Move Your Body, Move Your Spirit: Yoga and Cancer
Cancer patients are discovering that yoga offers both an accessible form of exercise and a path to mental clarity that is a welcome addition during and after treatment.
When Laura Kupperman, a yoga instructor in Boulder , Colorado , was diagnosed with breast cancer in 2003, she continued to practice yoga throughout her cancer treatment. “Instead of thinking ‘Cancer is going to get in the way of my yoga,’ I thought, ‘Yoga is going to help me get through my cancer,’” Kupperman says.
Kupperman used yoga as rehabilitation after her bilateral mastectomy, returning to her yoga practice as soon as her incisions healed. “During my first class, I could barely move. After only a few classes, my body was totally different,” she says.
When Kupperman returned to her doctor a few months later for a revision of her breast reconstruction, her doctor was impressed by the absence of scar tissue. “My doctor was so amazed and asked me what I had been doing. I can’t scientifically prove it, but I attribute it to my yoga practice,” Kupperman says.
Kupperman isn’t alone. More and more cancer patients are finding that yoga is a beneficial form of exercise both during and after treatment.
What is Yoga?
Yoga has been around for over 5,000 years, but has only recently entered the mainstream, as yoga classes have infiltrated the schedules of most fitness centers, edging out the aerobics classes of the 80s. Now, yoga is making the leap from fitness center to cancer center. According to information from Stanford University , approximately 25 percent of comprehensive cancer centers in the U.S. offer yoga. 
Yoga is a Sanskrit word meaning “union,” and though many people associate yoga with a series of strenuous postures that involve twisting into pretzel-like positions—which probably sounds very unappealing to the average cancer patient—those postures, or asanas, are only one small component of the practice. Though there are different interpretations of what elements are brought together in the union created in yoga—some view it as a union of the higher self and the lower self, or the individual consciousness and the Universal Consciousness—most interpret the practice as creating a union of the mind, body and spirit.
In the West, what most people simply refer to as “yoga” is in fact Hatha yoga. A combination of the words ha, which means sun, and tha, which means moon, Hatha yoga is often represented as the branch of yoga that brings union of opposites. Many different styles of yoga fall under the Hatha category, which promotes health and well-being and the unity of mind, body and spirit through three components: physical postures (asana), breathing practices (pranayama) and meditation (dhyana). Each of these components is an integral part of the practice.
When first introduced to yoga, many people assume that the practice consists solely of the physical asana postures. Howeve r, the ancient yogis considered these physical poses as simply a route to mental clarity. The physical postures and the breathing practices were a way to clear the mind for meditation and the ultimate goal, union.
For cancer patients, the breathing and meditative aspects of the practice can create much needed clarity and peace, while the poses themselves provide a beneficial form of exercise during treatment.
Yoga and Cancer
No one is going to claim that yoga will cure cancer; however, it may make cancer and its treatment more bearable, both physically and emotionally. Kupperman experienced firsthand the benefits of her yoga practice during cancer treatment. “I would go to my chemotherapy support group and all of the other women would complain about hot flashes and mood swings. I had so few side effects compared to the others. I kept thinking, ‘Why isn’t everyone doing this? Why am I doing so much better than everyone else?’”
Now that she has completed treatment, Kupperman teaches yoga to other cancer patients, hoping to provide them with an opportunity to live well during treatment. “I don’t want people to think that a cancer diagnosis means life has to stop,” she says.
Since yoga is far more than a simple asana practice, it has something to offer every cancer patient. “When you say yoga, some people think of standing on their heads, but it’s the non-physical aspects of yoga, such as breathing, that are fundamental to healing,” says Jnani Chapman, a Yoga Therapist at the Osher Center for Integrative Medicine in San Francisco .
Chapman has been teaching yoga to cancer patients for 20 years and advocates gentle yoga with a focus on breathing and imagery. Her work ranges from visiting patients in their hospital beds after surgery and working with them on breathing techniques to teaching classes that include physical asana work. “So much of my work in the beginning is to get people to reconceptualize their idea of yoga. When people understand what yoga is, then there is no time that a person can’t do yoga, even when they have cancer,” Chapman says.
Cancer or not, the benefits of yoga are well-documented. Practitioners of yoga report improvements in circulation, digestion, respiratory function, joint mobility, strength, endurance, balance and posture. Yoga can induce relaxation, improve sleep and relieve stress. Fueled by the proof of these welcome benefits of the practice, researchers are now starting to study the effects of yoga on cancer patients.
