Yoga as Medicine?by Hyoun Bae on 01/24/19
Yoga as Medicine?
Integrative Oncology: Yoga, Ayurveda and Chinese Medicine
Over ten years ago I participated in a Fellowship at local hospital. I had only a few opportunities to visit the Oncology ward, which also housed a wing for integrative yoga therapy.
It’s hard to imagine that massage or yoga would require substantial evidence to be incorporated into treatment approaches, if not for the benefit toward quality of life and palliative care. As a yoga researcher some fifteen years ago, the adjunct research department (consisting of just a handful of editors) IAYT, was in its fledgling state.
At this time, the field is moving toward insurance reimbursement and deepening integration in in-patient and outpatient settings.
A relatively recent review in the International Journal of Yoga by Ram P. Agarwal and Adi Maroko-Afek (2018) explores Yoga in Cancer Care, based upon evidence-based studies. You can look it up on NIH site and PubMed. Increasingly, Complementary and Alternative medicine is being included in pain-management and palliative care. Accordingly, integrative oncology may begin to incorporate CAM disciplines such as Yoga, as it has with Acupuncture.
In this review, the authors identify yoga as one mindbody approach to person-centered care. It reports on the literature up until the tail end of 2016, and many quality studies have certainly occurred in the last two years.
With over two-hundred studies and clinical trials, data for the efficacy of yoga therapy for a variety of cancer and cancer-related symptoms appeared overwhelmingly positive – for psycho-emotional and physical aspects during conventional care.
When it comes to quality of life, it’s important to zero in on individual’s experience of care – the realm of qualitative research. It’s also valuable to note what yoga interventions were applied, and why yoga may be different that physical therapy – including its meditation, breathwork and tailored adaptations in adjuvant care.
Timothy Mccall, MD, a leading author in the medical and therapeutic aspects of yoga therapy, details his account of integrative treatment (Saving My Neck: A Doctor’s East/West Journey through Cancer, 2018), in which he recounts his own journey through chemo and radiation therapy. This work is exceedingly important as a personal narrative, penned by a physician who chose out of necessity and reflection on the costs, risks and benefits of a variety of care options, and opted to integrate traditional Ayurveda and yoga.
Dr. Mccall's other works are defining contributions to the field of Yoga Therapy literature.
As a clinician, he came to the same realization that “Eastern (Asian)” medicine operates upon certain fundamental, holistic principles which offer a humane lens toward how we go about in health and healing. These medical traditions have a way of understanding the impact and management of conventional medical interventions, how to fill the holes or gaps, and as adjuvant care, an ability to provide options that would otherwise not be in a standard approach.
In other words, don’t go and try what he did as a recipe, but in the narrative there is much to learn regarding how his therapeutic choices might be regarded within mainstream care, and how he has a trained physician, was able and willing to try a variety of traditional medicine options.
I would agree with many in the integrative field, that “good medicine” is a blend of evidence-based approaches and pragmatism, and our needs as patients will often bring clarity to these areas and issues.
After some twenty-five years of study and training in Yoga and Ayurveda, aside from his thirteen year medical career, he courageously navigates the trail of integration as a patient – the role in which it is often most difficult to manage all of these routes of care. He is quick to clarify that no two journeys and choices are the same, especially with regard to personalized-care irrespective of diagnosis.
Some passages reveal how he utilized Ayurvedic treatment prior or in between conventional care, which we might call “purva-karma” – or measures taken to prepare before the main body of treatment.
I have just reached an early passage wherein he discusses his personal use of mantra and sound therapy, while undergoing treatment for oral squamous cell cancer. Most clinicians might look askance to any such mindbody intervention, lacking any evidence as to its benefit, while someone with a yoga background might adopt a practice based upon a traditional claim. Whether it’s a premodern text, or a book published and written in the last fifty years, it’s important to recognize that yoga science was exactly scientific, but maintained its own conclusions and theories from it’s particular “epistemic culture.”
“Good medicine” is in part, arrived at, through parsing and wading through supposed facts, beliefs and anecdotal reports, in the context of care (clinical reality).
I look forward to sharing further reflections on how this particular narrative work highlights personal and clinical decisions in integrative care management.
One thing I find invaluable about this text is the level of detail it provides around Dr. Mccall’s experiences during treatment, the quality relationships he had with his providers and the grey areas where evidence-based approaches do not support all of the personal decisions he made regarding his approach to care for certain side effects. It’s helpful to have such a clinical and subjective account of his experience during many phases of treatment and his response to a variety of side effects.
I was also surprised to read his anecdotal mention of utilizing private and community acupuncture, and the benefit he self-reported.
These are questions we all have to make with regards to our health. The blending of Asian medicine and conventional care strategies is again something we do as patients, as clinicians and in integrative medical settings.