The Effect of Yoga on Cancer-Related Fatigue and Quality of Life Among Racially and Ethnically Diverse Cancer Survivors: A Secondary Data Analysis

Introduction: Survivors from racially and ethnically diverse backgrounds tend to experience cancer-related fatigue (CRF) at higher rates than non-Hispanic Whites (NHWs), often leading to a decline in quality of life (QOL). It is crucial to consider the impact their marginalized identities have on cancer outcomes. Although yoga has shown promise as a supportive intervention for CRF and QOL, existing research has largely centered on NHW populations. This study seeks to evaluate the impact of yoga on CRF and QOL among racially and ethnically diverse survivors and compare outcomes with NHW survivors. Methods: This study used data from two randomized controlled trials (RCTs; n = 1,153) examining a 4-week Yoga for Cancer Survivors (YOCAS) intervention designed to address insomnia in survivors. YOCAS integrates elements of gentle Hatha and Restorative Yoga, featuring breathing techniques, mindful movement, and posture alignment, for 150 min each week for 4 weeks. Survivors were eligible if they (1) were age 21+, (2) were randomized to YOCAS^©®, (3) identified as Hispanic or a non-Hispanic person of color, and (4) provided evaluable data on the Functional Assessment for Chronic Illness Therapy-Fatigue and Functional Assessment for Cancer Therapy-General at pre- and postintervention. Results: Forty-nine participants were eligible (mean age = 53; 96% female; 79% stage 0-II cancer; 74% breast cancer). Participants reported nonclinically meaningful improvements in overall CRF improvement (1.55, standard deviation [SD] = 14.67, p < 0.061), total QOL (3.04, SD = 0.055, p < 0.055), the emotional component of QOL (0.85, SD = 6.3, p < 0.061), and significant improvements in the physical component of QOL (1.32, SD = 7.0, p < 0.035). Session attendance averaged six out of eight sessions. Participants also engaged in an additional self-guided yoga practice at home each week. Most (86%) participants expressed that the program was beneficial in managing symptoms and indicated they would suggest it to survivors. Discussion: Findings suggest: (1) YOCAS^©® has the potential to alleviate fatigue and enhance QOL in racially and ethnically diverse survivors; (2) while participation rates remain modest, there is openness to yoga; and (3) diverse survivors are capable of completing a 4-week yoga program, report it as useful for controlling symptoms, and are likely to suggest it to survivors. Future research should include well-powered RCTs to verify YOCAS^©®'s effects on CRF and QOL in these populations.