Indiana University Health Simon Cancer Center yoga program eases stress associated with diagnosis, treatment

Yoga therapy is an integrative medicine technique that supplements the traditional treatment regimens patients with cancer undergo.

A patient’s quality of life may be enhanced with yoga therapy through the promotion of healing and recovery measures designed to decrease the stress, anxiety and physical discomfort that often accompany cancer treatment.

Natasha Young

Natasha Young

The CompleteLife program at Indiana University Health Simon Cancer Center offers complementary therapies and patient support programs for adults with cancer and their family members. With a focus on the holistic approach to treatment, the CompleteLife program aims to treat the patient as a whole as opposed to just treating their disease.

HemOnc Today spoke with Natasha Young, project coordinator of the IU Health CompleteLife Program, and Stella Snyder, an oncology-trained yoga therapist, about the benefits of yoga therapy and the effect it has on patients’ well-being.

Question: How did the program come about?

Young: Our yoga services are a part of our overall CompleteLife program, which was founded in the late 1990s by Larry D. Cripe, MD. The program started off providing art and music therapy. As time went on, we added more programs. IU Health understands the need for integrative therapy options for patients and their families in addition to top-of-line medical care. Yoga therapy is offered to outpatients in collaboration with Little Red Door Cancer Agency in Indianapolis. Family members of patients and IU Health team members also like to participate. We recently started inpatient yoga services for patients with cancer, as well as other chronic conditions that require long hospital stays. We also offer yoga therapy groups for patients and staff and hope to continue to offer these groups as our program grows.

Q: What is the mission of the program?

Young: CompleteLife is a complementary therapies program that attends to the physical, emotional, spiritual and social needs of our patients and their families when they need it the most. Facing cancer is stressful and can cause anxiety, which can interfere with the healing process. We strive to ease that anxiety through patient education, creative art therapy and support groups provided by trained art and music therapists, social workers, and yoga and massage therapists. All of the programs and services provided by CompleteLife are free to our patients to help them cope with their health situations and confront their diagnosis and treatments.

Q: Can you describe the effect that yoga has on patients with cancer?

Snyder: The obvious effects include relieving stress and managing side effects of cancer and cancer treatment, but overall, yoga helps patients regain a sense of control. Patients with cancer often become the passive object of treatments, appointments, decisions by their doctors and so on. Yoga offers tools they can use to reacquire some feeling of control over their healing process, and they can use the practices to find relief from anxiety, depression and other psychosocial issues, or relief from pain, fatigue and other physical issues. Through practicing awareness, they become more aware of poor habits, such as unhealthy eating, negative thought patterns and aberrations of the breath, and they naturally begin to change these unhealthy patterns on their own. It is amazing how transformative yoga can be, and how much easier making healthy changes can come to a person through simply practicing awareness. The patient also receives support from their fellow yoga students because our classes begin to form a little community. Simply put, a yoga practice can improve a patient’s quality of life throughout their treatment.

Q: What research about the effect yoga has on cancer have you found particularly compelling?

Snyder: I am always surprised at how little research has been done about yoga for cancer. It is a 5,000-year-old practice but is just now beginning to undergo validation studies. It is complicated in that there are so many different styles of yoga. The International Association of Yoga Therapists established strict guidelines for yoga therapy training programs. Additionally, it can be complicated to determine exactly what we are measuring and how to calibrate those measures. The Patient Reported Outcome Measurement Information System is an NIH-funded measurement system, started more than a decade ago, that measures patient-reported health status physically, mentally and socially. This measurement system is starting to be applied to studying the effects of yoga, which is great because it offers a standard of measurement that we have been lacking. We have to lay a solid foundation of why we need to research yoga for cancer. A review on the efficacy of complementary health approaches published in 2014 in Journal of the National Cancer Institute showed yoga, meditation and relaxation with imagery were recommended for depression and mood disorders. Yoga and meditation were recommended for anxiety and stress reduction. This is a good representation of the first steps of showing that yoga produces positive benefits, and it may move into being an accepted part of our mainstream health care system.

Q: What does yoga practice for relaxation entail for patients with cancer ?

Snyder: We offer individual sessions or group classes. For group classes, I typically stick with a chair yoga format, so it is a very gentle and well-supported class that anyone can take. Depending on who is participating, I might change the level of the asana, or movement. People going through treatment need to conserve energy for the healing process and stay in the parasympathetic mode of the nervous system as much as possible, whereas people who have completed treatment might be interested in regaining health and strength and may be searching for a new normal. I often have both types of patients in my group classes, along with caregivers at times. Movements are based on uni-movements, or simple movements coordinated with breathing, and we take these movements dynamically as opposed to holding poses. Breath, awareness and meditation are a huge part of my classes and individual sessions, and although our physical practice is modified, the nonphysical aspects of our classes are actually much more advanced than what you would find in a typical yoga studio.

