Impact of Deep Breathing and Relaxation Exercises on Health Related Quality of Life in Breast Cancer Patients Receiving Chemotherapy.
Authors: Dhillon W. , Abd Al-Noor N. , Gill A. , Gupta N. , DeBari V. , Guron G. , Maroules M. 
Published: December 2010

Abstract
Background: Though chemotherapy improves outcomes in many cancer patients, it has a profound impact on quality of life (QOL). Alternative medicine is set to assume an increasingly important role in the management of treatment related side effects in cancer patients. Modification of breathing pattern is an essential part of Yoga, which has been shown to improve QOL in cancer patients. Yoga needs a dedicated trainer and requires considerable time commitment. This study examines the impact of self administered breathing and relaxation exercises on patients receiving chemotherapy for breast cancer.Methods: Non metastatic breast cancer patients currently receiving chemotherapy were considered. Patients who received less than 2 cycles of chemotherapy, had hemoglobin less than 9 g/dl, psychiatric illness or poor performance status (ECOG more than 1) were excluded. The breathing and relaxation exercise was a 5 minute long process designed to be performed twice a day at home. Participants were given technique demonstrations and written instructions. A questionnaire was used to assess compliance. FACT-B (version 4) questionnaires were used to obtain objective assessment of Health Related Quality of Life (HRQL) at enrollment and after 3 weeks of exercise. Pre and post intervention scores were analyzed. Out of 15 enrolled patients, 4 had to be excluded due to one of the above reasons.Results: The participants were all women (mean age 58.6) with a diagnosis of non metastatic breast cancer within 12 months. Patient responses were used to calculate scores in the following subscales: Physical Well Being (PWB), Social Well Being (SWB), Emotional Well Being (EWB), Functional Well Being (FWB) and Breast Cancer Subscale (BCS). The subscale scores were used to calculate 3 total scores: Trial Outcome Index (TOI, sum of PWB+FWB+BCS), FACT-G (PWB+SWB+EWB+FWB) and FACT-B (FACT-G + BCS).Baseline CharacteristicsMean Age58.6 RaceHispanic5 (45.4%) African American3 (27.2%) Caucasian1 (9%) other2 (18.1%)EducationSchool3 (27.2%) High School4 (36.3%) College5 (45.4%)Social Support∗24 (36.3%) 37 (63.6%)Stage13 (27.2%) 24 (36.3%) 35 (45.4%)Social Support: score of 1 each for spouse, children or parents and close friends.∗Comparison of pre and post intervention mean scores showed trends towards improvement in four out of five sub scores and all three total scores, although only FACT-B (p=0.04), BCS (p=0.05) and SWB (p=0.05) showed statistically significant increases. Patients with good social support had higher overall scores. Patients who finished education in high school had better scores than patients who had dropped out of school or had gone to college.ResultsSCORE TYPEMEAN (PRE)MEAN (POST)p VALUEFACT-B98.5102.90.04FACT-G7980.80.38TOI∗53.560.90.2PWB∗16.7180.4SWB∗2428.10.05EWB∗17.716.41.0FWB∗2021.20.46BCS∗19.521.50.05TOI: Trial Outcome Index; PWB: Physical Well Being; SWB: Social Well Being; EWB: Emotional Well Being; FWB: Functional Well Being; BCS: Breast Cancer Subscale∗Conclusions: Simple, self administered breathing and relaxation exercises can play an important role in improving QOL in breast cancer patients receiving chemotherapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3101.