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   Table of Contents     
PERSPECTIVE  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 95-98
The impact of the “Yogic Lifestyle” on cancer prognosis and survival: Can we target cancer stem cells with yoga?


Department of Biomedical Engineering Rutgers: The State University of New Jersey, USA

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Date of Web Publication2-May-2017
 

   Abstract 

Cancer has recently been known to originate from stem cell-like cells, called cancer stem cells (CSCs). Their unique properties of self-duplication, multiplication, as well as migration give the CSC resistance over conventional cancer therapies. Newer therapies are in developmental stage to target these stem cell-like populations and become the vanguard of future treatments. Several complementary and alternative treatments have been used in cancer management as an adjunct to conventional therapy to improve the overall quality of life and reduce recurrence. Yoga stands as the third most popular of all complementary and alternative medicine treatments currently used in cancer patients today. Preliminary results show that yoga modulates neural, hormonal, and immune functions at a cellular level. The scope of this commentary is to discuss the current evidence-based medicine on yoga and its effect on CSCs.

Keywords: Cancer, stem cells, yoga, treatment

How to cite this article:
Beri K. The impact of the “Yogic Lifestyle” on cancer prognosis and survival: Can we target cancer stem cells with yoga?. Int J Yoga 2017;10:95-8

How to cite this URL:
Beri K. The impact of the “Yogic Lifestyle” on cancer prognosis and survival: Can we target cancer stem cells with yoga?. Int J Yoga [serial online] 2017 [cited 2019 Dec 11];10:95-8. Available from: http://www.ijoy.org.in/text.asp?2017/10/2/95/205512

   Introduction Top


Targeted cancer treatment is the new focus in research for management of patients to improve overall outcome.[1],[2] In spite of recent advances, there has been no evidence that the prevalence of cancer has decreased.[3] These special stem cell-like cancer cells have the ability to originate, spread, and cause recurrence of cancer in the body.[4],[5] At the cellular level, aberrant expression of hormones, cytokines, and chemokines which include estrogens, androgens, tumor necrosis factor (TNF), and notch and tumorigenic signals such as nuclear factor-kappa B (NF-κB) and Myc-1 enhance the growth of cancer stem cell (CSC).[5] A study by Heddleston et al.[6] describes how CSCs work through multiple mechanisms and networks such as their ability to restrict DNA damage during radiation or chemotherapy by reduction of reactive oxygen species (ROS) and enhanced activity of DNA checkpoint kinases.[7],[8] In conclusion, it is believed that the CSC population survives with injury and continues to propagate the tumor by preventing DNA damage.

In yogic philosophy, prāna is the vital force in all living beings in the universe.[9] Prāna is the basic life principle that is responsible for all kinds of movement (of thought as well as matter) and has the ability to expand and contract by itself.[10] Prāna represents the interface between energy and consciousness.[9] Yogic philosophy also appreciates that mind is more powerful than prāna and hence can direct the pranic flow.[9],[10] The practice of yoga includes physical postures, breathing practices, and meditations.[11] It is known to alter immune and endocrine functions at the cellular level through influencing cell cycle, aging, oxidative stress, cell death, and several pathways of stress signaling.[12],[13] Yoga has also been shown to affect natural killer cell (NK cell) function and alter stress and DNA damage in breast cancer patients receiving radiotherapy.[14],[15]


   Cancer Stem Cell and the Role of Hypoxia Top


Hypoxia is necessary for stem cell survival.[16] Hypoxia enhances malignant potential of tumor cells by facilitation of tumor invasion and metastasis,[17] increased expression of drug resistance genes,[18] reduced expression of DNA repair genes,[19] and increased genomic instability.[20] Hypoxia-induced signaling is primarily mediated by hypoxia-inducible factor-1 (HIF-1a) molecule expressed by mammalian cells in response to hypoxia that regulates O2 homeostasis. HIF-1 has led to the concept of a “molecular target” of hypoxia in the development of cancer therapeutics.[21] Heddleston et al.[6] demonstrated that CSCs are critically dependent on hypoxia-induced factors for their survival, self-renewal, and growth. Presence of hypoxia in tumors can result in the promotion of CSC phenotypes even in the context of successful killing of other tumor cells and thus represents a challenge in therapy.[6] Experimental evidence puts an emphasis on micro-environmental conditions such as low-oxygen environments that govern CSC and suggests that the new targeted treatment modalities should be focused on influencing the niche of the CSC.[6] A strong correlation between tumor hypoxia and poor patient outcomes is seen in the presence of CSCs.[6]


