ISSN 0044-0507 www.ym-kdham.

in

Vol. 46 | Issue 1 & 2 | Jan-Jun 2014

Swami Kuvalayananda, Paramahansa

Founder of Kaivalyadhama Sri Madhavadasji Maharaj,
(1883-1966) the Guru (1798 – 1921)

"The specific aim is to coordinate ancient Yoga with modern science. Divorced from
each other Science and Spirituality do not seem to be of much avail.

While spirituality without science often tends to become a mass of superstition, science
without spiritual aims, as is being increasingly realized, threatens to lead mankind to
total annihilation.

A propagation of Yoga after due research in it goes a long way in bringing about a
healthy rapprochement between science and spirituality, thereby helping mankind to
YOGA MIMAMSA
A journal of scientific and philosophico-literary research in Yoga
lead a truly regenerative life.”
Swami Kuvalayananda Published since 1924

Kaivalyadhama
Scientific & Philosophico-literary research. Yoga education. Library. Yoga Publications.
Yoga therapy. Panchakarma. Naturopathy. Customized Wellness & Healing Programs. Official Publication of Medknow
Website: www.kdham.com I Email: info@kdham.com I Tel.: (02114) 276001/273001/273039 Kaivalyadhama
 Original Article

A novel rejuvenation program for cancer patients at

Kaivalyadhama, India
Lee Majewski1, Ananda Balayogi Bhavanani2
1
Kaivalyadhama Yoga Institute, Lonavala, Maharashtra, India, 2Centre for Yoga Therapy, Education and Research (CYTER), Mahatma
Gandhi Medical College and Research Institute (MGMCRI), Pillayarkuppam, Pondicherry, India

Abstract Background: The modern intensive treatment for cancer leaves the patients physically and mentally exhausted
by the end of it. There is great potential for Yoga, the original mind–body medicine, in such a situation as it
conjointly emphasizes body, mind, and spirit, which may be particularly useful for enhancing patients’ social
and spiritual well-being. Some studies have reported the effectiveness of Yoga, meditation, and mindfulness as
a rehabilitative and palliative therapy in various types of cancer.
Objectives: With the above background in mind, we created a 3-week residential program for cancer patients
to empower them in their journey, “back to health.” The curriculum was geared specifically for those who had
undergone chemotherapy and/or radiation.
Methods: The program utilized the sister life sciences of Yoga and Ayurveda with a healthy dose of self-education to
assist patients in their recovery from the devastation of cancer and its modern treatment. The modes of reintegration
used in this program were designed to specifically address the physical, mental, and psychic (spiritual) needs
of the participants. The curriculum included various asanas, kriyas, pranayama, mudras, and bandha, as well as
chanting. Ayurvedic treatment based on panchkarma science was designed and applied according to each patient’s
disposition. An educational component was included to inform patients of potential carcinogenic factors in their life
and to change their mindset and attitudes from victimhood to self-empowerment. In order to scientifically validate
the program, physiological, biochemical, psychological, and Ayurvedic assessment of tridoshas was carried out.
Conclusion: Our special Cancer Rehabilitation Yoga program is expected to have several beneficial effects for
those recovering from the aftermath of anti-cancer therapies even at 3-month follow-up. Subjective observations
so far reveal that the program led to overall empowerment of the participants.

