Yoga in der supportiven Therapie des Mammakarzinoms: Wissenschaftliche Evidenz

Zusammenfassung

Yoga umfasst körperliche Aktivität, Atem- und Entspannungstechniken und hat sich in den letzten Jahren zu einer vielgenutzten Methode der Komplementärmedizin entwickelt. In der Senologie wird Yoga insbesondere supportiv zur Linderung psychischer und körperlicher Beschwerden als Folge der Erkrankung selbst oder der kurativen Therapien eingesetzt. So hat eine Reihe indischer und US-amerikanischer randomisiert-kontrollierter Studien zeigen können, dass Yoga während Radiotherapie die körperliche Gesundheit und Fatigue positiv beeinflussen und eventuell auch Angst, Depressivität und Schlafstörungen lindern kann. Zum supportiven Einsatz während Chemotherapie hingegen existiert bisher nur eine indische randomisierte Studie, die auf positive Effekte des Verfahrens auf Angst, Depressivität und Nebenwirkungen der Chemotherapie hindeutet. Nach Abschluss der kurativen Therapie scheint Yoga insbesondere die Vitalität zu steigern und Fatigue zu lindern, die Wirkung auf Depressivität ist unklar. Einzelne Studien weisen darüber hinaus auf positive Effekte auf menopausale Symptome und Lymphödeme nach abgeschlossener Therapie des Mammakarzinoms. Insgesamt kann Yoga, in Übereinstimmung mit den aktuellen AGO-Leitlinien, zur Linderung physischer und psychischer Beeinträchtigungen während Radio- und Chemotherapie sowie persistierender Fatigue nach abgeschlossener Behandlung eines nicht-metastasierenden Mammakarzinoms empfohlen werden.

Summary

Yoga, incorporating physical exercise, breathing techniques and meditation, has now been adapted for use in complementary and alternative medicine. In supportive breast cancer care, yoga is mainly used to ameliorate physical and mental impairments associated with the disease and its treatment rather than to cure the disease itself. A growing number of US-American and Indian randomized controlled trials demonstrates effects of yoga on overall health, physical functioning and fatigue during radiotherapy. Effects on anxiety, depression and sleep were also found occasionally. A single Indian study conducted during chemotherapeutic treatment suggests further efficacy in relieving anxiety, depression, and treatment side effects, mainly nausea and vomiting. After completion of anticancer treatment, yoga seems to be mainly effective in increasing vitality, reducing fatigue and perhaps depression. Single studies further suggest its usefulness in improving menopausal symptoms and lymphedema-associated symptoms in breast cancer survivors. In accordance with recent German medical guidelines, yoga can be considered as a supportive intervention to improve physical and mental well-being during radiotherapy and chemotherapy as well as to improve persistent fatigue in breast cancer survivors.

Schlüsselwörter

Mammakarzinom - Yoga - supportive Therapie

Keywords

Breast cancer - yoga - supportive therapies

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