Yoga as Holistic Cancer Care with Teresa Miles

Dr. Vaughn:

Welcome to “Cancer Shop Talk: Behind the Diagnosis.” Many of you know how much we value the science behind holistic forms of cancer therapy at HOAF, and today we have the pleasure of speaking with a highly experienced yoga teacher, Teresa Miles. Teresa has a total of 20 years practicing and can break yoga down to simply knowing how to breathe, so we are honored to have Teresa today and I just wanted to just allow you to introduce yourself, Teresa, and what drove you into yoga as a practitioner.

Teresa Miles:

Thank you, Dr. Vaughn. It’s a pleasure to be here sharing my experience with the HOAF community. As you have said, I have 20 plus years of experience as a yoga teacher. I am also a cancer survivor. Five years ago I launched my private business called Ayurga, which is a common word between ayurveda and yoga. Ayurveda is basically healthful living. I also teach at HOAF as a means of giving back to society, yoga for holistic healing of cancer every Tuesday at 11:00.

Teresa Miles:

What sparked my interest to go into yoga was basically my accountability as a human being. I always felt that I had to be physically fit, a means of contributing to society. In doing so, I started working out. Then I realized I like working out so much to a point that I became a certified fitness instructor. I taught high impact classes. I taught bike spinning, kickboxing, you name it. Mind you, I was teaching nine classes a week in addition, and on top of my full-time job as an engineer for the department in the Navy. As an engineer for a Department in the Navy, I was under a whole lot of stress.

Teresa Miles:

Being a female engineer, good is not good enough. So I was always trying to be better than what I am. I found myself on travel for the government in Canada, and to treat myself. I decided to go for a massage. As the massage therapist was massaging me, she realized that my back was as hard as a table. You can knock on it, and there was no give and to which she said, “I recommend you take yoga.” To which I said, “Why?” “To learn how to breathe,” to which my logical mind said, “I’m breathing. I’m alive. Haven’t you not noticed?” “Yes, but you’re not breathing efficiently and effectively.” Those words were the turning point of my life. I felt that in order to learn yoga, I might as well go and be a yoga teacher. From that point on, I started to study how to be a certified yoga teacher and then at the same time, started teaching.

Teresa Miles:

With all things in life, the more you study, the more you learn, and I kept studying to a point that I have… So it’s like your BS degree, then your master’s degree, and then now you have your doctorate degree. And I learned that yoga is more than just the physical movement of your body. Studies have shown that yoga can obviously apply to cancer, has benefits for cancer, stroke, arthritis, depression, addiction, and so on and so forth. And I had an aha moment that wow, yoga is more than just physical. And that is when I transitioned to the medical community and here I am working with HOAF.

Dr. Vaughn:

That’s an amazing timeline. And just knowing your background from the Navy, I was wondering how I got into yoga, but that seems like initially it was sort of the stress of work that prompted that initiation. Just a couple questions, did you start treating patients with cancer, or was it almost a, “I’m going through cancer,” then you got into kind of yoga and helping cancer patients?

Teresa Miles:

No, I was purely at the time just a yoga teacher. I started as a fitness instructor, so it was the concept of working out. In the fitness community, fitness is a three-legged stool. You have cardio, you have weight lifting, and you have flexibility and balance, where yoga falls under that third leg. So I was in that, making sure that everybody was doing a three-legged stool for lack of… And then after that, I became a cancer patient, and then I eventually became a cancer survivor. And then when I launched my business, it occurred to me that now that I’m a cancer survivor, it would be prudent to give back to the community, and that’s when I applied to HOAF, and was accepted.

Dr. Vaughn:

And walk me through, just real quick, I know you had the interest of practicing yoga. I’m not as familiar with the discipline, but is it to become a teacher, how long is that? What do you have to go through?