Key Words: Cancer, rehabilitation, Yoga

INTRODUCTION cancer patients undergo extensive chemotherapy with or

without surgery, followed often by radiation (Life After Cancer,
The media worldwide is reporting an increase in the incidence of n.d.). After such intensive treatment schedules provided by
cancer, and the 5-year global cancer prevalence was estimated to modern medicine, patients are physically exhausted (Life After
be 28.8 million in 2008 with half the burden in areas of very high Cancer, n.d.; Shaw, n.d.). Their bodies are usually subjected to a
human development, comprising only one-sixth of the world’s wide array of chemical poisons, which indiscriminately attack
population (Bray, Ren, Masuyer, & Ferlay, 2008). Typically, all generative cells resulting in physical exhaustion. However,
the toll on the physical body is only one side of the coin as many
Access this article online enter various degrees of depression after completion of intensive
Quick Response Code: treatments (Feuerstein, 2007). Long-term chemotherapy results
Website:
in chemotherapy-induced cognitive dysfunction or “chemo
www.ym-kdham.in brain” that may be due to restriction in blood supply to the
brain, manifesting as depression, mental confusion, inability to
DOI: focus, and loss of short-term memory (Life After Cancer, n.d.;
10.4103/0044-0507.137843 Asher, 2011; Phillips et al., 2012). Such states often lead to a state
of confusion and crisis in values in the lives of cancer survivors.

Address for correspondence:

Dr. Ananda Balayogi Bhavanani, Deputy Director, CYTER, MGMCRI, Pillayarkuppam, Pondicherry - 607 402, India.
E-mail: yognat@gmail.com

20 Yoga Mīmāṃsā | Vol. 46 | Issue 1 & 2 | Jan-Jun 2014

 Majewski & Bhavanani: Rejuvenation program for cancer patients

The mental strain on cancer survivors is often underestimated. natural, inherent body, mind, and emotional healing processes
After their allopathic therapy is completed, patients are told to (Khalsa, 2004; Levine & Balk, 2012; Carlson et al., 2003, 2004;
go back to their “normal life” and are regarded by the society Coker, 1999; Wolsko, Eisenberg, Davis, & Phillips, 2004).
as “normal as before.” This adds to the patients’ confusion as
it increases their stress of not being “understood.” They begin Throughout the program, we adopted primarily the group
to feel that their family and friends do not understand their classes pattern as it has been previously noted that such
depression, mental confusion, and display of lack of memory. group Yoga classes provide patients with a community
and a forum in which to share their experience (Levine &
Yoga, the original mind-body medicine, is regarded as being Balk, 2012).
beneficial in various disorders (Funderburk, 1997; Innes,
Bourguignon, & Taylor, 2005; Khalsa, 2004; Yang, 2007; Sharma, Daily schedule Monday to Saturday
Gupta, & Bijlani, 2008), and can be of immense help to such 07:00-08:15 Yoga-Asana/pranayama
cancer patients as well. The practice of Yoga is therapeutically 08:30 Breakfast
unique in that it conjointly emphasizes body, mind, and spirit, 10:00-11:30 Cleansing and rejuvenating
Ayurvedic treatments (Panchkarma)
which may be particularly useful for enhancing patients’
12:00-12:30 Yoga-Silent meditation
social and spiritual well-being (Levine & Balk, 2012). Some
12:30 Lunch
studies have reported the effectiveness of Yoga, meditation,
03:00-04:30 Group activity (education, therapy)
and mindfulness as a rehabilitative and palliative therapy in
various types of cancer (Bower, Wooler, Sternlieb, & Garet, 05:00-06:15 Yoga Nidra
2005; Carlson, Speca, Patel, &  Goodey, 2003, 2004; Cohen, 06:30 Dinner
Warneke, Fouladi, Rodriguez, & Chaoul-Reich, 2004; Coker, 08:15-09:00 Yoga-Chanting and silent meditation
1999; Culos-Reed, Carlson, Daroux, & Hately-Aldous, 2006;
Harder, Parlour, & Jenkins, 2012; Wolsko, Eisenberg, Davis, & 1. Asana–pranayama–mudra–bandha
Phillips, 2004; Zhang, Yang, Tian, & Wang, 2012). We used the following strategy for this module:

