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CATEGORIES [ SURVIVORSHIP, ASCO2010 ]

Yoga: A do-it-yourself treatment program for cancer survivors

BY ELIZABETH WHITTINGTON | JUNE 24, 2010

While several small studies have suggested the benefits of yoga, ASCO's annual meeting highlighted the largest and most definitive study to date on the benefits of the therapy.

Researchers randomized more than 400 cancer survivors who had significant sleep issues to either simple monitoring or 75-minute yoga sessions twice a week for one month. The results, said lead author Karen Mustian, of the University of Rochester Cancer Center in New York, were remarkable.

The benefits of the intervention were seen across the board, reducing several common side effects reported by cancer survivors. Individuals in the yoga group reported less fatigue and daytime sleepiness, decreased use of sleep medication, and increased quality of sleep and quality of life.

"If you ask a cancer patient who is suffering with sleep problems...who is trying to work, raise children, take care of elderly parents, or live their life in a healthy manner and this is interfering with the ability to live their life...I think these findings are striking," she says. "The fact that we can reduce the amount of fatigue by almost half--42 percent--is huge as well because it's probably the most prevalent and troubling side effect reported by the greatest number of cancer patients across all diagnoses."

You can read the full article on the study here.

The fact the study was so prominent at ASCO, a meeting of oncologists, highlights the possibility that this may be something survivors may be hearing from their doctor soon. "This is a readily applicable approach that improves quality of life and reduces medicine intake in cancer survivors. This is a real positive," said ASCO president, Douglas W. Blayney, MD, at a press conference in May. "This emphasizes the increasing importance of ameliorating complications of therapy in long-term cancer survivors. There are literally millions of patients to whom this might be applicable in the United States."

What's so exciting about this study is that researchers really had the real-world patient in mind. Mustian noted they chose types of yoga that would be most readily available to people in as many communities as possible in the U.S. The two types of yoga--gentle Hatha yoga and restorative yoga--are also gentle on the body and focuses on various poses, breathing exercises, and mindfulness.

"Those gentle Hatha yoga poses are almost in every type of yoga," Mustian says. "By using that, we felt people would have a good chance of finding instructors after the study was done to teach them these poses."

While restorative yoga is less widespread, it's gaining in popularity. For most of the poses, pillows, blocks, towels, and other props are used to support the body. "You're in different positions, but you're fully supported by blankets and bolsters, and your eyes can be covered with eyepads. The idea is to completely let your body be supported by something else," Mustian says. "It focuses a lot on the restoration of balance and really paying attention to your body."

She recommends finding a yoga instructor certified by the Yoga Alliance, and if they have prior experience working with cancer patients and survivors, that's an added plus. She also stressed that these outcomes may not extend to other types of yoga, such as yoga in a heated room or vigorous yoga that raises the heart rate.

You can read more about the different types of yoga at Yoga Journal.

When CURE posted the results on our Facebook page, we discovered that many patients and survivors have already tried the integrative therapy. Here's what a few of our Facebook friends had to say:

"Yoga has kept me moving during a year of surgery chemotherapy and rads. I have good mobility after a partial mastectomy. Pain persists but the gentle yoga approach has allowed me to move as I am able. I see the difference measured in months as I continue to build strength and regain flexibility. It also is very calming to an agitated mind. I suggest a well trained iyengar teacher and not just someone at a gym."--Wendy

"I practice yoga when my body allows me to. As anyone going through chemo knows ... some days it just isn't going to happen. For me, I have intense bone pain following each treatment ... as that begins to subside, I find yoga to be a wonderful retreat ... stretching my legs in various poses and my arms absolutely LOVE being in plank ... feeling strong after periods of such weakness. I find yoga also helps me settle into my body and to notice what is good in both body and mind. I can't practice the full practice that I did before chemo but I find any little bit that I CAN do is wonderful. Sometimes it's hard to be friends with a body that hurts you so much but yoga is a constant reminder that my body is indeed my friend."--Michelle

Do you use yoga either during or after cancer? Did you notice a difference in your sleep or fatigue or general quality of life?

We'd love to hear your personal story of how yoga has affected your cancer journey and what you think of the study!

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CATEGORIES [ ASCO2010 ]

ASCO & FDA partner to streamline expanded access process

BY ELIZABETH WHITTINGTON | JUNE 4, 2010

For many patients who have run out of treatment options, investigational drugs are usually seen as a last hope. While clinical trials are the best way for patients to get access to unapproved drugs, many are ineligible, leaving a little-known loophole called compassionate use.

In the past, physicians and their patients had to do a lot of legwork on their own to get access to unapproved drugs outside of a clinical trial, which is usually approved on a case-by-case basis between each patient and drug maker--a time-consuming and complicated process. But today, on the opening day of the largest cancer meeting in the world, the American Society of Clinical Oncology announced a partnership with the Food and Drug Administration that could help streamline the process.

Last year, the FDA updated its expanded access regulations, but "many physicians and most patients do not understand how to take advantage of unapproved therapies," said George W. Sledge, Jr., MD, ASCO's President-Elect, at today's press conference. Hopefully, the new resources developed by the two groups will help educate both patients and doctors on expanded access.

The set of resources, found at university.asco.org, can aid doctors, and ultimately patients, in requesting expanded access drugs. Although the resources are geared toward physicians, it also helps take some of the burden off of the patient to do much of the work themselves.

The resources include a process for requesting expanded access, explanation of the doctor's legal responsibility for treating patients with investigational drugs outside of a clinical trial, and templates that can help with requesting treatments from a drug manufacturer.

You can read more about expanded access in "Ethics of Access." The FDA also has information on expanded access at www.fda.gov.

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CATEGORIES [ NEWS, ASCO2010 ]

What's coming at ASCO

BY ELIZABETH WHITTINGTON | MAY 20, 2010

It's still two weeks from the start of the biggest oncology meeting of the year, but the ASCO (American Society of Clinical Oncology) commmittee has chosen six abstracts to be released to the public before the start of the meeting on June 4.

The abstracts included:

1) A study showed that a four-week gentle yoga program improved fatigue, sleep quality, and general quality of life in women cancer survivors. (Read "Yoga helps fatigue, sleep in cancer survivors.")

2) Two separate studies determined that maintenance treatment is useful in follicular lymphoma and myeloma. Maintenance treatment with Rituxan in follicular lymphoma reduces the risk of recurrence, while treatment with Revlimid delays disease progression in myeloma. (Read "Rituxan halves risk of lymphoma recurrence"; "Celgene's Revlimid positive in maintenance trials.")

3) Scientists found gene variants that increase the risk of heart failure with anthracyclines in childhood cancer patients. The finding could help physicians determine treatment strategies for patients and develop individual survivorship plans that screen for late effects of cardiac toxicity. (Read "Genes predict anthracyclines cardiotoxicity.")

4) A promising screening strategy to detect early-stage ovarian cancer was announced that includes annual CA-125 testing in post-menopausal women at average risk. (Read "New approach to old test may detect ovarian cancer.")

5) A study found that women who are 70 and older may not need radiation therapy after a diagnosis of early-stage breast cancer. (Read "Older patients can skip radiation: study.")

They'll be more news from the late-breaking abstracts and plenary sessions, which we will be reporting on from the meeting. We'll have four bloggers at the international conference, including Dr. Debu Tripathy, editor-in-chief, and publisher and cancer survivor, Sue McClure.

If you want more updates from ASCO, we'll be featuring the top stories in the Summer issue of CURE and in the ASCO edition of CURExtra. (If you're not yet receiving CURExtra, you can sign up at www.curetoday.com/newsletters).

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