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How Yoga Helped One Child with Cancer Recovery

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Take a Look Inside The Rady Children's Hospital Yoga Program

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A volunteer yoga program at Rady Children’s Hospital in San Diego is bettering the lives of its oncology kids.

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Why Isn’t Yoga Covered By Health Insurance?

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The short answer is, it’s complicated.

We spoke with John Kepner, executive director of the International Association of Yoga Therapists (IAYT), and Courtney Butler-Robinson, stress management specialist and yoga therapist for the Dean Ornish Reversal Clinic at Saline Heart Group in Benton, Arkansas, to find out why yoga therapy is largely uncovered by health insurance companies. Dean Ornish, MD, made headlines in 2010 for convincing insurance companies that yoga and meditation, when combined with proper diet and exercise, could reverse heart disease. To date, yoga therapy is covered only under the Ornish Reversal Program for heart disease, but some affiliated clinics, such as Saline Heart Group, are beginning to offer cancer care.

Yoga Journal: With all of its proven benefits, why is it so hard to get yoga covered by insurance?

John Kepner: That’s the big question. IAYT is a self-regulated organization—it’s all voluntary. We have standards and an accrediting body, continued education, certification, and an enforceable code of ethics, but we don’t yet have a certification exam. All professional health fields have some kind of exam. IAYT has just launched that effort, and I expect it will take another two years to complete. Those are necessary but not sufficient pillars when you’re talking about insurance. In most cases, but not all, insurance coverage extends to licenced health care fields.

Courtney Butler-Robinson: We are a wellness center and offer different programing. We recently extended into cancer care. The Ornish Reversal Program is the only program I know of where the whole thing, including yoga therapy, is covered by Medicare. Oftentimes, people who have cancer or have been given chemo will end up with heart problems, and in that case, we can often bill under that.

JK: One of my personal goals is yoga therapy insurance coverage for people recovering from cancer care. Their bodies have been wrecked by chemo. They need something to bring body and mind back to well-being. There’s a lot of research showing yoga can help with that. IAYT is connected with the Society for Integrative Oncology, which is seriously exploring yoga now.

See also Why More Western Doctors Are Now Prescribing Yoga Therapy

YJ: How do you see this goal coming to fruition? Will insurance-covered yoga therapy be siloed by illness or ailment, beginning with cancer and heart disease?

JK: I just don’t know. We are feeling our way. As mentioned, the Society for Integrative Oncology has two committees looking to yoga. For now, they are working independently of us, although we communicate with them. We are also developing a way to have insurance cover yoga therapies by health condition. My personal thought is that cancer is a good disease to start with. There is a lot of research and general sympathy. Heart disease is already addressed by the Ornish program.

CBR: I think Ornish will get prostate cancer covered in the next five
years. We just need to prove to insurance that this therapy will save them money.

JK: There are plenty of creative possibilities for financing yoga therapy in a health care setting beyond insurance. I wrote about it in 2005, but it’s still relative today. Anyone interested can look to my paper, “Financial Support for Yoga Therapy: A Montage of Possibilities,” published in the International Journal of Yoga Therapy



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How Yoga Is Helping Kids with Cancer

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A volunteer yoga program at Rady Children’s Hospital in San Diego is bettering the lives of its oncology kids.

Aimee DeLuna practice yoga in her hospital bed. 

The cornflower-blue sleeper sofa. The formica closet. The tea cart clanking by. Jaymee Jiao will never forget the eight months she spent living in this hospital room with her son Savior-Makani Jiao as he underwent around-the-clock treatment for acute myeloid leukemia. But today, the rambunctious two-and-a-half-year-old is in remission, and he’s arrived at his former bedroom at San Diego’s Rady Children’s Hospital in a red plastic Radio Flyer. “I had to buckle him in because he was going crazy downstairs,” Jiao says when we meet, exhaling. It’s true: Right now, Savior’s energy could fuel a turbine. The familiar nurses who pass by gush over his vivacity and thick, wavy tuft of black hair. You’d never guess that just last year he was undergoing chemotherapy full time.