A recent review by Levine and Balk concluded that yoga a. Simple joint movement and warming up stretching
benefits women’s emotional functioning during and after b. Asanas
breast cancer treatment, and causes decrease in anxiety and
1st week 2nd week 3rd week
depression and enhanced cognitive functioning (Levine &
Lying supine
Balk, 2012). They mentioned thus: “patients cite physical
Supta Tadasana
activity, breathing, meditation, and group support as
Simple crocodiles‑ 1, Crocodile (with Crocodile‑ 5th
particularly helpful components of Yoga.” Practitioners of 2, 3, 4 maintenance)
Yoga vouch for its efficacy and relative safety in a multitude
Suptabhadrasana
of conditions. Yoga may be understood as a re-integrator (butterfly)
of this complex, inducing a state of dynamic well-being, Ekapada uttanasana Ardhahalasana‑ Ardhahalasana‑
a state of health (Bhavanani, 2011a, 2011b). one leg both legs
Setubandhasana
METHODS Ardha‑pavanamuktasana Pavanamuktasana Pavanamuktasana
(single leg)
We created a 3-week residential program for cancer Lying prone
patients to empower them in their journey, “back to Niralambasana (without raising) (with raising)
health.” The curriculum was geared specifically for those Simple bhujangasana
who had undergone chemotherapy and/or radiation, and (forearm support)
the program utilized the sister life sciences of Yoga and Ardhashalabhasana
Ayurveda with a healthy dose of self-education to assist (with support)
patients in their recovery from the devastation of cancer Sitting
and its modern treatment. The first of these programs was Marjarasana (simple
cat/cow)
held recently at Kaivalyadhama Yoga Institute in Lonavla,
India (www.kdham.com/cancer). Vajrasana

Modes of re-integration Shashankasana Uttanamandukasana

The modes of re-integration used in the program were Gomukhasana
designed to specifically address the physical, mental, and Bharadwajasana Vakrasana
psychic (spiritual) needs of the participants. Many studies Simple janusirasana
have reported the effectiveness of yogic techniques, while Bhadrasana
the technique of silent meditation and chanting may enhance Contd...

