Sushma Bhatnagar,
T. Velpandian,
Santosh Patnaik,
Madhulika Mehrotra,
Neeta Kumar,
- Palliative Medicine Specialist, Apollo Hospital, Sarita Vihar, New Delhi, Delhi, India
- Professor, Department of Ocular Pharmacology & Pharmacy, Dr. RP Centre, AIIMS, New Delhi, Delhi, India
- Assistant Manager, Department of Medical Affairs, Jubilant Generics Ltd., Greater Noida, Uttar Pradesh, India
- Scientist & Mentor, Nano Science and Technology Consortium (NSTC), Sector-63, Noida, Uttar Pradesh, India
- MD Scientist F, Descriptive Research Division, Indian Council of Medical Research, ICMR Hqrs, New Delhi, Delhi, India
Abstract
Background: Breast cancer patients in advanced stages of cancer are managed by palliative care. This study reports important prostaglandin changes observed with added intervention of Sudarshan Kriya in their ongoing palliative care. Level of Prostaglandin A₂ (PGA₂) indicates tumor growth suppression; its level rises if person’s general condition is good, physically fit and active while PGE₂ and D₂ are considered pro-inflammatory. Quantitative assessment of Prostaglandins was done pre and post intervention of Sudarshan Kriya Pranayam (SKP) among 150 stage 4 breast cancer females above 50 years age. Methods: The study conducted in pain and palliative clinic of AIIMS Delhi patients after obtaining informed consent to enroll in standard versus added intervention of SKP. Patient data were kept coded by one team and three other teams worked in double-blinded manner on coded data since randomization/ allocation till intervention and testing using separate teams for opening envelopes for arm allocation and imparting care/ intervention and testing markers. Consenting participants (n = 147) randomized, received standard care (n = 69) and standard care plus SKP (n = 78). SKP arm patients learned Sudarshan Kriya in level one course of Art of Living – 3 hours per day for 4 days. Pre and post intervention blood samples collected at baseline-day 1, and at 3rd month post enrollment/ intervention. Results: A significant difference (rise) in blood prostaglandin levels of PGA₂ at 3 month’s sample in SKP intervention observed – PGA₂ (mean 549.2 ng/ml) versus mean 341.2 ng/ml of control arm (P ≤ 0.002). PGD₂ and E₂ levels, however, showed no difference with baseline, 3rd month’s samples. PGD₂ and E₂ both changed in intervention as well as in control arm from its baseline mean, differences are not significant unlike PGA₂. Conclusion: Added intervention of SKP during palliative care boosts wellbeing among advanced stage breast cancer patients.
Keywords: Breast cancer, cancer, inflammation, prostaglandin, Sudarshan Kriya Pranayam (SKP)
[This article belongs to Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy ]
Sushma Bhatnagar, T. Velpandian, Santosh Patnaik, Madhulika Mehrotra, Neeta Kumar. Sudarshan Kriya Intervention and Rise of Protective Prostaglandins in Advanced-Stage Breast Cancer: Double-Blind, Randomized, Controlled Trial. Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy. 2026; 15(01):62-68.
Sushma Bhatnagar, T. Velpandian, Santosh Patnaik, Madhulika Mehrotra, Neeta Kumar. Sudarshan Kriya Intervention and Rise of Protective Prostaglandins in Advanced-Stage Breast Cancer: Double-Blind, Randomized, Controlled Trial. Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy. 2026; 15(01):62-68. Available from: https://journals.stmjournals.com/joayush/article=2026/view=240162
Browse Figures
References
- Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World J Clin Oncol. 2022 Mar 3;13(3):209.
- Liska CM, Morash R, Paquet L, Stacey D. Empowering cancer survivors to meet their physical and psychosocial needs: An implementation evaluation. Can Oncol Nurs J. 2018 Apr;28(2):76–81.
- Kumar N, Bhatnagar S, Velpandian T, Patnaik S, Menon G, Mehta M, et al. Randomized controlled trial in advance stage breast cancer patients for the effectiveness on stress marker and pain through Sudarshan Kriya and pranayam. Indian J Palliat Care. 2013 Sep;19(3):180–5.
- Vendramini-Costa DB, Carvalho JE. Molecular link mechanisms between inflammation and cancer. Curr Pharm Des. 2012;18(26):3831–52.
- Brenner DR, Scherer D, Muir K, Schildkraut J, Boffetta P, Spitz MR, et al. A review of the application of inflammatory biomarkers in epidemiologic cancer research. Cancer Epidemiol Biomarkers Prev. 2014 Sep 1;23(9):1729–51.
- Brock TG, McNish RW, Peters-Golden M. Arachidonic acid is preferentially metabolized by cyclooxygenase-2 to prostacyclin and prostaglandin E2. J Biol Chem. 1999;274(17):11660–6.
- Schrey MP, Patel KV. Prostaglandin E2 production and metabolism in human breast cancer cells and breast fibroblasts: Regulation by inflammatory mediators. Br J Cancer. 1995;72:1412–9.
- Sheng H, Shao J, Washington MK, DuBois RN. Prostaglandin E2 increases growth and motility of colorectal carcinoma cells. J Biol Chem. 2001;276(21):18075–81.
- Wu J, Zhang Y, Frilot N, Kim JI, Kim WJ, Daaka Y. Prostaglandin E2 regulates renal cell carcinoma invasion through the EP4 receptor-Rap GTPase signal transduction pathway. J Biol Chem. 2011;286(39):33954–62.
