Yoga Practice Predicts Improvements in Day-to-Day Pain in Women With Metastatic Breast Cancer



      Women with metastatic breast cancer (MBC) experience a significant symptom burden, including cancer pain. Yoga is a mind-body discipline that has shown promise for alleviating cancer pain, but few studies have included patients with metastatic disease or examined the acute effects of yoga practice.


      To determine whether daily pain changed significantly during a randomized controlled trial of the Mindful Yoga program among women with MBC and whether time spent in yoga practice was related to daily pain.


      On alternate weeks during the intervention period, we collected daily measures of pain from a subset of 48 women randomized to either yoga (n = 30) or a support group condition (n = 18). We also assessed daily duration of yoga practice among patients randomized to yoga.


      Pain levels were low for women in both conditions, and no differential treatment effects were found on daily pain. However, among women randomized to yoga, a dose/response relationship was found between yoga practice duration and daily pain. When patients had spent relatively more time practicing yoga across two consecutive days, they were more likely to experience lower pain on the next day. This finding is consistent with an earlier MBC study. Meditation practice showed the strongest association with lower daily pain.


      Findings suggest that yoga practice (meditation practice in particular) is associated with acute improvements in cancer pain, and that yoga interventions may be more impactful if tested in a sample of patients with advanced cancer in which pain is relatively elevated.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pain and Symptom Management
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Lim B.
        • Hortobagyi G.N.
        Current challenges of metastatic breast cancer.
        Cancer Metastasis Rev. 2016; 35: 495-514
        • Walters S.
        • Maringe C.
        • Butler J.
        • et al.
        Breast cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK, 2000-2007: a population-based study.
        Br J Cancer. 2013; 108: 1195-1208
        • Porter L.S.
        • Carson J.W.
        • Carson K.M.
        • et al.
        Feasibility of a mindful yoga program for women with metastatic breast cancer: results of a randomized pilot study.
        Support Care Cancer. 2019; 27: 4307-4316
        • Fayers P.
        MRC quality of life studies using a daily diary card--practical lessons learned from cancer trials.
        Qual Life Res. 1995; 4: 343-352
        • Bolger N.
        • Davis A.
        • Rafaeli E.
        Diary methods: capturing life as it is lived.
        Annu Rev Psychol. 2003; 54: 579-616
        • Carson J.W.
        • Carson K.M.
        • Porter L.S.
        • Keefe F.J.
        • Seewaldt V.L.
        Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.
        Support Care Cancer. 2009; 17: 1301-1309
        • Downie W.W.
        • Leatham P.A.
        • Rhind V.M.
        • et al.
        Studies with pain rating scales.
        Ann Rheum Dis. 1978; 37: 378-381
        • Jensen M.P.
        • Karoly P.
        • Braver S.
        The measurement of clinical pain intensity: a comparison of six methods.
        Pain. 1986; 27: 117-126
        • Jensen M.P.
        • Turner J.A.
        • Romano J.M.
        What is the maximum number of levels needed in pain intensity measurement?.
        Pain. 1994; 58: 387-392
        • Carson J.W.
        • Carson K.M.
        • Oleson M.K.
        • Sanders L.
        • Porter L.S.
        Mindful Yoga for women with metastatic breast cancer: design of a randomized controlled trial.
        BMC Complement Altern Med. 2017; 17: 153-163
        • Carson J.W.
        • Carson K.M.
        • Porter L.S.
        • et al.
        Yoga for women with metastatic breast cancer: results from a pilot study.
        J Pain Symptom Management. 2007; 33: 331-341
        • McCracken L.M.
        • Carson J.W.
        • Eccleston C.
        • Keefe F.J.
        Acceptance and change in the context of chronic pain.
        Pain. 2004; 109: 4-7
        • Vempati R.P.
        • Telles S.
        Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels.
        Psychol Rep. 2002; 90: 487-494
        • Breitbart W.
        • Rosenfeld B.
        • Gibson C.
        • et al.
        Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial.
        Psychooncology. 2010; 19: 21-28
        • Affleck G.
        • Zautra A.
        • Tennen H.
        • Armeli S.
        Multilevel daily process designs for consulting and clinical psychology: a preface for the perplexed.
        J Consulting Clin Psychol. 1999; 67: 746-754
        • Schulz K.F.
        • Altman D.G.
        • Moher D.
        CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials.
        BMJ. 2010; 340: c332
        • Carson J.W.
        • Carson K.M.
        • Jones K.D.
        • et al.
        A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia.
        Pain. 2010; 151: 530-539
        • Carson J.W.
        • Carson K.M.
        • Jones K.D.
        • Mist S.D.
        • Bennett R.M.
        Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group.
        Clin J Pain. 2012; 28: 804-813