It’s movement with a mission as cancer patients practice yoga at their own pace.

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THE REQUESTS AT the beginning of yoga class were simple and familiar — students asked teacher Mem Rippey to work on shoulders, hips, hamstrings. Others said they were there for mental calmness.

Class started with students seated in chairs doing a breathing exercise. The students, following Rippey’s instructions, inhaled with their arms open wide, then exhaled and brought their hands to their chests. They added in slow arm sweeps, one at a time, and gentle side-to-side movements of their heads.

Many students had their eyes closed as they concentrated on their breath and movement.

It looked like a gentle yoga class. But unlike other yoga classes, the students in this class are all in treatment for cancer.

Jacob Bruggman had been practicing yoga for a couple of months when I met him. He has Hodgkin lymphoma, and since his diagnosis six years ago, he has dealt with fatigue and pain in his shoulder and his right hip. He often feels achy.

Yoga has helped the 33-year-old become more aware of his posture, and manage anxiety. It helps him go out with his girlfriend and do functional things.

“A lot of things I struggle with physically,” he said. “Being more aware makes it easier to manage it.”

Seattle Cancer Care Alliance has offered yoga for many years, and is now making a more concerted effort to help patients with their overall wellness through a new program, Integrative Medicine. Research shows that patients who make time to be active or take on activities that alleviate stress, like meditation, do better during treatment, said Dr. Heather Greenlee, medical director of the program.

Yoga, for example, reduces stress and anxiety, and also can help with depression, mood disorders and overall improvement in quality of life. But other physical activities also make a difference.

“Get moving, get your heart rate up and do it in a way that works for you,” Greenlee says.

Physical activity is one component of the big picture, she says. Managing stress, diet and activity are all connected to positive outcomes from cancer treatment. Studies show meditation can ease stress and depression, and acupuncture can help alleviate side effects and pain.

Going through cancer treatment is inherently stressful, not to mention coping with side effects from medication. Making time to go to yoga in the middle of doctor appointments might seem nonessential.

Greenlee’s goal is to help people make changes that will make a difference. The SCCA offers a nutrition program and yoga; the Integrative Medicine program will bring more support in-house, including a nurse practitioner trained in mindfulness-based stress reduction, a massage therapist and an acupuncturist. Greenlee is a trained naturopath.

Patients want to know what else they can do to stay as healthy as possible, Greenlee says.

Karen Ledger already did yoga before she was diagnosed with sarcoma. Ledger, who moved to Seattle for treatment, struggled with the idea of going to a studio yoga class.

She needed mindfulness, rather than a strong, physical class.

“You already are in a space of dealing with cancer, interpreting why your body is going haywire,” she says. “The state of mindfulness helps you stop your mind from running in circles.”

In Rippey’s class, Ledger can do more, or she can do less, and it’s OK, she says. It’s a different kind of yoga than she once did.

“But it’s very powerful and very important,” she says.