In a study at M.D. Anderson Cancer Center , patients participated in regular yoga classes that incorporated controlled breathing and visualization, mindfulness techniques and low-impact postures. The patients reported an improvement in their overall quality of sleep, including using fewer sleep medications, falling asleep faster and staying asleep longer. 
In another study, patients participating in regular yoga classes at the Stanford Cancer Supportive Care Program reported increased well-being, decreased stress, pain reduction and more restful sleep. 
But, Is It Safe?
What’s unique about yoga is that in our current go-go-go society, where more is better, yoga is quite the opposite. In yoga, students are encouraged to do only what feels good. Most yoga instructors coach students not to push too far. In fact, many yoga instructors seem to repeat the same mantra throughout classes: “If you can’t breathe, you shouldn’t be there.”
This makes it the optimal form of exercise for cancer patients who may be facing compromised mobility and overall health. It’s gentle, but it puts the body in motion.
Kupperman advises, “The bottom line is that patients and survivors should use common sense along with the input of a doctor and a yoga instructor to decide what is right for them.”
The beauty of yoga is that whether practiced at home or in a class full of people, it’s always practiced individually. Each posture can be as easy or as hard as you make it.
Yoga isn’t for everybody, but with the appropriate precautions, it can be performed safely both during and after treatment.
From Chemo to Yoga Class
For Marcia Dellacroce, it wasn’t a question of if she should practice yoga, it was a question of where and when. The Broomfield , Colorado , resident had been practicing Bikram yoga for about a year when she was diagnosed with breast cancer, seven years after having been declared free of the disease. Dellacroce underwent a lymph node dissection and then began chemotherapy. Her treatment couldn’t keep her down, though. She immediately started searching for a yoga class for cancer patients. “I was actively seeking someone because I had already discovered that yoga is incredible,” Dellacroce says.
Dellacroce attended weekly yoga classes throughout her chemotherapy treatment. “I guess I did feel kind of bad during that time now that I look back. But, I felt incredibly good after class. It felt like I had more energy. It improved my energy and improved my ability to relax. I would even come home and do some of it on my own during the week,” she says.
Not all patients feel as motivated to exercise during cancer treatment, but the benefits could be invaluable. Dellacroce says she never felt like the yoga class was too much. In fact, she felt it was integral to her rehabilitation. “The stretches were helpful, particularly in the arm area where the surgery was. Moving like that pulled and stretched a little bit in a safe kind of loving way that was terrific,” she says.
Stephanie Broschinsky, a cancer survivor from Vail, Colorado , found yoga after she completed treatment. “I was very reluctant at first because of my situation and I’m in my 60s. This is a big step. When you go in there and they’re all 23 years old with their little tattoos, it can be intimidating.”
Although she was reluctant at first, Broschinsky is now hooked. She says yoga has helped her cope with the unbelievable fatigue that followed her cancer treatment. Furthermore, it has boosted her self confidence. “I feel so good when I get home from yoga class. I would have never thought I could do this a year ago,” she says. “It’s the best thing that has happened to me since my cancer.”
Like many cancer patients, Broschinsky made her way to the yoga mat in search of physical exercise and found much more.
Beyond Exercise: Practicing Peace
More often than not, the mental and emotional benefits of yoga outweigh the physical benefits. Cancer patients looking for relief from anxiety and fear may find the peace they’re seeking in a simple yoga practice.
Yoga is referred to as a practice because it is ever-evolving for each individual. No one ever masters yoga. In fact, some yogis believe that yoga is more than a practice, that it is a philosophy or a way of life. One of the fundamental principles of the yogic philosophy is ahimsa, which translates as peacefulness in thought, deed and action toward other human beings, all living creatures and, most importantly, toward ourselves.
Many cancer patients struggle to find this sense of peace toward self as they battle a disease that has taken over their body. Cancer can often cause a unique sense of separation between self and body, as patients “fight” their cancer, often forgetting that the cancer is a part of them and grew out of their own cells. Ironically, they are fighting themselves. Yoga is a way to bridge this gap, to ease this sense of separation and to embrace the whole self.
Yoga is available to all cancer patients, regardless of physical constraints. Cancer patients who lack mobility may still find comfort through the breathing and meditation practices.
Breathing practice, also known as pranayma, is fundamental to yoga. In yoga, the breath is considered the source of life force or prana in the body. The purpose of breathing practice is to promote proper breathing, thereby oxygenating the blood and brain and controlling the prana. Breathing practice revitalizes the body and induces a state of relaxation.