Yoga Mīmāṃsā | Vol. 46 | Issue 1 & 2 | Jan-Jun 2014 21

 Majewski & Bhavanani: Rejuvenation program for cancer patients

1st week  2nd week 3rd week be useful in stress management and in creating an inner
Standing sense of relaxation manifested as reduced heart rate (HR)
Tadasana and blood pressure (BP) (Bhavanani, Madanmohan, Sanjay,
Katichakrasana‑ 1, 2 (waist rotation) & Vithiyalakshmi, 2012).
Parvatasana
Side bending chakrasana Konasana Simple Trikonasana 3. Ayurveda: Every morning patients had Ayurvedic
Natarajasana‑ 1st step Natarajasana treatment based on panchkarma science. The treatment
Padhastasana‑90° Padhastasana was designed and applied according to each patient’s
disposition and was very personalized. It included
cleansing practices, full body massage, steam bath, herb oil
c. Following pranayama application, and three daily meals based on sattvic vegan
diet. Licensed Ayurvedic therapists administered it under
Practices 1st week 2nd week 3rd week the watchful eyes of two Ayurvedic doctors. Ayurveda is
Kapalabhati 40-40-40 60-60-60 80-80-80
viewed as a sister science of Yoga and, hence, we felt the
Lung expansion skills Upper lobe‑ 8 10-12 15-20 integration of both ancient sciences can produce a better
Lower lobe‑ 8 sense of healing and well-being in the participants.
Puraka-rechaka Bhramari‑ 8-10 10-12 15-20
Easy kumbhaka Ujayi‑ 8-10 8-10 rounds 4. Education: The goal of educational component of the
Shitali‑ 8-10 Bhastrika‑ Bhastrika program was to inform patients of potential carcinogenic
3-5 rounds 10-12 rounds
factors in their life and to change their mindset and
Gradual development 5-6 rounds
of Kumbhaka
attitudes from victimhood to self-empowerment. As
the International Association of Yoga Therapists (IAYT)
definition of Yoga therapy includes the empowerment of
Bandha-Mudras: Three basic bandhas, ashwini mudra, and the individual (Taylor, 2007), we considered this a vital
brahmamudra component of our program and every afternoon, patients
spent 90 min learning about Ayurveda treatments, yogic
We used simplified asanas and increased the complexity values, environmental toxicity, diet, healthy lifestyle, and
over 3 weeks, always being mindful of the following: yogic tools to maintain health and well-being. Change must
• to meet individual client level of tolerance, come from within, and this was the goal, to educe such a
• of skin incisions and peripheral neuropathy, and positive change in our participants.
• of poor balance issues.
5. Therapy: Throughout the program, patients had access
The pranayama also had to be modified according to Ayurvedic and allopathic doctors for any consultations
to specific cancer. So, those with colon cancer would if needed. Yogic therapy was also available upon request
replace Kapalbhati with alternating nostril breathing and generally the participants were eager to discuss their
(Nadhi Shoddhana). These psycho-physical practices of issues with chosen specialists. In addition, toward the end
Yoga enable participants to get to “know their bodies” of the program, they worked on creating personal mandalas
better and create a positive sense of oneness between breath to help them find a new sense and direction in life.
and body movements.
Psycho-physio-biochemical parameters
2. Chanting: Chanting is widely used in the Yoga tradition In order to scientifically validate the program, we tested
as it creates a sense of inner peace that is conducive to the following parameters with plans of repeating them at
healing. When we chant, we are in the “now” and this 3 months follow-up:
induces empowerment as we begin to take charge of our 1. Psychological tests: Given that a majority of patients
thoughts, feelings, and actions (Bhavanani, 2011b). For end up depressed after completing modern anti-cancer
our participants, we used healing mantras culled from therapy, we used standard tools such as WHO Quality
different traditions. In the first week, the Ra Ma Da Sa of Life, Hospital Anxiety and Depression Score
from Kundalini Yoga tradition was used as it also provides (HADS), and Profile of Mood States (POMS). These
a beautiful musical experience. It was noticed that even are standardized tools that enable us to document the
those who do not usually like chanting enjoyed the beautiful state of mind, levels of anxiety and depression, and
music and mantra intonations. In the second week, we understand the subjective feelings of our participants
switched to chanting 108 rounds of the Maha Mrityunjaya both before and after the program (Levine & Balk, 2012;
(Om trayambakam) mantra as this is traditionally believed Carlson et al., 2003; Cohen et al., 2004; Culos-Reed
to reduce the fear of death and create a sense of life and living et al., 2006; Harder et al., 2012). Such tools are used
in the individual. In the third week, we used 108 rounds regularly in both in-patient and out-patient scenarios
of Omkara as the Pranava AUM has been documented to to understand the psychological effects of different

