in the study.
Rao, 2009 [50]		n = 98; % women: 100% Age: ?	Exclusion Having a concurrent medical condition likely to interfere with the treatment; any major psychiatric, neurological illness or autoimmune disorders; secondary malignancy.
Vadiraja, 2009 [46–48]	Breast cancer (stage II and III), during adjuvant	n = 88; % women: 100% Age: 46 (9.1) yrs yoga; 48.4 (10.2) yrs C.	Inclusion Recently diagnosed with operable breast cancer; aged between 30 and 70 years; Zubrod’s performance status 0–2; high school education; having a treatment plan with surgery followed by adjuvant chemotherapy or by both adjuvant radiotherapy and chemotherapy; consenting to participate in the study.
Vadiraja, 2009 [46–48]	Breast cancer (stage II and III), during adjuvant		Exclusion Having a concurrent medical condition likely to interfere with the treatment; any major psychiatric, neurological illness or autoimmune disorders; any known metastases; prescribed concurrent chemotherapy cycles during radiotherapy.

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