“Dear Tari – I am 8 weeks post bilateral breast surgery with tissue expanders.  I have to be careful of engaging my pec muscles and lymphedema.  I am receiving PT for shoulder / range of motion issues.  What is your staff’s expertise?  How are the poses modified to accommodate my needs? Thanks, Jane“

Tari’s Response:

Jane – First, how is it going with the expanders? Eight weeks should be great timing to start a yoga practice (yoga4cancer) specifically designed to help you maintain range of motion until you have the implant surgery. 

Yes, I have personally trained all the y4c teachers. Some have experienced bi-lateral reconstruction.

There are many ways to protect the pec muscles allowing the expanders to do their job. The y4c (yoga4cancer) methodology places focus on each survivors individual needs based on research and experience. And each teacher is trained to accommodate and modify accordingly. We understand how to make you comfortable at the same time assist the muscles to stay healthy and function well.

Lymphedema is a concern for every breast cancer survivor. Myself included. There are many ways the yoga we do in y4c classes can be preventative as well as provide relief. At this time for you prevention is the focus.  But over your lifetime you are at risk. Understanding how yoga works for both relief and prevention is part of every y4c yoga class. Learning how and knowing this give you confidence and reduce your concerns.

Here are some videos to get you started… but in the class you will experience many others. 

• https://www.youtube.com/watch?v=rS11-z-e5Bs
• https://www.youtube.com/watch?v=m9QD1IgWovI
• https://www.youtube.com/watch?v=JgY2tKMmoM8 (Apologies for the low volume.  we are working on editing.)

Please know that its important to keep your ‘team’ aware and informed.  For example:

1. Share with your DR and oncology team that you want and are attending yoga classes.
2. Be sure to share your current situation, any challenges, needs or concerns with your yoga teacher..  They can help provide modifications and support.

All that being said, I hope you join us in a y4c class. You will meet others who have been on a similar journey, learned to use yoga properly, have seen and experienced the benefits.

Please check out the schedule here and be sure to sign up in advance.  https://y4c.com/nycclasses/. And please let me know if you have any further questions.

Best,

Tari

Recently, a friend, student and fellow yoga teacher asked me what poses I would recommend for breast cancer post surgery, as she is now facing this situation herself.  This is a common question, since 30% of all women’s cancer is of the breast. For that reason, I will share the answer.

The answer to this question is not as straightforward as one would expect.  But to put it simply = all of them.  The key is to understand what symptoms or issues an individual is facing, what that person needs to manage or wants to alleviate.  For example, is the individual wanting to build strength, reduce scar tissue, avoid the occurrence of lymphedema, detoxify or simply relax and manage stress?  These are all things that breast surgery and breast cancer treatments can cause, not the cancer. Thus, all yoga poses should be embraced and used to manage the side effects of cancer and its treatments.

As the question makes reference to ‘post-operation’, my feeling is that the request for poses were more about scar tissue, flexibility and, ultimately, strength of the arms and torso.  So here are four exercises that I have found useful both in my own recovery and with my students. But there are many, many more in my book – Yoga for Cancer.

1. Cactus Clap

2. Dirty Tshirt 

3. Restorative Fish

4. Full Body Stretch 

As mentioned above, these are just my recommendations for the immediate post-operation symptoms and side effects.  The management of a breast cancer surgery can often be short sighted.  Any breast surgery or lumpectomy brings other risks, like lymphedema, or loss of strength and support of other body parts and systems.  So although the initial concern might be for the breast / upper body areas post surgery, I urge everyone to embrace yoga as a tool to manage all the side effects of any cancer and its treatments. But most importantly, yoga helps keep your immune system strong reducing the risk of recurrence or other cancers.

Question: What’s the difference between a ‘traditional’ yoga teacher and a yoga teacher for a “cancer survivor?”

At first glance, the idea of yoga for cancer patients undergoing treatment and now in survivorship seems an obvious, logical step. What better way is there to manage anxiety, gain strength, increase flexibility and create feelings of well-being?  It seems like everyone knows yoga is beneficial.  So, why would teaching yoga to cancer patients and survivors be any different than teaching yoga to healthy people?

The popular notion is that all yoga is beneficial, whatever its style or flavor.  But as yoga teachers, we know that is not true.  Just like cancer, yoga is not one-size-fits-all.  Everyone’s cancer, treatments, side effects and body are all different. Yoga teachers must be ready to adapt teaching styles to the changing needs of students.  The difference in teaching yoga to cancer survivors is that the risks are higher and a teacher should know what those risks are.

The answer can be found found in the words of BKS Iyengar, from his book, Light on Life:

“Do not imagine that you already understand and impose your imperfect understanding on those who come to you for help.”

Most yoga teachers are trained to teach to a diverse, yet general, population, but not to teach to the specific needs of the cancer survivor.  Most likely, their training did not cover the life-long side effects and vulnerabilities triggered by cancer treatments, chemotherapy or radiation.

Compassion starts with a teacher’s willingness to learn about cancer, to be properly trained to teach yoga for cancer survivors, and to take the time to understand each student’s needs and concerns.  Knowing and understanding the conditions of the wounded body under that baggy t-shirt requires a yoga teacher training specialization.  This is the first step to creating safe healing conditions for those touched by cancer. 

