Nancy Scholberg (front) regularly does yoga to help her deal with lingering effects from a double mastectomy 11 years ago. She is shown in Dallas during a yoga class.

By Leslie Barker

Dr Jaya Juturi prescribes plenty of medications for her cancer patients, but she would be remiss, she says, if she stopped there. Which is why the Dallas oncologist also suggests a treatment not found in any pharmacy: yoga.
“We’re supposed to practice a certain way and tell people what’s proven to help them,” says Juturi, who is on the medical staff at Texas Health Presbyterian Hospital Dallas. “If we didn’t bring up yoga in the context of emotional or physical distress, we’re not doing our job.
“If we said, ‘See a counsellor and take medicine,’ that might be meaningful, but we need to create an empowering long-term strategy that will bring them everlasting results.”
The medical field has been “late in catching on to” such complementary treatments, Juturi says. Now data has begun backing up the effectiveness of yoga, and doctors, she says, “are all about data.”
Medically proven benefits include these:
Yoga helps ease stress: Research from the University of Texas MD Anderson Cancer Center showed, among other benefits, yoga’s ability to regulate the stress hormone cortisol.
Yoga helps cancer patients sleep better: A study published in Journal of Clinical Oncology reported improved sleep quality in cancer survivors and thus, fewer sleep medications needed.
Yoga can help improve quality of life: On its website, the Stanford Cancer Center reports that yoga “as a complementary therapy” has also been shown to relieve various symptoms associated with cancer.
Nancy Scholberg can attest to that. A dozen years after her double mastectomy, followed by chemotherapy and breast reconstruction, the Dallas woman relies on yoga to keep at bay the side effects no one told her about. “You go through this stuff, and a lot of times the side effects don’t hit till years later,” says Scholberg, 54.
Her toes tingle almost constantly. She doesn’t have a lot of use of her thumbs. Physicians constructed her breasts from muscles in her back, leading to “so much scar tissue and so little movement,” says Scholberg, an avid runner and walker. “Yoga helped with stretching and making me feel so much better.”
Her one regret? That she didn’t practice yoga while undergoing treatment. No one thought about it then, she says.
“Yoga is all about mind, spirit and body. When you’re going through chemo, it’s such a traumatic time. Your body changes. You lose your hair. What yoga does is bring me to a place of peacefulness a person going through that needs.”
Plus, yoga helps patients deal with the stress of recurrence, Juturi says.
At Dallas Yoga Center, owner and director David Sunshine says clients at all stages of cancer ask about yoga.
“I tend to tell people that yoga doesn’t necessarily heal cancer, but it is scientifically proven to help in many ways getting through the process of recovery,” Sunshine says. “It’s about making the body a safe place to feel comfortable and return home to, so one is able to soften and relax and let go of a lot of the stressors and feel normal once again.”
Peace of mind is the first phrase that comes to mind when Jenny Parum, Scholberg’s instructor and owner of the newly opened Yoga Movement studio, names the benefits of yoga for people dealing with cancer.
“It’s the mental aspect,” Parum says, “the healing that’s necessary in the mind. The focus and the release are the main aspects. You have to nurture yourself on a completely different level.”
She credits yoga with turning her own life around after her doctors diagnosed rheumatoid arthritis at age 19, so she understands its transformative power. Cancer is a fearful time for people, she says. Yoga is all about “getting them to a place where they feel sure of themselves, developing internal strength, keeping their bodies active and moving.”
Scholberg, who stopped running marathons after undergoing knee surgery, decided to try yoga when her company offered classes twice a week.
“Because of my mentality, I really like the physical challenges,” she says. “It’s still hard for me, and I’ve been doing it almost four years.”
Parum has taught her to modify certain poses that she either can’t do or are too painful because of her chemotherapy. Some days, for instance, her fingers and hands hurt.
“So instead of spreading them on the mat, I put them in a fist. Jenny knows the limitations I have, and if something is hard for me, she’ll remind me, ‘Do it this way.’”
The breathing and meditation inherent to yoga help strengthen muscles, says Bonnie Lucio. She’s a rehab supervisor and physical therapist for Baylor’s rehabilitation outpatient oncology clinic, which has free yoga classes for cancer patients three Fridays a month.
“Yoga can help alleviate symptoms of pain, insomnia, fatigue,” says Lucio, who recommends it to all her patients. “Cancer-related fatigue is really big. Yoga is also good for flexibility and balance, plus it helps psychological health and reduces anxiety and depression.”
It helps people escape from what they’re dealing with, says Leslie Storms. The registered nurse, yoga instructor and former family therapist used to teach a yoga class in Plano, Texas, to cancer survivors, their families and caregivers.
“For a moment, they’re focusing and thinking about something that’s not the illness,” Storms says. “It’s a moment of freedom from the mind, from their ‘oh-I’m-sick’ story and getting to focus on their breathing and their intention. To me, that’s the sweetness of someone struggling with that.”
Yoga is empowering, she says, a notion that comes up frequently with those who work with yoga practitioners who have cancer. “It’s seeing how people can overcome limitations of the mind and what their doctor told them, limitations of what society tells them and what their illness tells them.”
Jennifer Trimmer, 51, credits various aspects of yoga with helping her deal with her breast cancer — the diagnosis, the lumpectomy and the radiation she had almost eight years ago.
“It’s the Zen experience you have in the class, the camaraderie, the community you have with fellow yogis,” she says. “The breathing techniques taught me to step back and look at it as what it really is. There’s so much more to life than whatever is causing stress.”
Juturi, who takes various yoga classes herself, says people don’t leave those feelings on the mat after class or their yoga tape ends. “It takes them from the mode of ‘I’m very vulnerable; I have cancer,’ to ‘I feel empowered; this is what I can do.’” — The Dallas Morning News/MCT

