Grant R15CA169994

A Pilot Study of Yoga for Breathing and Quality of Life of Lung Cancer Patients

DESCRIPTION (provided by applicant): Lung cancer, the leading cause of cancer mortality worldwide, affects almost 400,000 individuals in the United States, and has devastating effects on physical and psychological health which compromise overall quality of life (QOL). Although the 5-year survival rate has slowly increased for non-small cell lung cancer (NSCLC) patients, excessive symptom burden due to stage at diagnosis, cancer treatment, and concurrent co-morbidity remain extremely prevalent. Fear and anxiety is further intensified due to respiratory compromise, increasing stress, and impairing sleep and mood. Hence, there is a critical need for evidenced-based adjunctive therapies such as yoga for symptom management. This two-group randomized controlled study (N=60) aims to (1) Identify the effects of a standardized12-week yoga intervention on breathing, specifically spirometry values, respiratory rate, reported dyspnea intensity and discomfort, oxygenation, and breathing awareness of Stage I-IIIa NSCLC patients as compared with a health education group;and (2) Evaluate effects of a standardized 12- week yoga intervention on reported stress, mood, sleep and quality of life of Stage I-IIIa NSCLC patients as compared with a health education group. A sample of Stage I-IIIa NSCLC patients (N=60) who have undergone surgical intervention will be recruited at two National Cancer Institute Comprehensive Cancer Centers (lung clinics). Patients with bone metastasis, cognitive impairment, severe respiratory problems and/or receiving radiation will be excluded. Estimated 3-4 patients per month will be enrolled over a two-year period. Participants will be randomized to the intervention or control condition, defined as 12-weeks of a 45 minute yoga class (YG), or Health education (Health Ed) session once per week, respectively. Content for the Health Ed group has been delineated and includes topics such as nutrition and cancer, vitamins, supplements and herbs during treatment, survivorship and caregiver issues etc. which will be provided by a trained research assistant. Yoga classes will be provided by trained yoga teachers who have been oriented to our standardized yoga protocol (tested in previous pilot study);YG participants will receive Yoga Manuals to guide home practice. Outcome variables and related measures include: Breathing (spirometry, pulse oximetry, dyspnea, respiration rate, 6-Minute Walk test);oxygenation (pulse oximetry;heart rate);stress (Perceived Stress Scale;diurnal salivary cortisol);mood (Profile of Mood States-Brief);sleep (Pittsburgh Sleep Quality Index;Actigraphy);QOL (Functional Assessment of Cancer Treatment-Lung). Participants will also complete self report logs on yoga home practice (Intervention group), and breathing awareness (Intervention and control). Measures will be obtained at Baseline, and at three, six, nine and/or twelve-week intervals (depending on the measure), and at three follow-up time points (one, three and six months) post intervention.