Tell your students that yoga will enable them to maintain positivity, and allow them to deal with what comes up without fear.” Annette Loudon shares her insights from teaching yoga to women in various stages of breast cancer.
Satyasankalpa (Satya) is once again dealing with the issue of breast cancer, 17 years after her initial diagnosis, this time in the form of an aggressive secondary breast cancer. Before this episode of her illness she talked to me about how she had dealt with her initial breast cancer through yoga, knowing that this was a field of yoga in which I specialise. I had just completed giving her a Yoga Nidra (deep relaxation), and asked her how her yoga practices were helping her now. Her answer humbled me and reminded me of the very great privilege I have had in watching this dedicated and spiritual aspirant of yoga handle, through meditation, relaxation, chanting and other yoga practices, the invasion of her body. Her palliative care has been drug- free.
Most of us will not use yoga to the same extent as Satya in dealing with breast cancer. However, her words confirm a great amount of research that has shown the many benefits of yoga. For example:
• Research conducted by the Vivekenanda Yoga Research Foundation in India has shown that yoga practices of breathing, chanting, visualisation and meditation have notably lessened the degree of anxiety and depression that women can experience from diagnosis and through treatment of breast cancer (2009 Rao et al).
• Other research shows the lessening of nausea from chemotherapy experienced by women who did a daily integratedyoga program while receiving chemotherapy (2007 Raghavendra et al).
• In America, research conducted at the M.D. Anderson Cancer Centre in Texas has shown that women experienced a greater sense of well-being from a twice-weekly yoga practice based on breathing, relaxation and gentle movements, during the time of their radiation treatment (2006 Cohen et al).
• A study at the Ohio State University found that daily relaxation reduced the risk of breast cancer recurrence (2009 Sydney Morning Herald).
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So, why yoga?
Take a moment to think of someone you know who has ever been diagnosed with breast cancer … take a few minutes to recall the emotions they experienced, from diagnosis, through treatment and recovery. Reflect also on the changes to their life, including relationships that they went through. Now remember the actual physical effects they experienced.
I’m sure you will recall emotions such as shock, disbelief, grief, confusion giving way to their very strong will to survive. You may have also remembered how important hope and love were for them, from which their amazing resilience and courage continues to grow. I am certain you will have remembered how their usual routines had to change for a while, and how their relationships were affected. Perhaps the physical effects they endured, that seemed so unrelenting, were the easiest to recall. In other words, the effect of this illness occurs on many levels including the personal, inter-personal and physical.
The effects of Yoga
Yoga offers a means to work on ourselves on all these levels in a way that respects and honours whatever state our body is in.
The breath can change an agitated mind and tense body to a calm mind and relaxed body. Pranayama (the use of breath or prana) can balance the nervous system. “Witnessing practices” can enable awareness of what is happening in the present, without being drawn into fear or other negative emotions. Chanting can change a negative mind to a positive mind. Gentle then gradually stronger yoga postures and movements with the breath restores a sense of body and health and brings about a sense of recovery. In time, the progression of postures (asana) rebuilds strength and vitality in a way suited to each individual.
At every stage, meditation allows self-defeating thought patterns to change. As fear and negative thought patterns subside meditation enables a reconnection with that deep inner sense of constant and pure self that is always present, no matter what else is happening in people’s lives. From this they are able to face uncertainties and life changes that dealing with breast cancer brings, knowing that their integrity is still intact.
The yoga principles known as the Yamas (precepts which help people relate to the outside world with equanimity) and the Niyamas (precepts to help people relate to their inner world) can also be beneficial.
My students have also told me that visualisation helps them to see the cancer cells being destroyed. The deep relaxation of yoga gives them rest, when fatigue overtakes them or they are unable to sleep at night.
An example of a precept which helps us deal with the outside world at this time is the principle made famous by Gandhi i.e. non-violence, or “ahimsa” as it is written in Sanskrit. In times of illness, we need to remember to not be violent to ourselves. Many women have told me that, in the days after diagnosis and while receiving treatment, they could only cope with talking to very few family and friends in order to maintain and conserve their sense of dignity, positivity and energy. Purity or Shaucha is a Niyama, a way to look after oneself. It may be practised physically, perhaps by drinking lots of water or eating healthily to purify the inner body. Mentally and emotionally, it may be by having a refuge we can go to, to replenish and purify our mind.
