News
General exercise as good as yoga for female urinary incontinence
A study which compared pelvic floor yoga to general muscle conditioning found that yoga was only slightly better at relieving bladder issues.
Yoga has been recommended for years to treat or prevent health conditions that are associated with aging, such as urinary incontinence, but there’s been little data to back it up.
Now, a study led by the University of California, San Francisco has found that pelvic floor yoga is not superior to a general exercise programme at reducing urinary incontinence in older women.
The research, published in Annals of Internal Medicine, showed that regular muscle stretching and strengthening exercises could improve urinary incontinence symptoms almost as much as yoga.
“The results suggest that women who pursue specialised training in pelvic yoga for their bladder problems could see similar improvements if they instead dedicated the same amount of time and effort to other, general physical conditioning exercise,” said first author Alison J. Huang, a UCSF professor of medicine, epidemiology and biostatistics and urology.
“Some women may still prefer yoga because of its other potential mind-body benefits,” she said. “But because yoga tends to require specialised instruction and props, it may be easier and less expensive to engage in other forms of physical activity or exercise.”
Studies have shown that urinary incontinence is a common ailment affecting nearly half of midlife and older women. The condition can lead to depression, social isolation and functional decline.
Pelvic yoga, which has become popular among women of all ages, is designed to improve pelvic health problems such as incontinence, pelvic pain, or overactive bladder that can worsen due to childbirth, menopause or ageing. But there’s been little rigorous research to evaluate its effectiveness, and many clinicians have been skeptical that yoga provides special benefits.
The LILA study (Lessening Incontinence through Low-Impact Activity) involved 240 women 45 to 90 in California who were experiencing urinary incontinence at least daily, were not using other treatments for incontinence, and not already participating in yoga or organised muscle strengthening activities.
They were randomly assigned for three months either to the pelvic yoga programme of group classes twice a week and individual practice once a week, or to a physical conditioning programme of general muscle stretching and strengthening with an equivalent amount of group classes and individual practice.
The authors found that women in the yoga group reported more than a 60 per cent decrease in the average frequency of incontinence. However, women in the general conditioning programme also reported nearly a 50 per cent improvement in their symptoms.
The authors concluded that both groups experienced a “clinically meaningful” improvement in their incontinence, and that yoga was not clearly better, although it resulted in modestly greater improvement in some more specialised types of urinary symptoms.
“The results may provide support for a shift in thinking about treatment approaches for incontinence in older adults,” Huang explained.
“Rather than focusing primarily on treatments that target the bladder or pelvic floor, perhaps we should focus on strategies that improve our overall physical function as we age.”
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Diagnosis
Lung cancer drug shows breast cancer potential
Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.
PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.
Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.
The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.
In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.
Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.
Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.
Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”
John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”
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