Five months post-discharge, Jiao is settling into life back at home with her husband and four children, of whom Savior is the youngest. She is visibly tired, yet cheerful. Atop her left shoulder is a large, tight lump, and she points it out, pulling on it as if it might loosen and slip off. “I carry my stress physically,” she says with a shrug.

Also in Savior’s old hospital room is volunteer yoga teacher Liz Fautsch, a smiling brunette who worked weekly with Jiao to ease tension and stress while she was holed up at Rady. “Your shoulder is looking better!” Fautsch encourages. Jiao nods. “Yoga helped relieve my shoulder and back pain,” she tells me. “And,” she says, lowering her voice a little, “it would take my mind off things when we were having a bad day.” But between school drop-offs and shuttling her kids to sports practice and chasing Savior around the house, Jiao admittedly hasn’t kept up a regular yoga routine since she lived in this room.

See also Building a Strong Foundation for Cancer Healing

JAYMEEundefinedJIAO with her son, Savior-Makani Jiao in their former hospital room at Rady Children’s in San Diego.

The yoga program for cancer patients and their families here at Rady is powered by volunteers from the Sean O’Shea Foundation—a nonprofit organization that aims to empower youth through yoga, mindfulness, and optimistic teachings. It was founded by Gloria O’Shea to honor her late son Sean, a children’s yoga teacher who died in a fluke car crash in 2006. He was 32. While the foundation has been running programs for San Diego kids and teens since 2008, it partnered with Rady in 2011 to harness the research-backed benefits of yoga for kids undergoing cancer treatment and their families. Volunteer yoga teachers such as Fautsch, many of whom are health care professionals and specialize in yoga for cancer recovery, visit the hospital’s oncology unit three days a week, going bed to bed to offer individualized sessions to whoever’s in the room—be it patients, parents, or friendly visitors. Sessions typically last about 30 minutes and range from pranayama and meditation in bed to asana on colorful mats carried in on carts by volunteers.

“When the yoga instructors would come by, my eyes would blink little hearts,” says Jessica Davidson, whose 10-year-old daughter, Julia Davidson, spent two years at Rady battling stage four neuroblastoma. Today, after undergoing surgical tumor removal and six rounds of frontline chemotherapy followed by immunotherapy—plus plenty of yoga and bedside dance parties (’80s and ’90s music were the jams)—Julia is precocious and thriving in remission. She still dances and practices yoga regularly, and tells me, “It’s really calming and good for the human body, so I recommend it.”

Chemotherapy and other cancer treatments like radiation are notoriously volatile and can slow growth in children. The most common side effects apart from hair loss include nausea and vomiting, trouble breathing, nerve damage (neuropathy), and a weakened immune system. While a growing body of research from the past two decades supports yoga’s ability to reduce symptoms and stress and improve mood and overall quality of life in cancer patients, yoga and physical therapist Kelli Bethel, the director of yoga therapy at the University of Maryland School of Medicine’s Center for Integrative Medicine, says customized practices tailored to each patient, like those at Rady, work best in real-life scenarios. In a health-research setting, however, proving yoga’s absolute potential through standardized clinical trials is nearly impossible: “Everyone’s cancer journey is different and their needs and symptoms vary,” she says. “It’s one thing to understand which methods of yoga apply to cancer patients, but having everyone follow a script—this pose, this exercise—that will never accurately demonstrate the full benefits.”

Pediatric research is also hard to come by, but according to a 2019 clinical feasibility study that examined the impact of yoga on pediatric outpatients receiving chemotherapy, the results of two recent pilot studies show that individualized yoga programs improved quality of life for adolescents receiving cancer treatment. Ultimately, the authors called for further investigation. To date, much of the evidence for yoga’s treatment benefits comes from breast cancer clinical trials, says Bethel.

To that end, Julia Fukuhara was working as a nurse and volunteer yoga instructor at Rady in 2013 when she realized her unique potential as a data collector. “We have some research that shows how imperative integrative medicine is for adults and for kids, but to actually see it frontline was mind blowing,” she says. Kids could sleep better afterward. They were less anxious. Oftentimes they required less pain- or anti-nausea medication.

