Men who undergo radiotherapy for treatment of prostate cancer are at risk for several side effects, including fatigue, erectile dysfunction (ED), and urinary incontinence (UI). Experiencing these effects can have a negative impact on quality of life, leading to social isolation, depression, or anxiety. Oncologists don’t have a lot to offer their patients to counter these side effects, but a study recently published in the International Journal of Radiation Oncology, Biology, Physics found that men with prostate cancer who participated in a yoga program while undergoing radiotherapy experienced a decreased severity of these side effects than men who did not follow a yoga program.1
Researchers from the University of Pennsylvania in Philadelphia and Johns Hopkins University in Baltimore designed a randomized phase II trial to measure the potential therapeutic effects of yoga on fatigue, ED, UI, and overall quality of life in patients with prostate cancer who were receiving external beam radiation therapy. Patients were randomized to a yoga group (twice weekly yoga sessions, offered over 6 to 9 weeks of radiotherapy) or a no yoga group.
The yoga sessions lasted 75 minutes. They included breathing and centering techniques, and yoga positioning incorporating sitting, standing, and reclining positions. The positions were tailored to each participant’s ability or restrictions. Two to 3 weeks before starting radiotherapy, all men in both groups filled out a nine-item questionnaire assessing fatigue severity and its impact on daily life. The questionnaire was repeated twice a week during the course of radiotherapy and a final survey was completed within a week of their last yoga class or last radiation treatment, depending on the group.
The primary endpoint of the study was level and quality of fatigue; secondary endpoints were the presence of ED and UI, as well as quality-of-life time points before, during, and after radiotherapy. Sixty-eight patients started in the study; 18 withdrew early, most often due to treatment schedule-related time constraints, leaving 22 men in the yoga group and 28 in the no yoga group.
“At their baseline, before patients started treatment, patients in both groups were on the lower end of the scale, meaning they reported lower amounts of fatigue,” lead investigator Neha Vapiwala, MD, said in a release. “But as treatment went on, we observed a difference in the two groups.” Vapiwala is an associate professor of radiation oncology at the University of Pennsylvania.2
The results showed throughout treatment, the men who participated in the yoga program reported less fatigue than those in the control arm. In fact, the men in the control arm reported more fatigue as treatment progressed. The men in the yoga group also reported significant improvements in sexual health scores and urinary incontinence.
“Yoga is known to strengthen pelvic floor muscles, which is one of several postulated theories that may explain why this group did not demonstrate declining scores, as seen in the control group,” Vapiwala said. Vapiwala pointed out that the findings on improved or stable urinary function are consistent with other research on the effects of physical therapy on pelvic floor muscles.
The researchers concluded that men with prostate cancer who participated in a program of structured yoga intervention twice-weekly classes during their course of radiotherapy experienced significant reductions in pre-existing and radiotherapy-related fatigue, urinary, and sexual dysfunction.
- Ben-Josef AM, Chen J, Wileyto P, et al. Impact of Eischens Yoga During Radiation Therapy on Prostate Cancer Patient Symptoms and Quality of Life: A Randomized Phase II Trial. International Journal of Radiation Oncology, Biology, Physics. 2017 Mar 31.
- Penn Medicine News. Clinical Trial Shows Benefit of Yoga for Side Effects of Prostate Cancer Treatment. 2017 Apr 6.