The side effects of beam radiation therapy for prostate cancer are legendary. A whole suite of urinary, fatigue and sexual problems await men during the course of their treatment. Up until recently, most care givers and patients just viewed this as the cost of doing business with radiation therapy. Lately, however, more study and research is being thrown at maintaining patients’ quality of life during radiation treatment, and the new science has found an ally in the ancient discipline of yoga.
A clinical trial conducted by the Perelman School of Medicine at the University of Pennsylvania determined that twice-weekly yoga sessions could not only relieve fatigue (long regarded as a yoga benefit) but improve sexual and urinary functions in prostate cancer patients as well.
The test subjects were selected from among patients who had undergone between six and nine weeks of external beam radiation therapy for prostate cancer. The men were divided into two groups: one that met for yoga twice a week, the other a non-stretching control group.
The principal focus of the trial was on fatigue. Patients completed a nine-item questionnaire that spoke to the severity of their fatigue and its impact on their daily life.
"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," said the trial's principal investigator Neha Vapiwala, MD, an associate professor of Radiation Oncology. "But as treatment went on, we observed a difference in the two groups."
The more yoga sessions patients in the yoga group attended, the lower fatigue scores they reported, working to counter the normal increase in fatigue beam radiation treatment patients have come to anticipate.
"Levels of patient-reported fatigue are expected to increase by around the fourth or fifth week of a typical treatment course, but that did not happen in the yoga group," Vapiwala said. "Both the severity of the fatigue as well as the patients' ability to go about their normal lives appeared to be positively impacted in the yoga group."
Sexual dysfunction is another common complaint among radiation therapy patients – it is reported in 85 percent of the cases. It’s a situation made even worse for many because of the additional androgen deprivation therapy they undergo concurrently. But here, too, the yoga group had an edge.
"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. "That may also explain the yoga patients' improved urinary function scores, another finding of this trial." 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.
Perhaps less tangible but still meaningful, the researchers learned that the “emotional well-being” of the yoga group rose more rapidly than in the control group during the course of the trial.
The research has been published in the International Journal of Radiation Oncology, Biology, and Physics.