When making their yoga rounds, Fukuhara and the other teachers on the ward kept detailed notebooks with dated entries describing patient conditions, applied yoga exercises, and outcomes. “We already had all this documentation in place, so we thought, let’s see if we can numerically capture this data with some kind of pain, anxiety, and quality-of-life measure,” she says. What ensued was a six-month study of 32 kids and their families who were surveyed before and after yoga sessions. The results will hopefully be published in the coming months, and Fukuhara is excited to report that she saw significant positive change.

See also This is How One Yogi Doctor Used Ayurveda to Treat His Own Cancer

Ten-year-old Julia Davidson keeps up with her yoga practice while in remission from neuroblastoma.

Common chemo drugs are known to depress the nervous system, says Fukuhara. For the kids she worked with at Rady, this often manifested as trouble breathing, balancing, and focusing—and eventually irreversible neuropathy and numbness in fingers and toes. During her study, which she co-authored with pediatric oncology nurse practitioner Jeanie Spies, Fukuhara found that stimulating power poses such as Virabhadrasanas (Warrior Poses) and Vrksasana (Tree Pose) fired up her patients’ nerves, making them resistant to the negative side effects of their medications. “It’s like we were enhancing the nervous system,” she says.

Spies is the founder of the integrative medicine program at Rady and coordinator of the yoga initiative. Her warm red hair feels like an extension of her personality: She geeks out over things like bone marrow biopsies and witnessing a patient’s first steps (she beamed recounting Savior’s as he bounced around the room). Spies says that what surprised her most was the profound effect the yoga sessions had on parents, like Jiao, who face sleepless nights marked by constant worry and interruptions from hospital staff. “We turn their lives upside down with the diagnosis of cancer,” Spies says. “The beauty of the yoga here is that it gives them a sense of relaxation and control, even if it’s only for 10 minutes.”

Ping Cao has a petite, fragile-looking frame—but don’t be fooled. The lines on her soft, worn face, like the glossy black hair she wears in a tight pixie cut, are evidence of her perseverance. The Chinese immigrant is a volunteer yoga teacher with the O’Shea Foundation who recently finished treatment for breast cancer. Yoga and, in particular, Sama Vritti Pranayama—a technique in which you breath and hold to counts of four—helped Cao mitigate fatigue and nausea while she was undergoing chemotherapy and radiation. The strength she’s derived from the practice and from the support of other cancer survivors is what she says led her to start volunteering at Rady.

See also Dharma Talk: Yoga by the Throat

AIMEE DE LUNA practices yoga with breast cancer survivor Ping Cao during treatment.

Research shows that yogic exercises as simple as pranayama (controlled breathing) can stimulate the immune system, and Cao begins most of her sessions in the pediatric oncology unit this way. Today she sits in a little teal chair beside 17-year old Aimee De Luna’s hospital bed. Four weeks earlier, De Luna, a high school senior, was prom-dress shopping at the mall with her mom when she fainted in the checkout line. Her pediatrician suspected anemia, but blood tests revealed leukemia. As an outpatient, she and her parents make the 1.5-hour drive from their home most days so Aimee can get chemotherapy. Today she smiles, eyes closed, sitting up still in her hospital gown, a gray beanie atop her head, as Cao guides her through a bedside meditation and stretching exercise. They’ve been practicing together like this for about three weeks now.

“The first time she asked me if I wanted to do it, I was a hard No,” De Luna laughs. “But by the third time, I was feeling a lot better and was up for the challenge.” She likes Cao’s “relaxing vibe” and calls their sessions “a fun little escape from chemotherapy and needles and all that bad stuff.” She’s come to look forward to it—it’s relaxing, the stretching feels good, and she enjoys spending time with Cao, who not too long ago was in De Luna’s shoes.

“I’m in a unique position,” Cao says. “When I walk into a room, I can see it in the kids: They are in pain, or they are experiencing something uncomfortable from their treatment,
or they are scared. And I can feel it in the parents, too. But I can say, ‘Here I am. I had the same experience. I felt all these difficulties physically, emotionally, too, and I did yoga. It helped. And today, I’m still surviving, and you will, too.’”  



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