P3-08-01: Effects of an Integrated Yoga Program on Mood States, Distress, Quality of Life, Diurnal Cortisol Rhythms and Natural Killer Cell Counts in Metastatic Breast Cancer Survivors.

Abstract

Abstract Background and objectives: Metastatic breast cancer patients experience tremendous psychological distress due to treatment, disease and uncertainty of their survival. In this study we evaluated the effects of an integrated yoga program versus supportive counseling in advanced breast cancer survivors. Methods: Ninety one Metastatic breast cancer survivors (group mean age 50.54 yrs ± 8.53 yrs) registered in hospital based cancer registry were recruited if they satisfied selection criteria and gave written consent for participation in the study. The study was approved by the institutional review board. Subjects were randomized to either receive yoga intervention (n=45) or supportive therapy (n=46) counseling as a standard of care for 3 months of intervention period. Subjects were assessed at baseline and after intervention for mood states using hospital anxiety and depression scale, sleep quality using Pittsburg Insomnia rating scale, quality of life using EORTC Qol C30 for breast and perceived stress using perceived stress scale. Saliva samples were collected for three consecutive days at 0600hrs, 0900hrs and 2100hrs before and after intervention for cortisol rhythms using Enzyme Immune Assay kits from Salimetrics and blood samples were collected between 0800hrs to 01000hrs for NK cell enumeration using flow cytometry. 35 subjects in yoga and 31 subjects in controls completed the post measures. Data were analyzed using both parametric (ANCOVA with respective baseline measure as a covariate) and non parametric tests (Mann whitney U test) to evaluate effects of intervention on the above outcome measures. Data for salivary cortisol data was log transformed, area under the curve and cortisol slope computed using linear mixed effects model. Results: There was a significant decrease in anxiety (p < 0.001), depression (p < 0.001), perceived stress (p = 0.01), fatigue severity (p < 0.001) and interference (p < 0.001) in yoga group compared to controls post intervention. There was a significant improvement in emotional function (p < 0.001), role function (p = 0.03) and cognitive function (p < 0.001) and global quality of life (p < 0.001) in yoga group compared to controls. There was significant decrease in 0600 hrs cortisol within the yoga group (p =0.03) alone. There was a significant increase in Natural killer cell percent in yoga group (p =0.03) compared to controls after intervention. Conclusion: The results suggest biobehavioral effects of yoga intervention could possibly improve quality of life, reduce psychological distress and modulate abnormal cortisol profiles and immune responses in metastatic breast cancer patients. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-08-01.