Ready to start?

If you have cancer and want to try yoga, here are some suggestions from the experts.
Consider yoga a complementary therapy, used in addition to medications.
Get medical approval, says Dr Jaya Juturi. Your doctor can tell you what precautions to take.
Ask around about finding a class. Juturi tends to recommend those that are more about poses than cardio workouts. “I’m not saying that’s bad,” she says, “but we’re doing it for the mind, body and spiritual benefits.” The hospital or clinic where you’re treated may offer some.
Tell your instructor you have cancer, says David Sunshine of Dallas Yoga Center. “That way, the teacher can adapt accordingly and give proper variations.”

Exercise works as well as drugs for some ailments

Exercise might work just as well or better than drugs for people with coronary heart disease or recovering from a stroke, according to a review of evidence published recently.
The scientists looked at the outcomes of 305 previous trials with 339,274 participants to try to determine whether physical activity was as effective as drugs at preventing death among people with four conditions: coronary heart disease, rehabilitation from stroke, treatment for heart failure and prevention of diabetes.
There was no difference between exercise and drug interventions for the people with coronary heart disease and for the prevention of diabetes. Exercise was more effective than drugs for recovery from stroke. And drugs, specifically diuretics, were more effective for treatment of heart failure.
Exercise should be considered as “viable alternative to, or alongside, drug therapy,” the researchers said.
The exercise in the research generally took place in structured rehabilitation programmes to which patients had been referred by their doctors, said Huseyin Naci, an author of the study who is a fellow at the Harvard Medical School and a researcher at the London School of Economics. The patient’s condition would vary, he said, adding that for people with a prediabetic condition, an exercise programme might be more informal.
Naci added in the interview: “The results of our study by no means imply that people should stop taking their medications, especially without consulting their doctors.”
Research is lacking on the potential for exercise to prevent death as compared with drugs, the researchers wrote. Still, they said their “analysis suggests that exercise potential had similar effectiveness to drug interventions with two exceptions. In the case of stroke rehabilitation, exercise seemed to be more effective than drug interventions. In heart failure, diuretics outperformed all comparators, including exercise.”
They called the lack of medical literature a “blind spot” that leaves doctors without evidence of when drugs or exercise or a combination is the best choice.
They called for additional research and noted that their study is limited by the scarcity of studies on exercise interventions and by any limitations of the studies they used.
They were inspired by the well-documented benefits of exercise, including improved health and less likelihood of such things as needing hospitalisation. Also, only a third of adults in England meet the recommended levels of physical activity, but drug prescription rates are on the rise, with the average person there having an average of 17.7 prescriptions in 2010.
A survey released by Kaiser Permanente about walking in the United States found that almost everyone knows it’s good to do. But nearly 80% said they should walk more.
The researchers were from the London School of Economics, Harvard Medical School and Harvard Pilgrim Health Care Institute, and Stanford University. Their work was published in the British Medical Journal. — By Mary MacVean/Los Angeles Times/MCT

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