Guidelines for teaching yoga to women with breast cancer-related lymphoedema: an evidence-based approach

Abstract

Breast cancer-related lymphoedema (BCRL) is a chronic condition that requires lifelong management to prevent the condition worsening and to reduce the threat of infection. Women are affected in all domains of their life. As a holistic practice, yoga may be of benefit by reducing both the physical and psychosocial effects of lymphoedema. Women with BCRL are attending yoga classes in increasing numbers, so it is essential that yoga be based on principles that ensure lymphoedema is controlled and not exacerbated. Two Randomised Controlled Trials with a yoga intervention have had positive results after an 8-week intervention (n=28) and 6-months after a 4-week intervention (n=18). The first study had several significant results and women reported increased biopsychosocial improvements. Both studies showed trends to improved lymphoedema status. The yoga interventions compromised breathing, physical postures, meditation and relaxation practices based on Satyananda Yoga®, with modifications to promote lymphatic drainage and following principles of best current care for those with BCRL. Individual needs were considered. The yoga protocol that was used in the 8-week trial is presented. Our aim is to provide principles for yoga teachers/therapists working with this clientele that can be adapted to other yoga styles. Further, these principles may provide a basis for the development of yoga programs for people with secondary lymphoedema in other areas of their body as the population requiring cancer treatment continues to increase. Whilst the style of yoga presented here has had positive outcomes, further application and research is needed to fully demonstrate its effectiveness.