The Impact of Yoga on Fatigue in Cancer Survivorship: A Meta-Analysis

Background: Mind-body approaches, particularly yoga, are used by cancer survivors to cope with treatment-related symptoms. Consistency of yoga-related effects on treatment-related symptoms are not known. This meta-analysis was designed to examine effects of yoga on pre- to postintervention improvements in fatigue among cancer patients. Methods: PubMed and PsycINFO were searched for peer-reviewed articles of yoga randomized controlled trials including cancer survivors and reporting at least one fatigue measure. Twenty-nine studies met inclusion criteria (n = 1828 patients). Effect sizes (Hedge's g) were calculated for fatigue, depression, and quality of life. Patient-related and intervention-related characteristics were tested as moderators of outcomes. All statistical tests were two-sided. Results: Yoga practice was associated with a small, statistically significant decrease in fatigue (g = 0.45, P = .013). Yoga type was a statistically significant moderator of this relationship (P = .02). Yoga was associatedwith a moderate decrease in depression (g = 0.72, P = .007) but was not associatedwith statistically significant changes in quality of life (P = .48). Session length was a statistically significant moderator of the relationship between yoga and depression (P = .004). Neither timing of treatment (during treatment vs posttreatment) nor clinical characteristics were statistically significant moderators of the effects of yoga on outcomes. The effect of yoga on fatigue and depression was larger when the comparator was a "waitlist" or "usual care" than when the control group was another active treatment (P = .036). Conclusions: Results suggest yoga may be beneficial as a component of treatment for both fatigue and depression in cancer survivors.