Stella Snyder

Stella Snyder

Q: Should all cancer centers provide these program ?

Young: There is much more to battling cancer than destroying the cancer cells through chemotherapy and radiation. Programs like those at IU Health allow us to help patients and their families to cope emotionally, physical and spirituality before and after treatment. We envision expanding this to be available to all patients and their families free of charge, throughout their cancer journey. Cancer centers should offer a wide variety of services that focus on the mind–body connection and a person’s overall holistic health. Patient and staff education on the benefits of these types of programs is also important. This begins with education of staff and a shift in the general culture of the cancer center. The culture will then trickle down to patients and their families. Sometimes when a patient hears ‘yoga’ they may feel intimidated at first, especially if the patient has limited mobility due to treatment side effects. Meeting the patient where they are in their treatment and teaching them to become an active participant in their healing can give them a sense of control over their care and their bodies.

Q: How are patients at your center informed about the yoga program? Do oncologists mention it to their patients?

Young: All new patients are given a welcome binder that lists the IU Health CompleteLife services and how to contact specific programs. Program facilitators and therapists conduct in-service talks with staff, educating them about the benefits for patients and how to make referrals. Our program also has a physician–champion who helps to support our program by spreading awareness of yoga and other integrative services to staff across departments.

Q: Do you have any final thoughts for our readers?

Young: For cancer centers thinking of starting a yoga program for patients with cancer, it is imperative to have an oncology-trained yoga therapist with proper certification and experience. Having a regular yoga therapist is not always the best approach. Individuals with cancer have very specific needs when it comes to yoga practice.

Snyder: A main goal in my teaching is the idea of meeting people where they are. Most patients and caregivers I meet have little to no experience with yoga. They are looking to start a yoga practice because they heard it can help them feel better, so they come to me as beginners. Most are unfamiliar with the fact that yoga is so much more than just the physical practice Western culture showcases on television, in social media or through local yoga studios. They may be intimidated because they think they are going to need to be able to get into intense poses or do rounds of sun salutations. A big part of my role is educating people about the nonphysical aspects of a yoga practice — such as meditation, imagery, relaxation and breathing practices — so that they may use these tools for their healing process. – by Jennifer Southall

For more information:

Natasha Young and Stella Snyder may be reached at completelife@iuhealth.org.

Disclosure: Young and Snyder report no relevant financial disclosures.

Yoga therapy is an integrative medicine technique that supplements the traditional treatment regimens patients with cancer undergo.

A patient’s quality of life may be enhanced with yoga therapy through the promotion of healing and recovery measures designed to decrease the stress, anxiety and physical discomfort that often accompany cancer treatment.

Natasha Young

Natasha Young

The CompleteLife program at Indiana University Health Simon Cancer Center offers complementary therapies and patient support programs for adults with cancer and their family members. With a focus on the holistic approach to treatment, the CompleteLife program aims to treat the patient as a whole as opposed to just treating their disease.

HemOnc Today spoke with Natasha Young, project coordinator of the IU Health CompleteLife Program, and Stella Snyder, an oncology-trained yoga therapist, about the benefits of yoga therapy and the effect it has on patients’ well-being.

Question: How did the program come about?

Young: Our yoga services are a part of our overall CompleteLife program, which was founded in the late 1990s by Larry D. Cripe, MD. The program started off providing art and music therapy. As time went on, we added more programs. IU Health understands the need for integrative therapy options for patients and their families in addition to top-of-line medical care. Yoga therapy is offered to outpatients in collaboration with Little Red Door Cancer Agency in Indianapolis. Family members of patients and IU Health team members also like to participate. We recently started inpatient yoga services for patients with cancer, as well as other chronic conditions that require long hospital stays. We also offer yoga therapy groups for patients and staff and hope to continue to offer these groups as our program grows.

Q: What is the mission of the program?

Young: CompleteLife is a complementary therapies program that attends to the physical, emotional, spiritual and social needs of our patients and their families when they need it the most. Facing cancer is stressful and can cause anxiety, which can interfere with the healing process. We strive to ease that anxiety through patient education, creative art therapy and support groups provided by trained art and music therapists, social workers, and yoga and massage therapists. All of the programs and services provided by CompleteLife are free to our patients to help them cope with their health situations and confront their diagnosis and treatments.

Q: Can you describe the effect that yoga has on patients with cancer?