Many teachers will have their personal fears about cancer. Conversely, many cancer survivors are not familiar with what they should expect from a yoga teacher when seeking a safe and practical class.  Yoga teachers should know to shift their pedagogy to meet the needs, often unexpressed, of their students.

For more videos from Tari and y4c, please visit & subscribe to our YouTube channel.

For more information & research on Lymphedema, please visit National Cancer Institute.

Recently, I was asked if our yoga4cancer classes in New York City are women only. ‘Good question!’ I responded, and ‘Thanks for asking.’ This gives me the opportunity to clarify my approach and my working policy for our classes.

First, a little history is needed.  In 2003, I started a yoga class for women breast cancer survivors at OMyoga under the sponsorship of a foundation whose mission was to support women only programs.  Within the first few years, we extended the program to help women beyond  those suffering from breast cancer.  For many years the classes continued under the title: OMyoga for Women Cancer Survivors, WCS. Two years ago when OMyoga closed the doors of its studio in Manhattan, I knew our yoga classes must continue but in a new form.  This was the birth of yoga4cancer.

In setting the foundation for yoga4cancer, I knew I wanted to help as many survivors as possible – no matter race, gender, creed or background.  Cancer doesn’t distinguish, why should we?! It seemed appropriate to offer them to all cancer patients and survivors. Plus in the 10 years since the inception of the program, more men were interested in learning & participating in our classes and in yoga in general. Many men had become teachers within the y4c family and using our principles everyday to heal. So I didn’t want to exclude any type of cancer or person it effects.  Cancer is not gender specific and yoga is beneficial to all, male or female.  Our instructors and classes are capable of helping anyone no matter the type of stage or type of cancer – male or female.

That being said, like most yoga classes, whatever style or specialty, the number of women usually outnumbers the number of men participating.  So it often appears as if only women attend y4c classes. But in fact, we welcome all cancer survivors of both genders and all races to y4c classes. Spread the word.  Bring your male friends to class!

 Tari Answered: “Yoga for cancer patients is a specialization. When I was going through treatments, I found that there were few yoga teachers who understood what my needs and desires were as a patient. I went to classes that were designed basically as a series of restorative poses. Although this was lovely and relaxing, it was not satisfying nor inspiring.

I was surprised, and upset, that many yoga classes were offered by teachers without any supervised training, knowledge of cancer and Western treatments, and no personal experience with cancer. My feelings about the preparedness of yoga teachers beyond the 200-hr training programs are supported by the words of BKS Iyengar in Light on Life. ‘Is it an act of loving-kindness to assume you know the needs of those you come to you for help?”

Muriel W: Muriel completed her cancer treatments in May 2009. Her oncologist requested a CT scan for her first sixth month post treatment check up.

Muriel Asked Tari: Yesterday I was so nervous when I got onto the scanner, I stopped breathing before they told me to. My heart was pounding hard, I was feeling claustrophobic and extremely uncomfortable. Then I remembered your words, ‘Count your breath slowly and the mind will follow.’ I did. I immediately became calm, my muscles relaxed, and I finished the scan feeling optimistic and empowered. It was like magic. Thank you for this simple yoga lesson and breathing technique.
I was wondering at the time, was I doing yoga in a CT scanner? 

Tari Answered: Yes, Muriel you were doing yoga. You don’t need a class, a mat or a teacher to give you directions. That is what makes yoga such an important tool in your recovery process. You can do yoga anywhere and anytime. And it helps you manage those naturally scary moments we all have, like being in a CT scanner.

Sometimes we need yoga most for places not designed for quiet sitting or exercise. You are stuck in traffic, or waiting for a doctor’s appointment, or expecting a phone call with test results, or in your case, in a the CT scanner.

Yoga is a portable prescription for relaxation and renewal. I am sending you ten more yoga things you can anytime or anywhere…in a bed, in a chair, in a car, at the store, in the air… I call it Pocket Yoga©.

Muriel, I hope that your scans were all ‘negative’ and that you kept breathing calmly all the way home. I love hearing stories about how yoga has been helpful and comforting to people in the simple ways. Thank you.

Question: Do your students talk about their cancers?

Tari Answered: “Absolutely! Again, that sense of community is hugely important to what we do. When I started looking into yoga for cancer survivors, I wondered why yoga teachers never use the big “C” word– the word cancer. Instead, they emphasized, “relax” and “feel peaceful.” Ironically, these pleasant words sent my mind racing into thinking about dying. It was not healing to avoid the reason the class was offered, nor was it spiritual.

I find my students are comforted by the exchange of questions we have when I first meet them as to what kind of cancer they have, how long, what treatments, side effects and how is it going in their recovery. The relief that I am not afraid to acknowledge their illness is a relief akin to spiritual. When the class includes an explanation of how yoga deep breathing will assist in cleansing the immune system, and why that is important to lower the risk of cancer reoccurrence, the response is a smile with each inhale.