Teresa Miles:

Basically, a yoga teacher is 200 hours. Okay, that’s basically… You have the ability to teach breathing, you have the ability to teach the Asanas, which is basically your yoga poses. At that point, you break down every single pose, and obviously we learn all about anatomy. Each pose is broken down. We take about 20 minutes to learn a pose of basically how you’re breathing. If you’re standing, how your feet should be standing. Basically spinal alignment and anatomical alignment. That way we prevent any…

Teresa Miles:

The idea is not to hurt the student or the client. So, you have your 200 hours. If you want to become more, then you have an additional 300 hours. And then at that point, you can be a teacher of teachers and then however you have… You’re not qualified to even be a yoga therapist. It is when you have another additional 300 or 500 hours, then you become a yoga therapist. So at that point, when you’re a yoga therapist, then you can start transitioning to the medical community and having private clients where you can start treating the symptoms. Or let’s say if you have a cancer patient who has just been diagnosed, you can start to teach them how to breathe efficiently and effectively. In the classes that I teach at HOAF, I will try to meet the needs of every single person from if they are-

PART 1 OF 4 ENDS [00:08:04]

Teresa Miles:

Of every single person from, if they are just diagnosed and the world is a little bit overwhelming then probably all we need to do today is to breathe. And people say breathing, it seems so elementary, not really. Yoga breathing is a two part breathing process. You start with the air outside your nose, you allow it to come into your nostril, down to your chest cavity, down to your diaphragm, down to your lower abdominal muscles, down to your pelvic floor and that’s all on the inhale. You reverse the process on the exhale. To answer the question of its significance. The distance between the nose to the pelvic floor enables the speed of the air to slow down. And when it slows down, then the person comes down and that is the key. And probably I’m preaching to the choir. If you look at somebody who’s totally stressed, they breathe from their nose to the lung, which is a shorter distance between the nose and the pelvic floor. And that is why there’s such a thing called yoga breathing.

Teresa Miles:

You mentioned something about mindfulness. Mindfulness is a term that a lot of people just throw, seems like the latest buzzword, but basically it’s being aware. Mindfulness is awareness. Let’s just take how I describe breathing. When yogis breathe, we are aware where the air is coming from, where it’s going to, how it’s coming out. And that awareness is called mindfulness. That’s basically what mindfulness is all about.

Dr. Vaughn:

That was a tremendous explanation of everything you provide. Just one of the challenging things of oncologists, really managing some of the side effects of either the treatment or just the patient’s own experience with cancer. And you just touched on a few of the hardest things to treat what patients really kind of complain about and really are difficult for them. One is fatigue, insomnia, and neuropathy. You just hit on a lot of the items we try through either pharmaceutical treatments to improve on, but it’s nice and again, this is to use a better term, holistic. It’s nice to have one maybe therapy sort of encompassing all of those sorts of support things we try to improve during a cancer patient’s experience.

Dr. Vaughn:

May I ask you a question, Teresa? You mentioned how you ask certain clients what they may be suffering and it may be someone with more lymphedema, lymph node issues, and maybe someone with neuropathy. Is it easier for you to do a one hour group session or do you get more small groups or personal sessions and what’s the pros and cons of each?

Teresa Miles:

It depends. Like all things, it’s a fit. Some people like group therapy because they are with somebody so it meets their social needs. If they’re afraid, for lack of a better term, to say to me that I am having issues with lymph nodes, but if a fellow attendee says, Can we work on lymph nodes today? Then the person who does not want to broadcast what their concern is, that works.

Teresa Miles:

There are some clients who would prefer a one on one. It’s like somebody told me about her special tutor. Because the advantage of one on one is I have my eyeballs on that person. I’m watching how they’re breathing. I’m watching how they’re doing the poses. It might not be perfect, but for the energy that they have today, as always in yoga it’s the present moment and that’s the best. And when all things are said and done, yoga is about the person. It has nothing to do with me. My job is to guide.

