February is Ovarian Cancer Awareness Month. As a yoga therapist who works extensively with cancer patients, I have seen how yoga can support people with ovarian cancer to manage their symptoms and live more balanced lives.
About 1400 people are diagnosed with ovarian cancer in Australia every year and nearly 300,000 worldwide receive an ovarian cancer diagnosis. In Australia, it’s the 10th most common cancer in women. However, anyone with ovaries can get ovarian cancer, and so it can affect trans men and intersex people if they have ovaries.
Physical activity is highly beneficial for people with ovarian cancer, with a 2020 study showing that participating in physical activity after diagnosis is beneficial to function, quality-of-life and potentially survival. This study showed that higher levels of physical activity were associated with higher health-related quality-of-life and lower levels of anxiety and depression.
Other studies have shown that physical activity levels drop after a cancer diagnosis - that’s understandable. But finding ways to support people with ovarian cancer to continue to be physically active after diagnosis can offer significant benefits. That’s where yoga therapy comes in.
Yoga Therapy is specifically designed to meet the needs of individuals. It isn’t about modifying regular yoga classes so that people with health issues can join it. A skilled yoga therapist is able to craft a practice that precisely meets the needs of each student. For a person with ovarian cancer, there are a number of considerations to take into account before offering a yoga practice. If you are living with ovarian cancer - or teach students with a diagnosis - here’s a cheat sheet to help you develop an appropriate practice:
Ovarian cancer is usually treated with surgery. According to Oncology Physical Therapist Dr Angela Wicker-Ramos, exercise after ovarian cancer surgery can:
- Improve circulation, which improves wound healing and the fluid movement through the body
- Help soften scar tissue that may be in the area
- Improve endurance after surgery
Yoga is a great way to gently move the body to achieve the benefits above. For example, deep abdominal breathing and movements that extend the chest and arms (such as mild backbends) can really help to soften scar tissue in the abdominal region.
Simple twists, rotations and lateral bends are all great for mobility around the abdominal area, but keep everything gentle and optional. Use a bolster or cushion under the belly and slowly go forward bit by bit - no deep poses or long holds.
Invite students to pay attention to how their abdominal area feel - it should be comfortable throughout the practice. Encourage students to stop what they are doing if they feel any pain or discomfort.
It’s important to make sure that a student has permission from their doctor to go ahead with exercise after abdominal surgery and find out if there are any other issues you need to be aware of. Which brings us to…
Sometimes surgery for ovarian cancer removes part of the bowel, bladder or small intestine. This can necessitate the use of a stoma - an small opening in the body that is used to remove waste into an external collection bag. This can make practising some yoga poses awkward - your student will not want to hold their body in a position that puts direct pressure onto the stoma or collection bag.
When you conduct your intake process with the student, ask if they have a stoma (and where the collection pouch is located) so that you can teach postures that are comfortable for the student.
Mind the arm!
You might not think of the arm as being a primary consideration for people with ovarian cancer. But if your student has a PICC line, it’s important to work in a way that doesn’t compromise that line.
What’s a PICC line?
PICC stands for peripherally inserted central catheter. It’s a long IV tube that is inserted into a vein in the arm near the elbow and used to deliver chemotherapy. It stays there so there is no need to find a vein every time the person receives chemo.
For most students, it’s fine to practice yoga with a PICC line. However, it’s important to avoid any strain, pulling or weight being placed on that arm, such as arm balances or strong stretches. It’s also important to avoid fast movements that could dislodge the PICC line which can move back and forth or be pulled out, leading to serious complications including bleeding, blood vessel damage, blood clots or pain. Having said that, it’s important to keep the arm moving, so don’t avoid arm movements.
Keep it slow, gentle and mindful, steering clear of anything that is likely to affect the PICC line. That might mean a student only raises their arm half way, or takes the ‘hands on hips’ variation for some poses. Use a wall so anything can be done with one arm if necessary. Invite the student to experiment with different ways of moving - they are going to be the expert on how it feels, so don’t think that you have to know exactly what’s best for them!
Slow and steady
Fast, flowing vinyasa is unlikely to be a good choice for a person undergoing treatment for ovarian cancer. Slow, steady movements give students the time their bodies need to move in and out of postures, encourage mindful connection to the body and promote much needed relaxation.
People undergoing treatment for cancer often experience a slowing down of their cognition - a combination of medication, fatigue and the daily work of managing their cancer means that students will welcome a slower paced practice taught using straightforward language.
Try letting students set their own pace for the class and decide for themselves how many repetitions they do. Encourage students to find their own way into postures, taking them as gently or deeply as they need. Offer lots of encouragement to meet their own needs and provide plenty of options.