- Fabre JE, Coffman TM, Koller BH. Activation of the murine EP3 receptor for PGE2 inhibits cAMP production and promotes platelet aggregation. J Clin Invest. 2001;107(5):603–10.
- Basu S, Harris H, Wolk A, Rossary A, Caldefie-Chezet F, Vasson MP, et al. Inflammatory F2-isoprostane, prostaglandin F2α, pentraxin 3 levels and breast cancer risk: The Swedish mammography cohort. Prostaglandins Leukot Essent Fatty Acids. 2016;113:28–32.
- Allaj V, Guo C, Nie D. Non-steroid anti-inflammatory drugs, prostaglandins, and cancer. Cell Biosci. 2013;3:8.
- Finetti F, Travelli C, Ercoli J, Colombo G, Buoso E, Trabalzini L. Prostaglandin E2 and cancer: Insight into tumor progression and immunity. Biology. 2020;9(12):434.
- Yang SF, Chen MK, Hsieh YS, Chung TT, Hsieh YH, Lin CW, et al. Prostaglandin E2/EP1 signaling pathway enhances intercellular adhesion molecule 1 expression and cell motility in oral cancer cells. J Biol Chem. 2010;285(39):29808–16.
- Lupulescu A. Prostaglandins, their inhibitors and cancer. Prostaglandins Leukot Essent Fatty Acids. 1996;54(2):83–94.
- Watanabe K, Kawamori T, Nakatsugi S, Ohta T, Ohuchida S, Yamamoto H, et al. Inhibitory effect of a prostaglandin E receptor subtype EP1 selective antagonist, ONO-8713, on development of azoxymethane-induced aberrant crypt foci in mice. Cancer Lett. 2000;156(1):57–61.
- Ma X, Kundu N, Ioffe OB, Goloubeva O, Konger R, Baquet C, et al. Prostaglandin E receptor EP1 suppresses breast cancer metastasis and is linked to survival differences and cancer disparities. Mol Cancer Res. 2010;8(10):1310–8.
- Finetti F, Travelli C, Ercoli J, Colombo G, Buoso E, Trabalzini L. Prostaglandin E2 and cancer: Insight into tumor progression and immunity. Biology. 2020;9(12):434.
- Howe LR. Inflammation and breast cancer: Cyclooxygenase/prostaglandin signaling and breast cancer. Breast Cancer Res. 2007;9:210.
- Jara-Gutiérrez Á, Baladrón V. The role of prostaglandins in different types of cancer. Cells. 2021;10(6):1487.
- 21. Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. Arterioscler Thromb Vasc Biol. 2011;31:986–1000.
- Wang Q, Morris RJ, Bode AM, Zhang T. Prostaglandin pathways: Opportunities for cancer prevention and therapy. Cancer Res. 2022 Mar 15;82(6):949–65.
- 23. Park KM, Park JY, Pyo J, Lee SY, Kim HS. Induction of DR5-dependent apoptosis by PGA2 through ATF4-CHOP pathway. Molecules. 2022;27(12):3804.
- Seegers JC, Joubert AM, Panzer A, Lottering ML, Jordan CA, Joubert F, et al. Fumonisin B1 influenced the effects of arachidonic acid, prostaglandins E2 and A2 on cell cycle progression, apoptosis induction, tyrosine- and CDC2-kinase activity in oesophageal cancer cells. Prostaglandins Leukot Essent Fatty Acids. 2000;62(2):75–84.
- Choe YJ, Ko KW, Lee H, Lee SY, Kim BC, Kim HS. PGA2-induced HO-1 attenuates G2/M arrest by modulating GADD45α expression. Mol Cell Toxicol. 2015;11:465–74.
- Ishioka C, Kanamaru R, Sato T, Dei T, Konishi Y, Asamura M, et al. Inhibitory effects of prostaglandin A2 on c-myc expression and cell cycle progression in human leukemia cell line HL-60. Cancer Res. 1988;48(10):2813–8.
- Basu S, Harris H, Wolk A, Rossary A, Caldefie-Chezet F, Vasson MP, et al. Inflammatory F2-isoprostane, prostaglandin F2α, pentraxin 3 levels and breast cancer risk: The Swedish mammography cohort. Prostaglandins Leukot Essent Fatty Acids. 2016;113:28–32.
- Kumar N, Bhatnagar S, Velpandian T, Patnaik S, Menon G, Mehta M, et al. Randomized controlled trial in advance stage breast cancer patients for the effectiveness on stress marker and pain through Sudarshan Kriya and pranayam. Indian J Palliat Care. 2013;19(3):180.
- Zope SA, Zope RA. Sudarshan kriya yoga: Breathing for health. Int J Yoga. 2013;6(1):4.
- Sharma H, Datta P, Singh A, Sen S, Bhardwaj NK, Kochupillai V, et al. Gene expression profiling in practitioners of Sudarshan Kriya. J Psychosom Res. 2008;64(2):213–8.
- Liu L, Li YN, Zhang A, Yin Y, Yue Z, Pei L, et al. Clinical potential of serum prostaglandin A2 as a novel diagnostic biomarker for hepatocellular cancer. Clin Chim Acta. 2024;561:119814.

Journal of AYUSH: Ayurveda, Yoga, Unani, Siddha and Homeopathy
| Volume | 15 |
| Issue | 01 |
| Received | 10/03/2026 |
| Accepted | 09/04/2026 |
| Published | 10/04/2026 |
| Publication Time | 31 Days |
Login
PlumX Metrics