Teresa Miles:

Now, pros and cons. Group setting, you have synergistic group energy and one on one it is focused. Because remember there’s only me and let’s say I have 10 people, 10 students, and my eyeballs are going through all 10. While, so I might do a sweep and then I will just go with the common denominator. One on one is definitely just exactly that, one on one. Your private tutor, your private therapies. So there are good points and bad points.

Teresa Miles:

I’ve had students that when they find themselves to be the one and only, they get a little overwhelmed and they’re feeling like they’re back in grade school or something, feeling picked upon by the teacher. At the end of the day you want the cancer patient to feel good about themselves. You don’t want them to feel picked upon. So if their personality is better, they’re better off with a group setting. So I have both. I teach in group settings. I have five classes that I teach in group settings. And then I have five private clients. So I work with both scenarios.

Dr. Vaughn:

And do you work, Teresa, I know you have classes downstairs in our office, those are probably the group settings. Then do you do private sessions at patient’s homes?

Teresa Miles:

I do it two ways. They can come to my house or if they would prefer and distance is always a concern, then we can do it via Zoom. So I do both. During COVID, all of my clients obviously went through Zoom.

Dr. Vaughn:

I was going to ask if you were doing any sort of remote yoga. I guess definitely that’s the benefit is the transportation issues or obviously the close contact issues during COVID. I guess it may be more difficult if you had to reposition poses that way, I imagine. But that’s great for some of our patients, like you mentioned, who may have a travel issue.

Teresa Miles:

Yes. The one in home life right now, I am via Zoom, so the classes I used to do phase to face then COVID came and therefore we shifted it to via Zoom. So my Tuesday classes are via Zoom, which is for those patients who cannot travel, it works for them.

Dr. Vaughn:

And maybe this would help me and some of my colleagues, how do we get patients started or when should we recommend it? Is it more kind of, should we be more patient driven by us or how can we make sure… Because it’s such a useful strategy as you mentioned, to either it could be through almost like a support group of patients or really treating specific medical issues or having a treatment or the cancer themselves. But how do we get them started or interested in just starting yoga?

Teresa Miles:

If I were the one I would recommend from day one, the moment they are diagnosed, then you can offer yoga and it can be a-

PART 2 OF 4 ENDS [00:16:04]

Teresa Miles:

[inaudible 00:16:00], you can offer yoga, and it can be as simple as breathing. The benefit of that is now you as a community can work together to just enable them to have a clear mind, clarity of mind to get the next step. Okay. When they’re talking to you, they’re not clouded and overwhelmed to a point that they really do not understand what you the doctor is talking about. What the impact of cancer is, and where do they go next?

Teresa Miles:

Their plate is so full, and they’re overwhelmed. And the only way to do that is to have a clear mind. How do you get a clear mind? Breathing. So from day one, we as a community can start recommending that we might even offer classes. Or I can do an intro of what yoga is all about. Just like all things, I am so excited about this program, because there’s this misconception that holistic medicine is not scientific, but it is scientific.

Teresa Miles:

I mean, the journals that I get, International Association of Yoga Therapists, is full of studies, publicized studies. And I think people get themselves into trouble for lack of information. Nobody knows that yoga is good for cancer. Nobody knows that yoga is good for insomnia, nobody knows. You name it, you pick it and they look, “Oh, I did not know that.”

Teresa Miles:

I mean, after 20 plus years of experience, I still have people who come up to me and say, “I saw this TV program, and they said breathing is good for cancer.” They’re surprised. So I think it’s information. We can get them going, and we can work together, see what we can do to get the information out. And I will try to make it as simple as possible, and see if we can get the information out.

Dr. Vaughn:

We tend to be unfortunately a little bit more reactive when patients are starting to have problems instead of probably, like you mentioned, the best time is initially, and being more proactive from the start. Well, one big study, it was a study with breast cancer patients who as most are familiar with breast cancer, we do block estrogen as part of our treatment, and that can lead to a lot of arthralgias and just stiffness, and a lot of musculoskeletal complaints, fatigue, weight gain.