Snyder: The obvious effects include relieving stress and managing side effects of cancer and cancer treatment, but overall, yoga helps patients regain a sense of control. Patients with cancer often become the passive object of treatments, appointments, decisions by their doctors and so on. Yoga offers tools they can use to reacquire some feeling of control over their healing process, and they can use the practices to find relief from anxiety, depression and other psychosocial issues, or relief from pain, fatigue and other physical issues. Through practicing awareness, they become more aware of poor habits, such as unhealthy eating, negative thought patterns and aberrations of the breath, and they naturally begin to change these unhealthy patterns on their own. It is amazing how transformative yoga can be, and how much easier making healthy changes can come to a person through simply practicing awareness. The patient also receives support from their fellow yoga students because our classes begin to form a little community. Simply put, a yoga practice can improve a patient’s quality of life throughout their treatment.

Q: What research about the effect yoga has on cancer have you found particularly compelling?

Snyder: I am always surprised at how little research has been done about yoga for cancer. It is a 5,000-year-old practice but is just now beginning to undergo validation studies. It is complicated in that there are so many different styles of yoga. The International Association of Yoga Therapists established strict guidelines for yoga therapy training programs. Additionally, it can be complicated to determine exactly what we are measuring and how to calibrate those measures. The Patient Reported Outcome Measurement Information System is an NIH-funded measurement system, started more than a decade ago, that measures patient-reported health status physically, mentally and socially. This measurement system is starting to be applied to studying the effects of yoga, which is great because it offers a standard of measurement that we have been lacking. We have to lay a solid foundation of why we need to research yoga for cancer. A review on the efficacy of complementary health approaches published in 2014 in Journal of the National Cancer Institute showed yoga, meditation and relaxation with imagery were recommended for depression and mood disorders. Yoga and meditation were recommended for anxiety and stress reduction. This is a good representation of the first steps of showing that yoga produces positive benefits, and it may move into being an accepted part of our mainstream health care system.

Q: What does yoga practice for relaxation entail for patients with cancer ?

Snyder: We offer individual sessions or group classes. For group classes, I typically stick with a chair yoga format, so it is a very gentle and well-supported class that anyone can take. Depending on who is participating, I might change the level of the asana, or movement. People going through treatment need to conserve energy for the healing process and stay in the parasympathetic mode of the nervous system as much as possible, whereas people who have completed treatment might be interested in regaining health and strength and may be searching for a new normal. I often have both types of patients in my group classes, along with caregivers at times. Movements are based on uni-movements, or simple movements coordinated with breathing, and we take these movements dynamically as opposed to holding poses. Breath, awareness and meditation are a huge part of my classes and individual sessions, and although our physical practice is modified, the nonphysical aspects of our classes are actually much more advanced than what you would find in a typical yoga studio.

Stella Snyder

Stella Snyder

Q: Should all cancer centers provide these program ?

Young: There is much more to battling cancer than destroying the cancer cells through chemotherapy and radiation. Programs like those at IU Health allow us to help patients and their families to cope emotionally, physical and spirituality before and after treatment. We envision expanding this to be available to all patients and their families free of charge, throughout their cancer journey. Cancer centers should offer a wide variety of services that focus on the mind–body connection and a person’s overall holistic health. Patient and staff education on the benefits of these types of programs is also important. This begins with education of staff and a shift in the general culture of the cancer center. The culture will then trickle down to patients and their families. Sometimes when a patient hears ‘yoga’ they may feel intimidated at first, especially if the patient has limited mobility due to treatment side effects. Meeting the patient where they are in their treatment and teaching them to become an active participant in their healing can give them a sense of control over their care and their bodies.

Q: How are patients at your center informed about the yoga program? Do oncologists mention it to their patients?

Young: All new patients are given a welcome binder that lists the IU Health CompleteLife services and how to contact specific programs. Program facilitators and therapists conduct in-service talks with staff, educating them about the benefits for patients and how to make referrals. Our program also has a physician–champion who helps to support our program by spreading awareness of yoga and other integrative services to staff across departments.

Q: Do you have any final thoughts for our readers?

Young: For cancer centers thinking of starting a yoga program for patients with cancer, it is imperative to have an oncology-trained yoga therapist with proper certification and experience. Having a regular yoga therapist is not always the best approach. Individuals with cancer have very specific needs when it comes to yoga practice.

Snyder: A main goal in my teaching is the idea of meeting people where they are. Most patients and caregivers I meet have little to no experience with yoga. They are looking to start a yoga practice because they heard it can help them feel better, so they come to me as beginners. Most are unfamiliar with the fact that yoga is so much more than just the physical practice Western culture showcases on television, in social media or through local yoga studios. They may be intimidated because they think they are going to need to be able to get into intense poses or do rounds of sun salutations. A big part of my role is educating people about the nonphysical aspects of a yoga practice — such as meditation, imagery, relaxation and breathing practices — so that they may use these tools for their healing process. – by Jennifer Southall

For more information:

Natasha Young and Stella Snyder may be reached at completelife@iuhealth.org.

Disclosure: Young and Snyder report no relevant financial disclosures.