Pranayama and Cancer

As one of the steps on Patanjali’s eight-step path of yoga, pranayama has been practiced by yogis for thousands of years as a way to quiet the mind and tap into the subtle, energetic realms of the body. Prana is a Sanskrit term for the vital life force that animates all things; ayama translates as extension or elongation. Pranayama enables the practitioner to access prana and connect with the vast energetic network of the subtle body by controlling and playing with the flow of breath.

Current research has shown that beyond these subtle effects, pranayama has numerous observable health benefits. Several studies provide evidence that yogic breathing exercises help to induce a relaxed state by enhancing the action of the parasympathetic nervous system (otherwise known as the “rest-and-digest response”).

Researchers at the University of California – San Francisco investigated how the health benefits of pranayama specifically apply to cancer patients undergoing chemotherapy. The study had two aims:

  1. To determine whether it’s feasible for patients undergoing chemotherapy to practice pranayama

  2. To gauge the effect of pranayama on common chemotherapy-associated symptoms (fatigue, sleep disturbance, stress, anxiety, depression) and quality of life (QOL)

Patients in the study were separated into a treatment group and control group: the treatment group received the pranayama intervention during two consecutive cycles of chemo; the control group received only typical care during their first chemo cycle and the pranayama intervention during the second.

The pranayama intervention consisted of a 60-minute class once a week and daily home practice of 20-30 minutes twice a day. Patients were taught four pranayama techniques: Breath Observation, Ujjayi (Victoriously Uprising Breath), Kapalabhati (Skull Shining Breath), and Nadi Shodhana (Alternate Nostril Breath).

The treatment group saw improvements in stress, sleep disturbance, anxiety and mental quality of life (QOL) throughout both cycles of chemo. The control group experienced a worsening of sleep disturbance, anxiety, depression and mental QOL during the first cycle of chemo, and improvements in all these symptoms during the second. For patients in both groups, the more time spent practicing pranayama (either at home or in class), the greater the improvement observed in symptoms and QOL.

Previous studies have implemented a variety of yogic techniques such as asana, meditation and pranayama practiced in combination. In contrast, the results of this study indicate that practicing pranayama by itself is more feasible for patients in chemotherapy due to its ease of use: it requires no equipment, is relatively easy to learn and can be practiced at any time, even while patients receive chemo infusions. The class attendance rate was comparatively high and patients spent more time practicing at home than in prior studies in this area.

The researchers concluded that pranayama is appropriate, beneficial, and can be safely recommended for cancer patients undergoing chemotherapy. Further study in this area will hopefully offer even more definitive evidence of pranayama’s efficacy.

Below are instructions for the four breathing techniques taught to and practiced by patients in the study.

Breath Observation

Sit or lie in a comfortable position. Breathe naturally. Avoid forcing, controlling or manipulating your breath. Shift your attention to your breath. Simply observe and experience it without any judgment. You might notice the soft whispering sound the breath creates; how long or short the breath is; how deep or shallow it feels; or where in your body you feel the breath most noticeably. At certain points during this practice, you might notice that your mind is no longer focused on the breath. When this happens, acknowledge that the mind has wandered and gently guide it back to the breath.

Ujjayi (Victoriously Uprising Breath)

Sit or lie in a comfortable position. Keeping the mouth closed, inhale and exhale through the nose. Partially close the glottis (the opening between the vocal folds) by slightly constricting the muscles at the back of the throat. The action in these muscles should feel the same as when you exhale your breath onto a mirror to create fog. As the muscles contract, you’ll begin to notice that your breath creates a soft whispering sound similar to the sound of the ocean. Continue to create this sound with the breath and find a steady rhythm, breathing in for the same amount of time that you breathe out.

Kapalabhati* (Skull Shining Breath)

Sit comfortably in an upright position and bring your attention to your lower belly. It can be helpful to rest one or two hands on the belly below the navel. Breathe in deeply then exhale completely. Inhale about halfway; then begin a series of short, sharp exhalations by pumping the abdomen. After forcing the air out by contracting the abdomen, release the belly and passively inhale. Repeat this several times. Start with however many breath cycles (one inhale and one exhale) you can comfortably do, then relax and breathe normally. Gradually over time, increase the number of cycles.

*Kapalabhati is not recommended if you are pregnant or suffer from high or low blood pressure, glaucoma, cardiac issues, or hernia.

Nadi Shodhana (Alternate Nostril Breath)

Sit comfortably in an upright position. Spread the fingers of the right hand. Create Vishnu Mudra by curling the right index and middle fingers in towards the palm, while the thumb, ring finger and pinky remain extended. Hold the right hand just beside the nose as you take a deep breath in through both nostrils. Close the right nostril with the thumb then exhale through the left. Inhale through the left, close both nostrils by lightly touching the ring finger to the left nostril and the thumb to the right. Lift the thumb and exhale through the right nostril. Inhale through the right nostril, close both, then lift the ring finger and exhale through the left. Continue for several cycles of breath.

For more information on this study, see the Journal of Alternative and Complementary Medicine.

Christine Malossi, RYT 200 is based in New York City, where she offers a mindful, alignment-focused Vinyasa practice that cultivates balance, awareness and equanimity. In addition to teaching private clients and group classes at studios throughout Manhattan, she also teaches at the Spencer Cox Center for Health at Mount Sinai Hospital’s Institute for Advanced Medicine whereshe designs a practice specifically tailored to patients diagnosed with HIV and other chronic illnesses. Christine is honored to be teaching yoga and to have the opportunity to pass on to others the joy and freedom that she has found in her own practice. Find her at

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