Dr. Vaughn:

And there was a pivotal study that took a group of patients, and they practiced yoga, and a group that didn’t. And what they assessed was sort of just quality of life surveys on sense of wellbeing, fatigue, depression, how they felt. And the group after a year of yoga, scored much higher. And so there is some good medical data as you mentioned, about yoga as a really strong adjunct for patients on therapy. And it helps patients stay on their breast cancer therapy, which obviously leads to better outcomes. So do you think, Teresa, we’re seeing a change where you’re seeing more referrals? Or just more interest from providers on integrating some of these other integrative strategies to medicine?

Teresa Miles:

Yes. The definition of health has been shifted from rather than symptom management, to more of a wellness, which is a strategy on how to get you free… Before, it was to get you healthy, meaning free from disease. Now it’s more of a strategy where the quality of life is now being talked about. So yes, I have seen even in my own business where I’m a health and wellbeing coach, where there are seven layers to wellbeing. The first one is obviously physical wellbeing, where I use yoga to improve that physical wellbeing.

Teresa Miles:

Now the same tools of breathing I can use for mental wellbeing. So they’re inter-related, all layers of wellbeing. Yes, I have seen a lot of shifts. We’re not just symptom management anymore. It’s not like, okay, so you have a headache, here, get this medicine. We’re now more as a community asking, why do you have a headache? What’s the root cause of that headache? Is it stress, or is there really something deep down? Is there a lump? So it’s more really we’re getting the big picture as a community, which is exciting.

Dr. Vaughn:

And I imagine, Teresa, I mean just even for patients who are going through let’s say a defined time of cancer therapy, some of our patients. They’re staying with yoga with you even after, as part of their survivorship, sort of that general wellness strategy I imagine. Because it can also help with, as you mentioned, cardiovascular disease and other stuff. So I imagine you’re seeing them almost like lifelong patients.

Teresa Miles:

Yes. I actually have one whom I met a HOAF, and she has been now my private client. We are now in a different journey of fitness. I mean, we’re still working on a couple of issues, but now you’re right. They have moved on to quality of life improving. We’re talking weight loss, we’re talking strength training. So it started out in cancer, and now has moved on. And a couple of days ago, she did not realize that I was doing this podcast, but she said something to the effect of, “And here I thought when we started, I will never do yoga. Four years later, here we are.” You’re right, it becomes a lifestyle change.

Dr. Vaughn:

As an oncologist, obviously we have patients who are elderly. Do you find it different or difficult sometimes getting some of the older patients involved in yoga? How do you kind of separate? If there is something, how do you, maybe for lack of a better word, sell it to maybe some older patients and the benefits of yoga? Because maybe some just think it is fitness or strength, and not know maybe the mindfulness with it?

Teresa Miles:

Actually, it might not be cancer per se, but somehow I became, in one of the gyms that I teach, I am the SilverSneakers teacher. And SilverSneakers is basically a program of weight lifting for seniors. One of the things that I recommended to the gym is that, okay, you are missing cardio, and you’re missing the third leg, which is flexibility and balance.

Teresa Miles:

So I started doing chair yoga as part of the SilverSneakers program. And the SilverSneakers said they will take my advice from a fitness standpoint but not about life. And I looked at them, because they considered me as a baby. It’s true. My youngest student is 77, I have an 86-year-old, and 81 and so on and so forth. So I have an elder community that-

PART 3 OF 4 ENDS [00:24:04]

Teresa Miles:

So I have an elder community that I’m teaching them yoga breathing, so on and so forth, and to be honest with you, that is their favorite class. Their Friday chair yoga class is their favorite class, and it’s because it’s calming. And I’m basically teaching them basic life skills like holding onto a chair and standing on one leg, making sure that they have balance to prevent falling. And if they have heart issues, blood pressure issues, for their safety whenever we bend, I teach them how to bend properly and then when we come up, we check our blood pressure by just merely standing and breathing, which is once again, yoga breathing to regulate their blood flow and blood pressure.

