Electronic YOCAS©® Intervention For Pain: A Decentralized Digital Randomized Controlled Trial With Cancer Survivors

Pain is one of the most noxious toxicities cancer survivors experience. Our prior research suggests Yoga for Cancer Survivors(YOCAS©®) may reduce pain. Unfortunately, yoga is not accessible to all survivors, especially those living in rural communities. PURPOSE: We conducted a decentralized, digital, phase II randomized controlled trial (RCT) examining the preliminary efficacy of electronic YOCAS©® (eYOCAS©®) compared to standard care for treating pain in cancer survivors. METHODS: Using a decentralized, digital trial design (no in person contact/all procedures remote), we electronically consented cancer survivors 2-120 months post-treatment and randomized them to eYOCAS©® or a standard care control. Yoga sessions were delivered via Zoom by a certified instructor in small groups; (2-4 survivors/group; 75 minutes/session; 2x/week; 4 weeks). Electronic asessments at pre- and post-intervention included pain, pain severity, and pain interference with daily activities (Brief Pain Inventory; BPI). RESULTS: 42 survivors (93% female, 95% white, 57% breast cancer, mean age 58.6 ± 11.6 years) were randomized and completed the study. On average, participants attended 6.2 of 8 sessions. 44% of participants reported additional home practice of 62.8 minutes over the 4 weeks. 85% of participants reported eYOCAS©® yoga helped and 69% would recommend it to other survivors. Mixed models analyses showed a significant difference in pain between eYOCAS©® and standard care participants. Specifically eYOCAS©® participants reported significant decreases in pain (-0.85 ± 0.40, p = 0.04), pain severity (-0.96 ± 0.42, p = 0.03) and pain’s interference with daily activities (-0.76 ± 0.44, p = 0.09), while standard care participants did not. In fact, standard care participants reported a significant increase in pain severity (0.96 ± 0.42, p = 0.02). CONCLUSIONS: Our data suggest that eYOCAS©® may reduce pain, pain severity and its interference with daily activities in cancer survivors. Future phase III, decentralized, digital RCTs are needed to confirm these findings. NCI UG1CA189961