22 Yoga Mīmāṃsā | Vol. 46 | Issue 1 & 2 | Jan-Jun 2014

 Majewski & Bhavanani: Rejuvenation program for cancer patients

treatment modalities and, hence, their application gives up. However, our subjective observations indicate that
us a hardcore scientific understanding of the subjective yoga has benefitted those recovering from the aftermath
changes in our participants. of anti-cancer therapies in terms of empowerment of the
2. Physiological tests: We recorded the HR and BP both participants. This is likely because they are given the tools,
before and after the program. Changes in cardiovascular which make them feel in control of their health and well-
parameters such as HR and BP imply a better capacity to being. They arrived with long-drawn faces, often with a
manage stress with a more balanced autonomic nervous lot of pain and suffering. In the 3 weeks of the program,
system (Funderburk, 1997; Innes et al., 2005; Khalsa, their faces slowly lighted up, their moods changed, their
2004; Yang, 2007; Bhavanani et al., 2012). This can be friendships become strong, and their outlook on life
correlated with the psychological changes, thus enabling became optimistic. We hope to corroborate our subjective
us to understand the mind–body connections and observations with the results of our scientific assessments
positive psycho-physical changes occurring due to the in the future.
program. We also noted improvement in the physical
performance of asanas by both subjective and objective ACKNOWLEDGMENTS
assessment done by the participants and instructors,
respectively. The authors thank the management of Kaivalyadhama Yoga
3. Biochemical tests: Standardized complete hematological Institute and, especially, Swami Maheshananda for sparking the
analysis was done with liver and renal profiles. These idea and supporting the Rejuvenation and Detoxification Program
tests were used to determine changes in red and for Cancer Patients. They are grateful to Shri O. P. Tiwari for his
white blood counts, hemoglobin, liver function, and constant motivation and supportive guidance. They also thank all
the subjects for their wholehearted cooperation during the program.
kidney function due to the program. The psycho-
physiological changes measured by previous tests may
be corroborated with these to understand better innate REFERENCES
mind–body connections right down to the cellular levels
Asher, A. (2011). Cognitive dysfunction among cancer survivors.
too. As the participants had gone through extensive American Journal of Physical Medicine and Rehabilitation, 90(5 Suppl l),
chemo- and radiotherapy, these changes take on an S16-26.
important prognostic value and, hence, are vital to Bhavanani, A. B. (2011a). Are we practicing Yoga therapy or Yogopathy?
our understanding the benefits of this rejuvenation Yoga Therapy Today, 7(2), 26-28.
program. Bhavanani, A. B. (2011b). Understanding the Yoga Darshan. Puducherry,
4. Ayurvedic tests: The three fundamental humours or India: Dhivyananda Creations.
doshas (Vata, Pitta, and Kapha) were evaluated by the Bhavanani, A. B., Madanmohan, Sanjay, Z., & Vithiyalakshmi, L. (2012).
Immediate cardiovascular effects of pranava relaxation in patients
resident Ayurvedic doctor in the traditional manner. of hypertension and diabetes. Biomedical Human Kinetics, 4(1), 66-69.
The tridosha theory of health and disease that developed Bower, J. E., Wooler, A., Sternlieb, B., & Garet, D. (2005). Yoga for cancer
during the late Vedic period (circa 1500–800 BC) is patients and survivors. Cancer Control, 12(3), 165-71.
common to virtually all Indian systems of medicine. Bray, F., Ren, J. S., Masuyer, E., & Ferlay, J. (2008). Global estimates
Tridosha concept has correlation with pancha of cancer prevalence for 27 sites in the adult population in 2008.
mahabhutas (elements of the manifest universe) as International Journal of Cancer, 132(5), 1133-45.
well as triguna (inherent qualities of nature). Health Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-
based stress reduction in relation to quality of life, mood, symptoms
is understood to be the balanced harmony of the three
of stress, and immune parameters in breast and prostate cancer
humours in accordance with individual predisposition, outpatients. Psychosomatic Medicine, 65(4), 571-581.
while disease results from an imbalanced disharmony. Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-
based stress reduction in relation to quality of life, mood, symptoms
Based on this structure, Kaivalyadhama Yoga Institute has of stress and levels of cortisol, dehydroepi and rosterone sulfate
also started a full research project with a multinational (DHEAS) and melatonin in breast and prostate cancer outpatients.
Psychoneuroendocrinology, 29(4), 448-474.
research team from India and Canada. There will be three
Cohen, L., Warneke, C., Fouladi, R. T., Rodriguez, M. A., &
groups involved in this research: Group A, full residential Chaoul-Reich, A. (2004). Psychological adjustment and sleep
program described above; group B, 3 weeks program of quality in a randomized trial of the effects of a Tibetan yoga
3 hrs. daily yoga 6 days a week; and group C, control group. intervention in patients with lymphoma. Cancer, 100(10), 2253-2260.
We hope to report our result within next 2 years. Coker, K. H. (1999). Meditation and prostate cancer: Integrating a mind/
body intervention with traditional therapies. Seminars in Urologic
Oncology, 17(2), 111-118.
CONCLUSION
Culos-Reed, S. N., Carlson, L. E., Daroux, L. M., & Hately-Aldous, S.
(2006). A pilot study of yoga for breast cancer survivors: Physical
This paper was written solely with the purpose of describing and psychological benefits. Psychooncology, 15(10), 891-97.
the actual structure of the special Cancer Rehabilitation Yoga Feuerstein, M. (2007). Handbook of Cancer Survivorship. New York,
Program being carried out at Kaivalyadhama, Lonavala. We N.Y.: Springer.
are still in the process of collecting data of 3-months follow- Funderburk, J. (1977). Science Studies Yoga: A Review of Physiological