Teresa Miles:

So I have not had the pleasure of meeting the elder generation that has cancer and once again, I don’t know if it is because they do not know what yoga can do for them but I have experience with my Silver Sneakers group. They are very open and they love their classes.

Dr. Vaughn:

I could just tell you, I think you mentioned just some techniques, some breathing, core strength, just to feel stable, bending down, walking. It would just, I think it would provide a lot of support from some of our elderly patients. So no, I think it’s something we should definitely look into, at least introducing the idea to our patients.

Dr. Vaughn:

And that’s what I was trying to… I guess my question was, it shouldn’t seem to be age dependent, per se, because I think no matter how old you are, young, middle aged, adult, it all has wonderful aspects to help you in this certain life or place or I guess the place you are in life at that time.

Teresa Miles:

Yes, and in my seniors class, when I teach, I give them the so what questions. Like let’s say we’re teaching Silver Sneakers and they have hand weights, and I said, “Pretend that you went grocery shopping. Watch your spine, watch your posture and hold those weights on your side. You just went grocery shopping.”

Teresa Miles:

And so I’m giving them the practical benefit of just holding weights, breathing, I mean, just to calm them down. Something happened before they go into, “Oh my God, something happened,” or, “My car won’t start.” Just breathe. It might be as simple as, “Oh well, I guess I need the key to start my car.” Sometimes it might be something as obvious as that, and it becomes a funny moment and you go, “Oh well, of course I need to have the key in my car.”

Teresa Miles:

Sometimes we are so busy that we can’t understand why the car will not start. It’s because the key is not within them. With today’s society, which is keyless, all you need to have is the key inside the car for it to push the button and start but sometimes we leave the key in the kitchen or something, and of course we’re wondering why the car would not start and then people get into a panic, and I always tell them, “Breathe first. Breathe.” And then your mind will be clear and you go, “Oh, the key’s in the house.” Simple things, practical things.

Dr. Vaughn:

Well, it’s such an important strategy that you’re talking about because I really think that, at least I try to tell my patients, they’re living with cancer and the treatments and I don’t want that to define them and going to yoga and these integrative practices, it just helps them function at high levels during their journey.

Dr. Vaughn:

So I think it’s so helpful for your enlightenment, so we can maybe do a better job of getting patients into maybe just to see a yoga therapist like yourself so we can really help them and focus on wellness, as you mentioned. I think that’s the big thing is maybe shift the mindset to wellness as they’re even receiving therapies for cancer.

Teresa Miles:

Yes, it is all about wellness. I mean, the way I look at it, when we look at our lives, it might just be at some point in our lives that we have these challenges, and over time we will have quality of life. I mean, a little bit changed but we still, nothing’s preventing us from quality of life and yoga will get us there. And as serious it sounds, breathing, it’s the same phrase that I will never forget that massage therapy told me to breathe efficiently and effectively.

Teresa Miles:

That was my turning moment. It never occurred to me that something as simple as that will change my life and bring me to where we are today.

Dr. Vaughn:

Oh, well, Teresa, thank you so much for again, this enlightening talk and how much what you do can impact our patients and improve their quality of life and wellness as you just talked about. You mentioned your company, how do patients reach out to you or how do we get in contact with you? Is there a link?

Teresa Miles:

My company is Ayurga, A-Y-U-R-G-A.net, or they can email me, Hulagirltlm@verizon.net.

Dr. Vaughn:

Well, like I said, thank you so much.

Teresa Miles:

Thank you very much. It was an honor to be here. Thank you again.

Dr. Vaughn:

Thank you all for tuning in to the podcast and appreciate the wisdom of Teresa Miles and how we can all use yoga to improve our quality of life.

Dr. Vaughn:

We will continue with our miniseries next month to discuss other integrative forms of therapy to help support our cancer patients. Also, we plan on having some patient testimonials to pay tribute to breast cancer month which begins October 1st.