As "Puamana" played, the women, all lined up in a row, moved gracefully to the music, their arms forming graceful arcs as they danced to the classic Hawaiian song about a home in Lahaina surrounded by swaying coconut trees. They beamed as their hands flowed back and forth.

It may have looked like any other hula class, but this one was part of a University of Hawaii Cancer Center study. Researchers Lenora Loo and Erin Bantum want to determine if hula helps breast cancer survivors improve their quality of life from both a physical and psychological viewpoint, and whether the activity can reduce the risk of the cancer returning.

For six months, ending in mid-May, the 10 women met twice a week for a one-hour hula class at the Cancer Center.

"In a multicultural community like Hawaii, hula is a familiar form of cultural expression through dance," said Loo, an assistant professor in the center’s epidemiology program. "We believe hula can benefit cancer survivors on multiple levels because hula incorporates aerobic activity, whole-body movement, concentration and memorization."

Loo is working with Bantum, an assistant professor who is focusing on the psycho­social benefits of hula for survivors. Medical oncologist Dr. Clayton Chong and Cancer Epidemiology Program director Dr. Herbert Yu brought the team together.

Besides measuring height, weight and pulse rates, researchers are taking blood samples to detect biological changes in the dancers before and after the six-month study period. The data will be collected again in six months. The participants also will fill out questionnaires to assess their mood, fatigue levels and quality of life.

The researchers hope to publish the results some time next year and follow up with an even broader study.

To participate, female breast cancer survivors had to have been treated within the last five years and not have been exercising regularly for more than an hour a week prior to the study.

What the students discovered is not only a newfound love for hula but an inextricable bond.

"It’s amazing," said Sylvia Hakkert, 62. "Actually, on the first day, we started to connect and click."

Sheila Forman, 72, agreed.

"It’s like (cancer) was just the given and hula was the purpose," said Forman. "I’m hooked, completely. I hope everybody has a chance to do it. It’s the connection to Hawaii. I think the results are going to be compelling because we see it."

Joyce McQueen, 82, says she’s been in cancer support groups before that she found depressing.

"With this group, we do the hula and we laugh," she said. "It’s uplifting, plus I’ve made friends."

McQueen was diagnosed with breast cancer three years ago and the disease spread to her colon and pancreas, but she remains as active as she can.

Both Hakkert and Forman are in remission. Hakkert said she lost about 10 pounds by dancing hula, which has motivated her to swim, too. Forman says hula, particularly the music, makes her feel a connection to Hawaii and she hopes to teach the songs to her granddaughter.

"My husband, he memorizes the songs before I do and he corrects me," she said. "This hula just makes me feel really happy."

TeMoana Makolo, a breast cancer survivor herself, taught the classes.

Makolo, 72, stepped in to teach for her aunt, the late kumu hula Leilani Alama, who had agreed to teach the class but died in April 2014 at the age of 88. It is, in a way, healing for her as she grieves the loss of her aunt.

"Hula is the best exercise anybody could ever have because you use every single muscle in your being, plus you’ve got to use your brain," she said.

Participants must learn and remember the verses and accompanying, coordinated motions, and they must move together.

Makolo taught them auana (modern-style hula) with such songs as "Mahina O Hoku," "Pua Carnation," "Papalina Lahilahi" and "To You, Sweetheart Aloha." She says she has noticed improvement in the dancers’ rhythm and some are able to raise their arms a little better than before, which can be difficult after surgery.

The ladies even performed at a May Day Hulathon in support of the Iwalani Foundation, which promotes breast cancer awareness, at Ward Warehouse.

"The joy I’m getting out of this is they are enjoying it and I can see that," said Makolo. "I am very proud of them."

The women have had so much fun, in fact, they asked if they could continue after the study is done. Makolo plans to keep teaching at the center until they find a new venue.

"That’s what hula does," she said. "You become a hula family and it’s really marvelous."