Yoga for Psychological Distress in Gynecologic, Gastrointestinal, or Thoracic Cancer
Condition: Gynecologic Cancer; Adjustment; Gastrointestinal Cancer; Thoracic Cancer
MeSH terms: Gastrointestinal Neoplasms; Thoracic Neoplasms
Study type: Interventional

Summary: 
      This study will test the feasibility and acceptability of a yoga program for women with
      gynecologic, gastrointestinal (GI), or thoracic malignancies. This study will pilot an
      integrative yoga intervention that combines Western psychotherapeutic approaches with classic
      yogic philosophy to reduce emotional distress among women undergoing treatment for
      gynecologic, gastrointestinal (GI), or thoracic cancer and provide a comprehensive approach
      to stress management across the cancer care continuum.
    

Detailed description: 
      Gynecologic cancers are malignancies of the female reproductive tract that affect over 70,000
      women per year. Treatments for gynecologic cancer often result in numerous physical and
      emotional side effects that affect long-term adjustment, such as anxiety, depression, low
      self-esteem, sexual dysfunction, difficulties with fertility, and surgically-induced
      menopause. Even when initial treatments are successful, gynecologic cancers have a high
      recurrence rate that can reach nearly 80% among those with ovarian cancer. Fear of Cancer
      Recurrence (FCR) is described as one of the largest unmet psychological needs among
      gynecologic cancer patients and is associated with psychological distress, increased health
      care utilization, and functional impairment. Few studies have examined interventions designed
      to manage symptoms of FCR, which leaves a significant gap in the literature regarding
      treatment of this prominent psychosocial problem. Cancer patients report growing use of
      integrative medicine therapies (e.g., yoga, acupuncture, massage) to manage unmet physical
      and emotional needs related to their disease and treatment. The current study will take
      advantage of this trend in supportive oncology to investigate the feasibility and
      acceptability of a novel intervention program created specially to address FCR among women
      with gynecologic cancer. Patients will be recruited from the UF Health/Shands Hospital
      Gynecology Oncology Clinic and Medical Oncology clinic and invited to participate in a
      10-week, manualized, small group yoga course. Psychoeducation modules, meditation training,
      and gentle yoga poses will be integrated into a comprehensive program focused on managing the
      psychosocial concerns of newly diagnosed gynecologic cancer patients. Findings from this
      research will contribute to the existing literature on FCR and knowledge regarding the use of
      integrative medicine techniques for addressing unmet psychological needs among gynecologic
      cancer patients. If the intervention is deemed feasible and acceptable, future research may
      explore ways in which this manualized yoga program compares to other psychosocial treatments
      for managing FCR and other forms of emotional distress in women with cancer.
    

Intervention name(s): Stilling the Waters of Uncertainty: A yoga program for women with gynecologic, gastrointestinal (GI), or thoracic cancer
Intervention type(s): Behavioral
Intervention description(s): 'Stilling the waters,' the prominent theme of this program, is drawn from the core principle in yogic philosophy. It uses breath techniques and physical postures to cultivate inner peace and an ability to live in the present moment. The emphasis on stilling the fluctuations of uncertainty is a direct allusion to the intrusive and inherently unknown future, which characterizes the core experience of Fear of Cancer Recurrence (FCR). This is especially true among gynecologic, gastrointestinal (GI), or thoracic cancer patients for whom the likelihood of recurrence is quite high. An additional motif throughout the program is the lotus flower. The symbolic importance of the lotus in yogic culture is due to its requiring thick muddy waters for ideal growth. The metaphor of cancer as the muddy waters will be used to cultivate benefit-finding and acceptance regarding the mental and physical challenges participants endured during their initial diagnosis and treatment.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Gastrointestinal (GI); Fear of Cancer Recurrence (FCR)