   Yoga and Oxygenation Top


Yogic postures (asanas) and breathing techniques (pranayama) focus on airflow in the lungs, thus increasing their capacity, endurance, and efficiency.[22] Back-bending postures open the chest, improving both lung and heart functions.[22] A study [23] assessed blood oxygen saturation before, during, and after two yoga breathing techniques in 29 healthy male volunteers with ages ranging between 17 and 32 years. A significant increase (P < 0.01) in oxygen saturation was observed in the high-frequency yoga breathing. Another study measured the impact of asanas and pranayama on blood oxygen saturation level. It was observed from the study that the groups differed significantly with an increase in oxygenation in the pranayama group.[23] Yoga practices have also been shown to improve ROS levels and oxidation status. A study was conducted on healthy male volunteers divided into two groups: yoga (n = 34) and control groups (n = 8). The yoga group practiced yoga asanas, pranayama, and meditation for 3 months and the control group followed a usual routine. Blood samples done before, during, and after 3 months of practice showed an increase in total antioxidant status (P < 0.001), wherein glutathione peroxidase activity was increased (P < 0.001) and plasma concentration level of malondialdehyde (P < 0.01) and oxidized glutathione (P < 0.01) decreased significantly after 3 months in the yoga group suggesting an improvement in oxidative stress, these molecules are markers for oxidative stress.[24]

Sudarshan Kriya (SK), which is a type of pranayama in which breathing is in three different rhythms,[25] has been shown to lower blood lactate levels and provides better antioxidant defense.[25] In another study,[26] the effect of SK was studied at the transcriptional level of the antioxidant enzymes. There was a significant increase in the expression of glutathione-S-transferase in practitioners of SK compared to the normal controls, along with a significant increase in anti-carcinogenic molecules such as anti-apoptotic COX-2 and heat shock proteins-70. It was also observed that age-related human telomerase reverse transcriptase and regulator proteins such as anti-apoptotic Bcl-2 showed an increasing trend in SK practitioners.[26]


   Modulation of Neural, Endocrine, and Immune Functions Through Yoga Therapy Top


Aberrant expression and activities of hormones, cytokines, and chemokines which include estrogens, androgens, and transforming growth factor-notch and tumorigenic signaling elements such as telomerase, NF-κB, and Myc-1 may enhance CSC survival and contribute toward the malignant potential of tumors.[27],[12] The practice of yoga can bring a balance in the expression and activities of various hormones, cytokines, and tumorigenic signaling elements that help to reduce CSC survival, progression, and recurrence of the tumor. By increasing [28] NK cell activity, reducing plasma TNF-α levels following surgery, and modulating stress-induced DNA damage during radiotherapy in breast cancer patients, an improved prognosis can be expected.[29] Tseng et al.[30] demonstrated an increased lysis of CSC NK cells. This lysis was mediated by increased cytotoxicity as well as augmented secretion of interferon gamma (IFN-γ). They also established that inhibition of reversion of cells to a less-differentiated phenotype by blocking NF-κB or targeted knockdown of COX-2 in monocytes significantly augmented NK cell cytotoxicity and secretion of IFN-γ.[30] A study on 45 dementia caregivers showed that brief daily yogic meditation led to a decreased NF-κB-related transcription of pro-inflammatory cytokines and decreased interferon response factors 1.[31] This may enhance NK cell activity indirectly.[31] The lifestyle changes associated with the yogic practice have been shown to increase NK cell activity in breast cancer patients.[28],[32] A pilot study displayed that regular practitioners of yoga have lower cellular dysfunction perhaps due to reduced qualitative DNA damage and better restorative responses compared to control patients.[33] Long Parma et al.[34] reported the effect on inflammatory biological markers for twenty breast cancer survivors who participated in a 6-month yoga-based exercise program. Inflammatory markers such as interleukin-6 (IL-6), IL-8, TNF-α, and C-reactive protein were measured. The obtained results show the effectiveness of yogic asanas and pranayama exercises in improving body composition, but reported no significant changes in inflammatory markers or cytokines. Larger studies are needed to determine whether there are significant changes in inflammatory serum markers as a result of specific exercise modalities.[34]


