How to Practice Yoga Safely During Chemotherapy

Yoga may help relieve some chemotherapy symptoms — from stress and anxiety to sleep issues and fatigue. But check with your doctor before practicing.

When Barbara Baker-Kuterka was diagnosed with breast cancer in 2006, she had been practicing yoga for nearly three decades.

“Yoga has [been] and was a very important part of my lifestyle,” says Baker-Kuterka, who is a certified yoga teacher and continuing education provider.

Baker-Kuterka discovered the Christina Phipps Foundation, which provides training for instructors looking to work with the cancer community, and attended one of Phipps’ classes.

She credits yoga with helping her during and after treatment.

“You can do yoga as a form of exercise to keep yourself feeling at your best,” Baker-Kuterka says.

Experts and research support the benefits of yoga during cancer treatment. However, they also share that people undergoing chemotherapy will want to remember some safety tips.

Most importantly, always honor your mind and body in deciding whether to try yoga.

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Potential benefits of yoga during chemotherapy for breast cancer

Yoga may provide several benefits for people doing chemotherapy — including relief from side effects and improved mental health.

Yoga is also accessible. While it can involve physical movement and postures, yoga styles range from vigorous movement to gentle, floor, or chair-based postures.

In fact, yoga doesn’t have to involve movement at all.

“Yoga is more than just the pose,” says Bhavana Pathak, MD, a board certified hematologist and medical oncologist at Orange Coast MemorialCare Cancer Institute. “It’s comprised of poses, breathwork, meditation, intention setting — all designed to develop an absorptive state of peace.”

This is what makes yoga so accessible, as well as beneficial for physical and mental health.

Susan Brown, senior director of education and patient support at Susan G. Komen, says physical benefits can include managing side effects from chemotherapy.

Yoga may help:

• reduce fatigue
• increase strength
• improve balance
• improve sleep quality
• relieve nausea

Since yoga can also involve meditation, breathwork, and intention-setting, it also offers the potential for mental health improvements, explains Lisa Bondy, director of yoga and lead wellness instructor at Northwell Health’s Center for Wellness and Integrative Medicine.

Benefits may include:

• an increased sense of relaxation
• decreased anxiety and depression
• increased feelings of autonomy and empowerment
• a sense of feeling ‘whole,’ connected, or purposeful

“Yoga encourages people to become part of the treatment plan,” Bondy says. “You treat yourself as a whole human being, not just the breast cancer … It’s self-empowering.”

Baker-Kuterka shares that her yoga practice helped her manage treatment.

“When I went to my first chemo appointment, I was filled with nervousness. Before my first needle puncture, I gagged and heaved as if I had already been pumped with all the chemo medications,” Baker-Kuterka recalls. “I needed to steady my breath in order to calmly cooperate in the process.”

That breath-steadying practice was something she learned from yoga.

Plus, there’s a type of yoga for everyone.

“There’s a saying in the yoga community — if you have a body and can breathe, then you can do yoga,” Bondy says.

Pathak agrees, adding some important caveats.

“Anyone can participate in the dhyana or meditative aspects of yoga, most people can participate in the breathwork, and often people can participate in the sitting poses,” Pathak says.

At the same time, some precautions are important.

“The more rigorous, acrobatic versions of yoga can also be accessible with some patience and training,” he says.

However, it’s important to always ask a doctor before trying a new type of exercise. Your doctor may want to supervise your practice to make sure it’s safe for you.

“Remember, yoga is not about touching your toes,” says Pathak. “It’s about the journey there.”

Research on yoga and chemotherapy treatment

A 2017 research trial studied women practicing yoga during treatment for non-metastatic breast cancer. It showed that yoga didn’t make a significant difference in their quality of life.

However, the researchers suggest that yoga could significantly affect fatigue, emotions, and pain and is a low cost, low risk complementary treatment option.

A 2019 research review looked at 17 studies involving more than 2,100 people who were receiving or had received treatment for breast cancer. Of these people, 1,112 did yoga and 1,071 were part of a control group.

The research suggests that post-treatment participants who did yoga classes noticed major effects on their fatigue, while people currently receiving treatment noticed a smaller effect.

A 2020 study of 100 people with breast cancer receiving chemotherapy suggests that yoga practices might be effective at boosting quality of life, including health status and physical and emotional function.

Additionally, the research found that yoga practices might help reduce the following symptoms:

• fatigue
• appetite loss
• constipation
• insomnia

A small 2022 trial of 136 people found that yoga could assist with anxiety and depression in people with early-stage breast cancer who were receiving chemotherapy.

