ASCO Perspective Quote
“These results demonstrate that a focused yoga intervention can be successfully delivered in person or online not only to patients with cancer undergoing radiation therapy but also to their caregivers. Such an intervention can be beneficial for physical functioning, recovery, and nutrition intake,” said Charu Aggarwal, MD, MPH, FASCO, ASCO Expert.
Supportive care for patients with head and neck cancers undergoing radiation treatment
100 patients planning to receive ≥ 25 fractions of radiotherapy and their caregivers
Yoga program that included caregivers may prevent physical decline in patients with head and neck cancer receiving radiotherapy.
ALEXANDRIA, Va. — Patients with head and neck cancer undergoing radiation treatment may experience side effects that can lead to declines in physical functioning and increase healthcare utilization. According to a new study, yoga may help alleviate these negative side effects, especially when family caregivers also participate, and decrease the use of feeding tube placements and emergency department visits. The research will be presented at the 2023 American Society of Clinical Oncology (ASCO) Quality Care Symposium, taking place October 28-29 in Boston.
About the Study
“This study is one of the first to compare a patient-oriented behavioral intervention delivery to one that includes patients and their caregiver,” said lead study author Kathrin Milbury, PhD, associate professor in the Department of Behavioral Science at the University of Texas MD Anderson Cancer Center in Houston, Texas.
The study included 100 patients with head and neck cancer who planned to receive ≥25 fractions of radiotherapy and their caregivers. The mean age of patients was 60.3 years; 85% were male and 15% were female; 79% were non-Hispanic White, 16% were White Hispanic, 2% were Black, 2% were Asian, and 1% were biracial; 67% had early-stage cancer; and 54% were receiving radiotherapy delivered concurrently with chemotherapy. The median age of caregivers was 54.9 years; 83% were female and 17% were male; 73% were non-Hispanic White, 15% were White Hispanic, 7% were Asian, 3% were biracial, and 2% were Black.
Patients were randomized to either yoga with their caregiver (n=34), patient-only yoga (n=33), or usual care (n=33). Both yoga programs consisted of 15 sessions, either in-person or via videoconference, with sessions happening in parallel with the patient’s radiotherapy schedule. The program was designed to include poses that focused on preventing and reducing common side effects of head and neck cancer treatment, such as stretching and strengthening the neck and facial muscles, whole-body postures to prevent muscle loss, and breathing and meditation exercises to create a relaxed state and sense of wellbeing. The authors noted that patients frequently experience anxiety during radiation treatment and that some patients on this trial used the relaxation exercises during treatments in lieu of benzodiazepines.
Information on feeding tube placement, emergency department visits, and hospital admissions was extracted from the patients' electronic medical records. In addition, patients completed the self-report portion of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) on a weekly basis during the radiotherapy period to indicate their current food intake as compared to their normal food intake.
The trial found:
- Yoga session attendance was high in both groups with 88% of participants attending at least 10 sessions (13.1 sessions in the patient-caregiver group and 13.3 sessions in the patient group).
- A significant effect favoring the patient-caregiver group compared to the usual care group for patient reported physical function and nutrition intake was observed. Patients in both yoga groups had significantly fewer feeding tubes placed compared to those in the usual care group.
- The effect for emergency department visits was marginally significant and the effect for hospital admissions was not significant.
“I believe the lack of significant group difference between the patient-only yoga and patient-caregiver yoga groups is related to the high session attendance in both yoga groups. One of benefits of yoga is the immediate stress relief, and as such our participants experience the benefit early on in the program," said Dr. Milbury.
The researchers are currently studying the dyadic yoga intervention for patients with head and neck cancers undergoing concurrent chemoradiation. They also plan to test the acceptability of this intervention among minoritized and underserved groups.
This research was funded by the American Cancer Society.
View the News Planning Team disclosures: https://old-prod.asco.org/sites/new-www.asco.org/files/content-files/about-asco/pdf/2023-qcs-news-planning-team-disclosures.pdf
For your readers:
- ASCO Guideline: Salivary Gland Hypofunction and/or Xerostomia Induced by Non-Surgical Cancer Therapies
ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY QUALITY CARE SYMPOSIUM IS REQUESTED IN ALL COVERAGE.
Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to the principle that knowledge conquers cancer. Together with the Association for Clinical Oncology, ASCO represents nearly 50,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of high quality, equitable patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. Conquer Cancer, the ASCO Foundation, supports ASCO by funding groundbreaking research and education across cancer’s full continuum. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, Instagram, and YouTube.