Breast cancer: effect of yoga on endocrine-related musculoskeletal symptoms

The aim of this study is to assess the effect of yoga in women with a breast cancer diagnosis who suffer from joint pain and stiffness caused by hormone therapy.

  • Topic: Breast cancer
  • Institution: University Medical Centre Utrecht (UMCU)
  • Country: Netherlands
  • Status: Ongoing
Researcher: Evelyn Monninkhof

Endocrine treatment for breast cancer may take years; let’s work to minimize the troubling side effects along the way – Dr Evelyn Monninkhof

Grant title: The effect of yoga on endocrine therapy induced musculoskeletal symptoms in women with breast cancer


About 85% of women with breast cancer have a hormone-sensitive tumour. These women are eligible for hormone therapy (such as tamoxifen and aromatase inhibitors) that interferes with the production of female hormones. The therapy is prescribed for 5–10 years and increases the chances of survival. Unfortunately, the therapy can also result in side-effects that can negatively affect quality of life. These side-effects can lead to women stopping treatment, with about 30% of women doing so, resulting in worse survival. Common side-effects that cause women to stop taking hormone therapy are, for example, muscle and joint complaints. There is no effective intervention that can reduce these muscle and joint complaints, other than using pain medication, which also has side-effects. A possible non-drug solution is yoga. Yoga has proven positive effects on pain, stiffness, and function in patients with osteoarthritis.

Aim and objectives

The aim of this study is to assess the effect of yoga in women with a breast cancer diagnosis who suffer from joint pain and stiffness caused by hormone therapy. Primary outcome is the intervention effect on joint pain and stiffness. Other outcomes are menopausal symptoms (eg hot flushes), fatigue, sleep, quality of life, anxiety and depression, cognitive complaints, adherence to endocrine treatment, pain medication for the complaints, and inflammatory markers in blood.

How it will be done

The study design is a randomised controlled trial in 140 women with hormone-sensitive breast cancer who suffer from muscle and joint complaints during hormone treatment. Women will be allocated to a yoga (n=70) or a control group (n=70) by chance. The women in the yoga group will attend a yoga class (60 minutes) near home, twice a week for 4 months. They will additionally practice yoga at home for 30 minutes once a week using yoga videos. The classes will be led by experienced yoga teachers who are trained to guide this patient group. Every woman in the yoga group will start with a private lesson to get acquainted with the yoga techniques and for possible individual adjustment of certain exercises (in case of complaints). The intervention is an active form of yoga, such as Easy Vinyasa yoga. This yoga form consists of continuous slow movements linked with breathing. The control group are offered the yoga intervention after the study period of 4 months. The included women will visit the research centre for measurements at baseline and after 4 months. Three patients with breast cancer are actively part of the study team and will provide input during project meetings.

Potential impact

Muscle and joint complaints related to endocrine therapy in women with breast cancer affect quality of life and adherence to treatment. It is important to tackle this problem. This study is relevant because there is currently no effective approach and yoga shows great promise. If yoga is found to be effective, yoga could contribute to an improved quality of life and possibly a better prognosis for a large group of women with breast cancer.