'Gentle' yoga helping women find sea of calm amid breast cancer treatments

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Women diagnosed with and being treated for breast cancer face physical and emotional upheaval.

For more than five years, Wake Forest Baptist Medical Center has offered its breast cancer patients an escape from that upheaval— thanks to research studies that led to free weekly classes at the Comprehensive Cancer Center.

"When you're first diagnosed, it really knocks you for a loop,'' said Carol Amweg, 60, survivor of three separate breast cancer surgeries who's been in the yoga classes since April 2009. "This is really good. It relaxes you. It gives you a point of reference with other survivors.''

A program of research involving yoga for women with cancer was initiated in 2004 by Suzanne Danhauer, PhD, associate professor of social sciences and health policy in the Division of Public Health Sciences. The research began soon after Danhauer arrived at Wake Forest Baptist with one of her goals to pursue clinical intervention research with cancer patients.

Danhauer said that while doing her fellowship at Stanford University, she saw yoga being used in a supportive care program and was impressed. When she followed up to see what research had to say about yoga's potential benefit, she found almost nothing in medical literature. That led her to obtain funding for a series of trial studies at Wake Forest Baptist.

Through the years, the studies have largely demonstrated that women who take the yoga classes feel more relaxed amid the stress of a cancer diagnosis and treatment, and that some sleep better the night after taking a yoga class.

Though the benefits of yoga would appear to be obvious as a relaxing agent, Danhauer said that in the medical community, especially going back nine years ago, it wasn't that easy of a "sell.'' Physicians and health care providers wanted to know that their patients would be safe as they participated in the yoga intervention. They also wanted to see support for yoga as an evidence-based practice, as with other therapies.

"I think as we've done this over time, physicians and other health care providers see that what we're offering is gentle,'' she said. "They see their patients coming back and telling them that there are benefits to it.''

An instructor who understands

One reason for the success of "gentle'' yoga is having an instructor who can relate to the patients.

Lynn Felder is a Winston-Salem resident who teaches at her studio, the Yoga Gallery on Trade Street, in addition to the classes she leads Tuesdays at the Comprehensive Cancer Center. Felder is herself an ovarian cancer survivor and longtime yoga practitioner.

Danhauer happened to be taking some classes at Felder's studio not long after arriving in Winston-Salem and said she thought Felder would be a perfect fit for teaching the classes she envisioned at Wake Forest Baptist—even before knowing about Felder's own fight with cancer. From their initial conversation began their partnership; Felder has taught the yoga classes from the start. Felder said in working with patients in recovery, she took the yoga that she knew down a notch.

"It's still real yoga, which is defined by its intent—to unite body, mind and spirit within the person and to unite the person with his or her … inner healing ability,'' Felder said.

In her own cancer battle, yoga "helped me to re-friend my body. Cancer patients often feel betrayed by their bodies.''

Sharing experiences with others going through cancer is clearly something Felder enjoys.

"The cancer gave me a level of understanding about limited mobility and weakness that I would never have understood otherwise, and I feel that it gives me a big advantage when I'm teaching cancer patients,'' Felder said. "I totally get what they're going through and what yoga can do for them while they are dealing with it.''

Calming the mind

Indeed, one of Felder's key rules, which the patients know well, is not to do any movement if it hurts.

Students such as Marg Tuomi, 65, of Winston-Salem, appreciate Felder's willingness to bend rules when it comes to yoga, a field in which instructors more typically seek to correct students so they attain the perfect position. Gentle yoga, however, is far more forgiving, while still giving the women physical activity and a mental and emotional boost.

"I was prepared to walk away if they were all young women in tights,'' Tuomi said about her thoughts after agreeing to try a class in 2010. "But I walked in and the women were my age, very welcoming. Very non-threatening."

Having overcome a lumpectomy in 2009, Tuomi said she was tense and upset when she began her yoga classes, a time when she was struggling to work through problems with her elderly parents in Minnesota. From the very first class, she said, she took to gentle yoga despite having a body that she said is not particularly flexible.

"It was an oasis in the week,'' she said of the classes. "It just sort of calmed the mental madness in my mind.''

Although she is in Raleigh weekdays now and unable to take the classes, she said she uses the techniques she learned from Felder while doing morning exercises at home—breathing and stretching to relax her muscles and calm down.

Danhauer said the willingness of patients such as Tuomi to learn and accept yoga has been rewarding. When she began pitching the idea of gentle yoga for cancer patients at Wake Forest Baptist, she wondered whether people might worry that yoga would conflict with their religion, especially in this part of the country.

"I think once people do it, they see that there's nothing that we're offering that's against their religious faith,'' she said. "In many ways, becoming more mindful or more aware in taking time to slow down and breathe can actually enhance a person's spirituality.''

Although her research findings have appeared in several publications, Danhauer said more fully powered studies will be needed before gentle yoga can be fully supported as an evidence-based practice. It continues to be an area of "great promise,'' she said.

Danhauer's next yoga trial will be for a six-week class session for women during radiation therapy for breast cancer, in which they will take the classes over their televisions via a broadband Internet connection. Everyone in class will be able to interact with the teacher and each other, but from the comfort of their own homes.

"I've never been comfortable with the idea of just saying 'Well, here's a DVD' because I think there's a safety issue, especially for patients unfamiliar with yoga. There's also that whole group element,'' Danhauer said. "So I'm really curious to try this and see how much women interact when they're doing classes in this way.''