As a teacher of yoga
I have being teaching women who have had or are having treatment for breast cancer for the past fourteen years. During this time my learning curve has grown enormously. As well as learning about the nature of breast cancer, I have had to understand the effects of the different treatments, which are many and varied. Similarly, as a teacher, it is essential to know the effects of secondary breast cancer. Postures will change depending upon if the secondary is in the spine or the liver. The effects of lymphoedema in the arm or chest, that can affect women is another parameter that needs to be considered.
Yet, as with all yoga, it is possible to work with each woman independently to create a yoga practice that is suitable for her, while she is dealing with breast cancer. The woman’s age and type of breast cancer vary and so students include new and young mothers, through to older women. Women of all nationalities and backgrounds, including indigenous women, can be diagnosed with breast cancer. It is currently the most common cancer affecting women in Australia (2008 NBOCC). The good news however is that women are surviving longer and more and more research is being conducted for the prevention, treatment and survival of breast cancer, including in the field of yoga.
Some students will continue their most appropriate practices of yoga from the moment of diagnosis, as with Satya. Other students may be totally new to yoga and commence when their treatment is complete. Stephanie was one of the latter. Her comments were as follows:
“Sue proposed that I join a yoga group that was held in our suburb. I was a bit sceptical as I had just finished my treatment on the previous Friday. But, with some encouragement, she came by and collected me on the following Monday and I commenced my recovery program through yoga. I tried to go twice a week. Little by little my aches and pains left. Also, I slept so well after each yoga session. Now ten years after my treatment for breast cancer, I still attend yoga, even though my husband’s job moved us to Paris! It has changed the way I think – I take each moment one at a time and ‘take time to smell the roses’ now.”
Other students will not have known they had a primary breast cancer, and be treated for secondary breast cancer. So, they will attend yoga lessons while having treatment for the rest of their lives. Sue is one such inspirational woman. Courage is a quality she abounds in, and interestingly this transfers to her favourite posture being the yoga posture about courage – the Warrior Posture (Virabhadrasana). She told me: “The warrior position is two-fold to me. Firstly, I have this overwhelming feeling of peace and being ‘at one with myself’. Then I have a feeling of empowerment where nothing is going to defeat me. I imagine this is what the Warrior Pose was meant to do originally! Surprisingly, I am at peace with my cancer, I do not consider it the enemy as it is part of me and it has in many ways made me a more tolerant, compassionate and giving person. Our lives change for all sorts of reasons. I feel ultimately for the better because of my experiences. Acceptance of what I have not been able to change has made me stronger – physically, spiritually and psychologically.”
For me personally, the benefits I have seen from yoga in the women I have taught and the increasing body of research showing positive outcomes, are proof that this ancient system will continue to be of use to all women who have been diagnosed with breast cancer.
[ It is with my hearfelt gratitude that I acknowledge the inclusion in this brief article of the words of Satyasankalpa, Stephanie and Sue. Each has given her permission for her words to be included, always in the hope of helping someone else who is undergoing what they have had to face. You are my heroines. Annette Loudon]
• Cohen L., Chandwani K.D., Thornton B. et al., (2006) Randomized trial of yoga in women with breast cancer undergoing radiation treatment (2006 ASCO Annual Meeting Proceedings) Journal of Clinical Oncology 24(suppl June20):8505
• National Breast and Ovarian Cancer Centre (NBOCC) (2008) Guide for women with early breast cancer. NBOCC, Surry Hills, NSW
• Rao R.M., Raghuram N., Nagendra H.R. et al., (2009) Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial. Complementary Therapies in Medicine 17(1):1-8
• Raghavendra R.M., Nagarathna R., Nagendra H.R. et al. (2007) Effects of an integrated yoga program on chemotherapy-induced nausea and emesis in breast cancer patients. European Journal of Cancer Care 16(6):462-74
• Stephens A., (2009) Relax. It’s good for you. Sydney Morning Herald (Life and Style) August 20.