The impact of Iyengar yoga on demands of illness, coping, and lymphocyte NF-kB activation in breast cancer survivors

Pamela Ellen Schultz

Breast cancer survivorship is associated with changes in physical, psychological, and social aspects of well-being. Such changes may require significant cognitive and emotional adaptation. Coping strategies whether positive or negative may predict how well a survivor is able to adapt and may affect how their body responds to the illness. Integrative medicine often incorporates mind-body therapies, such as yoga, to increase overall wellbeing and physical health in breast cancer survivors. The present study was designed to investigate the relationship between Iyengar yoga practice, illness-related stressors and lymphocyte NF-KB activation in female breast cancer survivors. Females who were approximately 1 to 11 years post-diagnosis with stage I-IV breast cancer were randomly assigned to either the yoga (Y, n = 13) or control (C, n = 11) group. The eight-week yoga intervention included three yoga sessions per week. Participants completed a Demands of Illness Inventory (DOII) and Revised Ways of Coping Checklist (RWCCL) prior to (T1) and following (T2) the intervention. Blood samples were taken at T1 and T2 for use in in vitro unstimulated and stimulated lymphocyte NF-KB analyses. Lymphocytes were stimulated with phytohemaglutinin (PHA), phorbol 12-myristate 12-acetate (PMA), and ionomycin. Nuclear extracts of stimulated cells were analyzed for NF-KB activation by an electrophoretic mobility shift assay. Cytosolic and nuclear extracts from unstimulated and stimulated paired aliquots were analyzed for cellular location of NF-KB by chemiluminescence. Data were analyzed by independent and paired t-tests, and linear regression. A global measure of the DOII revealed a significant interaction between time and group effects (F = 5.275, p = 0.028) revealing decreased DOII in the yoga group from T1 to T2. DOII was inversely correlated with overall active coping strategies (r = -0.23, p = 0.05) and "count your blessings" (r = -0.51, p <0.000). Yoga participation was associated with a trend for decreased lymphocyte activation (p = 0.077). The decreased change in lymphocyte NF-KB activation was correlated with increased use of passive coping strategies (r = 0.900, p = 0.03). The results support the hypothesis that yoga participation mediates perceived demands of illness associated with breast cancer survivorship and that lymphocyte NF-KB signaling pathways are involved in physiological changes that enhance psychosocial well-being.

The impact of Iyengar yoga on demands of illness, coping, and lymphocyte NF-kB activation in breast cancer survivors

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