At the end of class the glow on each woman’s face is the goal of yoga. Not some kind of nirvana, nor profound enlightenment, or even heightened awareness. But simple contentment in the sheath of Anandmayakosha, the Bliss Factor that yoga offers to aid healing. This is yoga’s gift to them and to me.

Cynthia Asked Tari: Since my mastectomy surgeries I have not been about to gain back all the strength and mobility in my right arm and the implant makes me nervous about moving it a lot. My sister has done yoga for years and is encouraging me to start yoga classes because she believes yoga can help me regain the use of my arm. I have never done yoga before. When is it safe for me to start?

About Cynthia: Cynthia had a mastectomy and then breast reconstruction using an implant. She is 45 years old and a single working mom.

Tari Answered: The unqualified answer is, Start Now! However, you used the most important word in your question to me. SAFE. I thank you for that. Our loved ones encourage us with ideas and suggestion to speed our recovery. You have to love them for that.

At first glance, the idea of yoga for cancer patients undergoing treatment and now in survivorship seems obvious, a logical step. What better way to manage anxiety, gain strength, increase flexibility and create feelings of well being? I agree. That is certainly what I did and continue to do. However, helpful ideas come in big packages and you are right to ask when is it safe to do yoga.

Yoga is a big package. In it there are some yoga secrets as well. What is good for your sister may not be good for you as a cancer survivor. The popular notion is that yoga is good for everyone, whatever its style, flavor or size. But we know that is not true. Just like cancer, yoga is not one-size-does-fits-all. Everyone’s cancer, treatments, side effects and body are different. 

To help you understand how yoga can be good for you and when it is safe to start, here are questions back to you:

Are you ready? 

It is a good idea to have your doctor’s permission. You may have other physical conditions not related to the cancer that should be considered. In relation to your cancer surgeries, however, it is critical that all surgical drains and staples have been removed and that your incision is healing well.

What Kind of yoga? 

There are many. I have prepared a list of the yoga styles most commonly practiced and taught in the West with a short description of what to expect in a class that is based on these styles is included to help you discern what style is best for you.

A better question is: With whom? 

Healing begins with feeling safe. Feeling comfortable with a yoga teacher is the most important factor to putting yoga into your life as tool of self-healing and creating health in your future.

Yoga teachers are trained to teach to a diverse yet general population. Awareness of the limitations imposed by surgeries, chemotherapy and the many life-long side effects and vulnerabilities of cancer treatments and reconstruction are not covered in most yoga teachers training. Observe what questions a teacher asks you. This is your best test of whether the style, class and teacher are a good solution for you to begin or continue yoga.

You ask the questions! Learn about the teacher’s training and experience with cancer patients undergoing treatment and survivors in general.

Where to find a yoga class?
In generic gym-based yoga classes, teachers are not usually trained and knowledgeable of the limitations and concerns of survivors. These venues can be intimidating and risky for someone who is trying not only to gain physical strength, but also, self esteem. Find a yoga class specifically for cancer patients and survivors. Get a schedule, visit a class and talk to the teacher. Again, if you would like to know about y4c trained teachers in your location, please here.

How often?

Yoga is a practice not an event. In order to feel the benefits of yoga finding time in your schedule to practice, 2-3 times a week or more, is important. Also, it is recommended that average weight survivors maintain at least 150 minutes of exercise per week to reduce reoccurrence, and for those that are carrying weight that amount should be 300 minutes per week.  So do as often and as much as you can.  Are the classes located conveniently and at times that will fit easily into your life? Large classes can be discouraging for beginners. Trust your intuitions.

I hope this helps you find a yoga teacher and class that allows you to thrive, as well as survive. Yoga can be a tool to help you reclaim your life during and after cancer. If used properly, yoga can also be a lifetime companion that will smooth out all the challenges of life, not just the ones we experience on the cancer journey. In the meantime, please send me more questions, share your findings and stay in touch.

Namaste,
Tari

Tari Answered: “Yoga makes you stronger in mind and body; gives courage, hope and confidence; breaks down barriers of isolation and stigma; and can be a great way to relax.

But not to be underestimated is the connection to others. When you are told you have cancer, often it feels like you are alone. You feel stigmatized because every one treats you differently. Yoga creates community. Knowing you are not alone in your challenge is a tool to finding courage and hope.”

Tari Answered: “Maya Angeleo said, “I have learned that people forget what you say, forget what you did, but never forget how you made them feel.” My goal is to help cancer patients feel empowered, hopeful and not alone. I love what I do –teaching yoga to survivors– because it gives me a way to do all those things. And it gives me the same.”

Tari Answered: “My dream is that Western medical professionals and hospitals will recognize that yoga taught by a specially trained and specifically certified yoga teachers is the last prescription a cancer patient/survivor needs. Beyond all the treatments, when all that is over and they send the cancer patient/survivor home, there is something else they can prescribe. Yoga for life, Yoga for all the life-long side effects that will be there no matter if the cancer is not.”

Tari Answered: “My students come with curiosity, hope and a willingness to be partners in a joint exploration. They also come with fear, doubts and questions about both cancer and yoga. Cancer is scary. Chemo is scary. Even yoga can be frightening to some people. We can take some of that mystery out with knowledge and wisdom, through breathing, movement and community.”