Different styles of yoga rely on different breathing techniques, but they all have one thing in common: breathing. It sounds simple, but often it isn’t.
“We take breathing for granted,” says Chapman. “Most of us in this culture are shallow breathers, non-breathers or reverse breathers. So much of what I do is getting people conscious about the physiological aspect of the breath. If you distill yoga down to its most important aspect, it’s the breath. The breath is a bridge between the invisible world and the physical world.”
Newcomers to yoga will be surprised to find that the challenge is not necessarily in the bending, twisting postures; more often, it’s in the breath.
“I think the breathing is the hardest part of yoga,” says Broschinsky. “Nobody knows how to breathe. It’s very hard for me. I have to force myself to lie down and breathe deep into my stomach because I forget to do that.”
Broschinsky isn’t alone. Modern Western culture has unknowingly shifted from nasal breathing to mouth breathing. Nasal breathing activates the parasympathetic nervous system, thereb y promoting a sense of calm and peace, whereas mouth breathing is connected to the sympathetic nervous system, triggering stress and agitation. Babies are born knowing how to breathe properly, but over time this breathing becomes habitually modified.
The breath is as vital to the body as food and water. Regulating the breathing process helps ensure full nourishment from the breath and opens a channel to a state of peace.
Chapman works with cancer patients to breathe, relax and train the mind. She says that distracting and redirecting the mind can be helpful to cancer patients dealing with physical and emotional pain.
“Breathing is very important. Many breast cancer survivors become very rounded and hunched over, very chest-protective. Breathing really helps to open up the chest. It helps to relieve some of the tension, which is physical, but also emotional,” Kupperman says.
You and Your Mat: Create Your Own Reality
Of course, the ancient yogis would say that the ultimate purpose of the physical postures and the breathing practice involved in yoga is to clear the mind and enter a meditative state.
Chapman teaches her students relaxation and imagery techniques to learn to discipline and control the mind, leading it toward a quiet, clear place. “We create such an adversarial relationship between the body and the mind. The body says, ‘I’m tired’ and the mind says, ‘Okay, I’ll pump you full of coffee so you can keep going.’ I teach techniques that allow the mind to take a backseat and let the body run the show so that the body’s own healing can take place,” she says.
While completely clearing the mind is nearly impos sible, techniques like those that Chapman teaches can help patients quiet their minds and can provide a healthy escape from all things cancer. “When you practice yoga, you have to be focused and clear, so I didn’t have to think about my cancer during yoga. It was a relief to have a break and be away from all of that,” Kupperman says.
Both Kupperman and Chapman integrate breathing, meditation and restorative postures into their classes. Sometimes a student simply needs to be propped up with pillows and allowed to enter a state of relaxation that is inaccessible throughout the rest of their day.
By taking to their mats, cancer patients can replenish their energy, rather than spend it, and can find that quiet place inside to uncover what was there all along: peace.
Off the Mat
Ideally, the benefits of yoga won’t be limited to the time on the mat, but will carry over into everyday life.
“To me, the yoga class was kind of a lifeline. I felt like if I could do that, then I would be okay. I discovered that I still had some energy that I didn’t know I had,” Dellacroce says.
What’s more, at a yoga class, cancer patients will find a sense of camaraderie and support. “It’s a place to interact with other survivors in a positive setting,” Kupperman says.
Dellacroce agrees. “I could walk in and I didn’t have to wear my little cap that I wore everywhere else because hair was definitely not in the majority in this class. There’s just this instantaneous sense of support. People are really interested in how everyone else is doing,” she says.
Cancer is a life-changing event that no one would intentionally choose; however, cancer doesn’t necessarily mean that life has to stop. Yoga is one way to set cancer patients in motion, both on and off the mat, during and after cancer.
Perhaps the greatest testament to the benefits of yoga is that most cancer patients say that once they’ve left cancer behind, they’ll continue to practice yoga. “I’m a real late starter, but I’m going to keep it up,” Broschinsky says. “I hope I’m this old, wrinkled lady still doing it. That’s my goal. I want to do this the rest of my life.”
 Stanford Cancer Center. Available at: http://cancer.stanfordhospital.com/healthInfo/alternativeTherapy/yoga/Accessed July 12, 2005.
 Cohen L, Warneke C, Fouladi RT, et al. Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer. 2004; 100: 2253-2260.
 Rosenbaum E, Gautier H, Fobair P, et al. Cancer supportive care, improving the quality of life for cancer patients. A program evaluation report. Support Care Cancer. 2004 May;12(5):293-301.