   Future Aspects Top


The relationship between the 5000-year-old practice of yoga, based on ancient Vedic scriptures, and the newly discovered science of CSC inspires the researcher to examine the biological implications of ancient metaphysical practices. More research and larger trials on various yogic techniques and types and stages of cancer could give us valuable information and also deeper understanding and functioning of CSCs. Yoga therapy may have a complementary effect with conventional modalities of treatment in preventing cancer progression and recurrence by increasing the susceptibility of CSCs to conventional treatment. Future research may focus on the study of lysis of CSC by specific yoga techniques posttreatment and the quantitative assessments of inflammatory mediators.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
World Health Organization. World Health Report Factsheet. Factsheet; 2012. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/index.html. [Last cited on 2012 Apr 24].  Back to cited text no. 1
    
2.
Cancer IA for R in. 2008. Available from: http://gicr.iarc.fr/.  Back to cited text no. 2
    
3.
Gupta M, Shafiq N, Kumari S, Pandhi P. Patterns and perceptions of complementary and alternative medicine (CAM) among leukaemia patients visiting haematology clinic of a North Indian tertiary care hospital. Pharmacoepidemiol Drug Saf 2002;11:671-6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12512243. [Last cited on 2012 Apr 16].  Back to cited text no. 3
    
4.
Heddleston JM, Li Z, Lathia JD, Bao S, Hjelmeland AB, Rich JN. Hypoxia inducible factors in cancer stem cells. Br J Cancer 2010;102:789-95. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2833246&tool=pmcentrez and rendertype=abstract. [Last cited on 2012 Jul 16].  Back to cited text no. 4
    
5.
Mimeault M, Batra SK. Concise review: Recent advances on the significance of stem cells in tissue regeneration and cancer therapies. Stem Cells 2006;24:2319-45.  Back to cited text no. 5
    
6.
Heddleston JM, Li Z, Lathia JD, Bao S, Hjelmeland AB, Rich JN. Hypoxia inducible factors in cancer stem cells. Br J Cancer 2010;102:789-95.  Back to cited text no. 6
    
7.
Bao S, Wu Q, McLendon RE, Hao Y, Shi Q, Hjelmeland AB, et al. Glioma stem cells promote radioresistance by preferential activation of the DNA damage response. Nature 2006;444:756-60.  Back to cited text no. 7
    
8.
Diehn M, Cho RW, Lobo NA, Kalisky T, Dorie MJ, Kulp AN, et al. Association of reactive oxygen species levels and radioresistance in cancer stem cells. Nature 2009;458:780-3.  Back to cited text no. 8
    
9.
Tapasyananda S. Bhagavat Gita. Economy Edition. Mylapore: Math, Sri Ramakrishna; 1988.  Back to cited text no. 9
    
10.
Taimni IK. The Yoga Sutras of Patanjali. 1st ed. New York: Quest Books; 1999.  Back to cited text no. 10
    
11.
Kulkarni DD, Bera TK. Yogic exercises and health – A psycho-neuro immunological approach. Indian J Physiol Pharmacol 2009;53:3-15.  Back to cited text no. 11
    
12.
Bhargav H, Raghuram N, Rao NH, Tekur P, Koka PS. Potential yoga modules for treatment of hematopoietic inhibition in HIV-1 infection. J Stem Cells 2010;5:129-48.  Back to cited text no. 12
    
13.
Ross A, Thomas S. The health benefits of yoga and exercise: A review of comparison studies. J Altern Complement Med 2010;16:3-12.  Back to cited text no. 13
    
14.
Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med 2003;65:571-81.  Back to cited text no. 14
    
15.
Kiecolt-Glaser JK, Bennett JM, Andridge R, Peng J, Shapiro CL, Malarkey WB, et al. Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: A randomized controlled trial. J Clin Oncol 2014;32:1040-9.  Back to cited text no. 15
    
16.
Cipolleschi MG, Dello Sbarba P, Olivotto M. The role of hypoxia in the maintenance of hematopoietic stem cells. Blood 1993;82:2031-7.  Back to cited text no. 16
    
17.
Subarsky P, Hill RP. The hypoxic tumour microenvironment and metastatic progression. Clin Exp Metastasis 2003;20:237-50.  Back to cited text no. 17
    
18.
Comerford KM, Wallace TJ, Karhausen J, Louis NA, Montalto MC, Colgan SP. Hypoxia-inducible factor-1-dependent regulation of the multidrug resistance (MDR1) gene. Cancer Res 2002;62:3387-94.  Back to cited text no. 18
    
19.
Mihaylova VT, Bindra RS, Yuan J, Campisi D, Narayanan L, Jensen R, et al. Decreased expression of the DNA mismatch repair gene Mlh1 under hypoxic stress in mammalian cells. Mol Cell Biol 2003;23:3265-73.  Back to cited text no. 19
    