Yoga Mīmāṃsā | Vol. 46 | Issue 1 & 2 | Jan-Jun 2014 23

 Majewski & Bhavanani: Rejuvenation program for cancer patients

Data. Honesdale. Pennsylvania, USA: Himalayan International Terhune, D. B., ... Renshaw, P. F. (2007). Yoga asana sessions
Institute of Yoga Science and Philosophy. increase brain GABA levels: A pilot study. Journal of Alternative
Harder, H., Parlour, L., & Jenkins, V. (2012). Randomized controlled and Complementary Medicine, 13(4), 419-26.
trials of yoga interventions for women with breast cancer: A Taylor, M. J. (2007). What is Yoga Therapy? An IAYT definition. Yoga
systematic literature review. Support Care Cancer, 20(12), 3055-64. Therapy in Practice, 3(3), 3.
Innes, K.E., Bourguignon, C., & Taylor, A.G. (2005). Risk indices Wolsko, P. M., Eisenberg, D. M., Davis, R. B., & Phillips, R. S. (2004).
associated with the insulin resistance syndrome, cardiovascular Use of mind-body medical therapies. Journal of General Internal
disease, and possible protection with yoga: A systematic review. Medicine, 19(1), 43-50.
The Journal of the American Board of Family Practice, 18(6), 491-519. Yang, K. A. (2007). Review of yoga programs for four leading risk
Khalsa, S.B. (2004). Yoga as a therapeutic intervention: A bibliometric factors of chronic diseases. Evidence-Based Complementary and
analysis of published research studies. Indian Journal of Physiology Alternative Medicine, 4(4), 487-91.
and Pharmacology, 48(3), 269-85. Zhang, J., Yang, K. H., Tian, J. H., & Wang, C. M. (2012). Effects
Levine, A.S., & Balk, J.L. (2012). Yoga and quality-of-life improvement of yoga on psychologic function and quality of life in women
in patients with breast cancer: A literature review. International with breast cancer: A meta-analysis of randomized controlled
Journal of Yoga Therapy, 22(1), 95-99. trials. Journal of Alternative and Complementary Medicine, 18(11),
Life After Cancer. (n.d.). In National Comprehensive Cancer Network 994-1002.
(NCCN). Retrieved June 23, 2014, from http://www.nccn.org/
patients/resources/life_after_cancer/.
Phillips, K.M., Jim, H.S., Small, B.J., Laronga, C., Andrykowski, M.A., & How to cite this article: Majewski L, Bhavanani AB. A novel
Jacobsen, P.B.(2012). Cognitive functioning after cancer treatment. rejuvenation program for cancer patients at Kaivalyadhama, India.
Cancer, 118(7), 1925-1932. Yoga Mīmāṃsā 2014;46:20-4.
Sharma, R., Gupta, N., & Bijlani, R.L. (2008). Effect of yoga based
lifestyle intervention on subjective well-being. Indian Journal of Source of support: The authors thank the management of
Physiology and Pharmacology, 52(2), 123-31. Kaivalyadhama Yoga Institute for administratively and financially
supporting the Rejuvenation and Detoxification Program for
Shaw, G. (n.d.). Breast cancer survivors: Life after the treatments end.
Cancer Patients.
Retrieved June 23, 2014, from http://www.webmd.com/breast-
cancer/guide/life-after-breast-cancer-treatment. Conflict of interest: Dr. A. B. Bhavanani is currently Deputy
Streeter, C. C., Jensen, J. E., Perlmutter, R. M., Cabral, H. J., Tian, H., Director of CYTER, MGMCRI, Pillayarkuppam, Pondicherry, India.

24 Yoga Mīmāṃsā | Vol. 46 | Issue 1 & 2 | Jan-Jun 2014