Safety considerations for yoga during chemotherapy

Everyone will experience yoga differently, and a person may feel energized one day and fatigued the next. It’s important that you don’t expect your body to perform the same way all the time, especially during chemotherapy.

“Fortunately, yoga focuses on being in tune with your body and can be scaled up or down from simple breathwork to sitting postures to standing postures, based on your needs that day or week during your treatment,” Pathak says.

With that in mind, experts share some essential tips:

• Speak with a member of your care team to ensure the yoga practices you’re trying are appropriate for your needs.
• Practice under the guidance of an experienced yoga teacher.
• Skip any physical poses if you’re not feeling up to them.
• Don’t practice poses that feel uncomfortable.
• Remain hydrated before, during, and after your practice.

“The first and foremost safety tip is to consult with your doctor before starting any exercise program while undergoing treatment,” Brown says. “Discuss any guidelines and limitations with them, considering your diagnosis in advance.”

On top of that, self-monitor and assess whether a yoga practice is appropriate from day to day.

“In general, if you have new pain, shortness of breath, or any other changes, you might skip yoga and consult with your doctor,” says Brown.

Bondy jokes that yoga isn’t like your typical gym workout.

“In yoga, we have an expression, ‘No pain, no pain,’” she says. “We always listen to our bodies. Pain is information that we don’t want to ignore. It’s not, ‘No pain, no gain.’” Back off if feeling discomfort in poses.”

People can do yoga at home or in a studio. Some studios are heated. Wherever you do yoga, remaining hydrated is critical.

“If you do go to [a heated studio], it would be very important to ensure you have adequate hydration and electrolytes in your body, given the different medications you may be on during your therapy, such as nausea medicines,” Pathak says.

While you should check with your medical team before doing yoga anyway, it’s especially important to do so before trying hot yoga.

Yoga and breathwork to try during chemotherapy

Bondy cautions that the highly personalized nature of someone’s breast cancer journey makes it challenging to recommend catch-all poses.

Fatigue levels, surgery, time between chemotherapy treatments, and mobility are some factors that might affect a person on any given day — on the mat or off.

“I look at the individual and where they’re at, what they need,” Bondy says. “People might need a gentler approach. Some might be able to raise their arms. Others might not. Some might want more rigorous [poses].”

That said, here are a few exercises to try, including options focused solely on breathwork and meditation.

Box breathing

Bondy says that box breathing is an excellent place to start, particularly if you’re feeling anxious. During box breathing, you count to 4 for the inhale, exhale, and a brief pause in between each.

Bondy likes to have students move their hands or arms, tracing the direction of the breath during the practice. Alternatively, you can visualize the movement instead if you prefer.

1. Start in a comfortable seated position or lying down.
2. Place your right hand on the floor next to your right hip bone.
3. Inhale for a count of 4, slowly moving your hand to your right shoulder.
4. Hold your breath for 4 counts, moving your hand to your left shoulder.
5. Exhale for a count of 4 as you take your hand down to your left hip bone.
6. Hold your breath for a count of 4 as you move your hand to your right hip bone.
7. Repeat 3–5 times. You can also reverse the hand movement if desired.

Watch a video on box breathing.

Child’s Pose

Elethia Gay of Alexander Q Health loves this pose for its potential mental health benefits.

“This posture helps to calm the mind, reduce stress, and induce relaxation,” Gay says. “It can be beneficial for individuals with breast cancer by promoting deep breathing, relieving anxiety, and releasing tension in the upper body.”

Child’s Pose can be practiced on a yoga mat, carpet, or even a firm bed.

Watch a video of Child’s Pose.

Seated Cat-Cow

Gay says that Cat-Cow poses offer a gentle spine stretch.

“It can help improve flexibility and strengthen the spine and core muscles,” Gay says. “It can also help to increase circulation to the breast area and reduce stiffness in the back and shoulders.”

Bondy suggests trying it while seated in a chair.

In this pose, you’ll likely feel a stretch across the chest.

“It can feel nice or possibly like too much,” Bondy says, recommending you back off if feeling discomfort.

Watch a video of Seated Cat-Cow.

Warrior II

“Warrior II helps to build strength in the legs, arms, and core,” says Gay. “It promotes stability, focus, and balance, which can be beneficial for individuals going through breast cancer treatment and facing physical and emotional challenges.”

Watch a video of Warrior II Pose.

Takeaway

There may seem like a lot of things you can’t do during chemotherapy treatment, but yoga doesn’t have to be one of them.

With approval and collaboration from your medical team, you may find relief, peace, and even joy from trying a yoga practice.