20.
Koshiji M, To KK, Hammer S, Kumamoto K, Harris AL, Modrich P, et al. HIF-1alpha induces genetic instability by transcriptionally downregulating MutSalpha expression. Mol Cell 2005;17:793-803.  Back to cited text no. 20
    
21.
Melillo G. Inhibiting hypoxia-inducible factor 1 for cancer therapy. Mol Cancer Res 2006;4:601-5.  Back to cited text no. 21
    
22.
Bhargava H, Metri K, Raghuram N, Ramarao NH, Koka PS. Enhancement of cancer stem cell susceptibility to conventional treatments through complementary yoga therapy: Possible cellular and molecular mechanisms. J Stem Cells 2012;7:261-7.  Back to cited text no. 22
    
23.
Bhattacharya S, Pandey US, Verma NS. Improvement in oxidative status with yogic breathing in young healthy males. Indian J Physiol Pharmacol 2002;46:349-54.  Back to cited text no. 23
    
24.
Del Rio D, Stewart AJ, Pellegrini N. A review of recent studies on malondialdehyde as toxic molecule and biological marker of oxidative stress. Nutr Metab Cardiovasc Dis 2005;15:316-28.  Back to cited text no. 24
    
25.
Sharma H, Sen S, Singh A, Bhardwaj NK, Kochupillai V, Singh N. Sudarshan Kriya practitioners exhibit better antioxidant status and lower blood lactate levels. Biol Psychol 2003;63:281-91.  Back to cited text no. 25
    
26.
Sharma H, Datta P, Singh A, Sen S, Bhardwaj NK, Kochupillai V, et al. Gene expression profiling in practitioners of Sudarshan Kriya. J Psychosom Res 2008;64:213-8. doi: 10.1016/j.jpsychores.2007.07.003.  Back to cited text no. 26
    
27.
Mimeault M, Brand RE, Sasson AA, Batra SK. Recent advances on the molecular mechanisms involved in pancreatic cancer progression and therapies. Pancreas 2005;31:301-16.  Back to cited text no. 27
    
28.
Rao RM, Telles S, Nagendra HR, Nagarathna R, Gopinath K, Srinath S, et al. Effects of yoga on natural killer cell counts in early breast cancer patients undergoing conventional treatment. Med Sci Monit 2008;14:LE3-4.  Back to cited text no. 28
    
29.
Rao RM, Nagendra HR, Raghuram N, Vinay C, Chandrashekara S, Gopinath KS, et al. Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Int J Yoga 2008;1:33-41.  Back to cited text no. 29
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30.
Tseng HC, Arasteh A, Paranjpe A, Teruel A, Yang W, Behel A, et al. Increased lysis of stem cells but not their differentiated cells by natural killer cells; de-differentiation or reprogramming activates NK cells. PLoS One 2010;5:e11590.  Back to cited text no. 30
    
31.
Black DS, Cole SW, Irwin MR, Breen E, St Cyr NM, Nazarian N, et al. Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology. 2013;38:348-55. doi: 10.1016/j.psyneuen.2012.06.011. Epub 2012.  Back to cited text no. 31
    
32.
Nakau M, Imanishi J, Imanishi J, Watanabe S, Imanishi A, Baba T, et al. Spiritual care of cancer patients by integrated medicine in urban green space: A pilot study. Explore (NY). 2013;9:87-90.  Back to cited text no. 32
    
33.
Ram A, Banerjee B, Hosakote VS, Rao RM, Nagarathna R. Comparison of lymphocyte apoptotic index and qualitative DNA damage in yoga practitioners and breast cancer patients: A pilot study. Int J Yoga 2013;6:20-5.  Back to cited text no. 33
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34.
Long Parma D, Hughes DC, Ghosh S, Li R, Treviño-Whitaker RA, Ogden SM, et al. Effects of six months of yoga on inflammatory serum markers prognostic of recurrence risk in breast cancer survivors. SpringerPlus 2015;4:143.  Back to cited text no. 34
    

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Correspondence Address:
Kavita Beri
Department of Biomaterials, Center for Dermal Research, Rutgers University, 145 Belvoir Road, New Brunswick, NJ
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6131.205512

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    Abstract
   Introduction
    Cancer Stem Cell...
   Yoga and Oxygenation
    Modulation of Ne...
   Future Aspects
    References

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