The effect of yoga on women with secondary lymphoedema from breast cancer treatment. A pilot trial.

The lymphatic transport system provides the way for extra-cellular fluid and other substances to be transported back to the venous system. This fluid is taken up by lymph capillaries, flows into lymph collectors, then to lymph nodes in various parts of the body. Each part of the body flows to its own nodes eg fluid from the left arm will flow to the axilla under the left arm. In Australia a major cause for disruption to the lymphatic system is surgery and radiation therapy. Breast cancer treatment commonly includes modified radical mastectomy surgery, radiation to the chest wall, and removal of lymph nodes. These treatments all contribute to disruptions in lymphatic system function. Secondary arm lymphoedema after treatment from breast cancer occurs in at least 20% of women although this figure is usually quoted as being higher. Research into the effects and benefits of different exercise modalities for women with secondary arm lymphoedema as a result of breast cancer treatment have shown that various types of exercise do not worsen lymphoedema - as long as the exercise is given in a supervised and controlled way, with adequate warm-up and cool-down. Women also report that attending a group exercise class helps keep them motivated to continue with their self-management regime. Recently, studies based on tai-chi and breathing and gentle exercises including breathing and relaxation, have led to slight decreases in the amount of fluid in the affected arm. Yoga has been reported to lower levels of anxiety and depression and improve quality of life and immune function in women. However to date there has been no investigation on the effectiveness of yoga in the treatment of lympoedema. This study will examine the effects of an eight week yoga intervention on lymphoedema in breast cancer survivors. A range of measures of degree of lympoedema, strength, range of motion and quality of life will be measured in women on commencement and after four and eight weeks of a yoga intervention and at four weeks after completion of the intervention. Results will be compared with a control group who receive usual care.