Supportive Care in Cancer

, Volume 20, Issue 6, pp 1235–1242 | Cite as

Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial

  • Byeongsang Oh
  • Phyllis N. Butow
  • Barbara A. Mullan
  • Stephen J. Clarke
  • Philip J. Beale
  • Nick Pavlakis
  • Myeong Soo Lee
  • David S. Rosenthal
  • Linda Larkey
  • Janette Vardy
Original Article

Abstract

Purpose

Cancer patients often experience diminished cognitive function (CF) and quality of life (QOL) due to the side effects of treatment and the disease symptoms. This study evaluates the effects of medical Qigong (MQ; combination of gentle exercise and meditation) on CF, QOL, and inflammation in cancer patients.

Methods

Eighty-one cancer patients recruited between October 2007 and May 2008 were randomly assigned to two groups: a control group (n = 44) who received the usual health care and an intervention group (n = 37) who participated in a 10-week MQ program. Self-reported CF was measured by the European Organization for Research and Treatment of Cancer (EORTC-CF) and the Functional Assessment of Cancer Therapy—Cognitive (FACT-Cog). The Functional Assessment of Cancer Therapy—General (FACT-G) was used to measure QOL. C-reactive protein (CRP) was assessed as a biomarker of inflammation.

Results

The MQ group self-reported significantly improved CF (mean difference (MD) = 7.78, t51 = −2.532, p = 0.014) in the EORTC-CF and all the FACT-Cog subscales [perceived cognitive impairment (MD = 4.70, t43 = −2.254, p = 0.029), impact of perceived cognitive impairment on QOL (MD = 1.64, t45 = −2.377, p = 0.024), and perceived cognitive abilities (MD = 3.61, t45 = −2.229, p = 0.031)] compared to controls. The MQ group also reported significantly improved QOL (MD = 12.66, t45 = −5.715, p < 0.001) and had reduced CRP levels (MD = −0.72, t45 = 2.092, p = 0.042) compared to controls.

Conclusions

Results suggest that MQ benefits cancer patients’ self-reported CF, QOL, and inflammation. A larger randomized controlled trial including an objective assessment of CF is planned.

Keywords

Cancer Cognitive function Quality of life Inflammation Medical Qigong 

References

  1. 1.
    Vardy J, Wefel JS, Ahles T et al (2008) Cancer and cancer-therapy related cognitive dysfunction: an international perspective from the Venice cognitive workshop. Ann Oncol 19(4):623–629PubMedCrossRefGoogle Scholar
  2. 2.
    Jenkins V (2006) A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer 94:828–834PubMedCrossRefGoogle Scholar
  3. 3.
    Shilling V, Jenkins V (2007) Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer. Eur J Oncol Nurs 11(1):6–15PubMedCrossRefGoogle Scholar
  4. 4.
    Boykoff N, Moieni M, Subramanian S (2009) Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232PubMedCrossRefGoogle Scholar
  5. 5.
    Vardy J, Rourke S, Tannock I (2007) Evaluation of cognitive function associated with chemotherapy: a review of published studies and recommendations for future research. J Clin Oncol 25(17):2455PubMedCrossRefGoogle Scholar
  6. 6.
    Schagen SB (1999) Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 85:640–650PubMedCrossRefGoogle Scholar
  7. 7.
    van Dam FS (1998) Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 90:210–218PubMedCrossRefGoogle Scholar
  8. 8.
    Castellon SA (2004) Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen. J Clin Exp Neuropsychol 26:955–969PubMedCrossRefGoogle Scholar
  9. 9.
    Ahles TA (2002) Neuropsychological impact of standard-dose chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol 20:485–493PubMedCrossRefGoogle Scholar
  10. 10.
    Vardy J, Xu W, Booth C et al (2008) Relation between perceived cognitive function and neuropsychological performance in survivors of breast and colorectal cancer. ASCO Meeting Abstracts, p 9520Google Scholar
  11. 11.
    Schagen SB, Muller MJ, Boogerd W et al (2006) Change in cognitive function after chemotherapy: a prospective longitudinal study in breast cancer patients. J Natl Cancer Inst 98(23):1742–1745PubMedCrossRefGoogle Scholar
  12. 12.
    Wefel J, Lenzi R, Theriault R et al (2004) Chemobrain in breast carcinoma? A prologue. Cancer 101(3):466–475PubMedCrossRefGoogle Scholar
  13. 13.
    Von Ah D, Harvison KW, Monahan PO et al (2009) Cognitive function in breast cancer survivors compared to healthy age- and education-matched women. Clin Neuropsychol 23(4):661–674CrossRefGoogle Scholar
  14. 14.
    Fan HGM, Houede-Tchen N, Yi Q-L et al (2005) Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer: 1- and 2-year follow-up of a prospective controlled study. J Clin Oncol 23(31):8025–8032PubMedCrossRefGoogle Scholar
  15. 15.
    Vardy J (2009) Cognitive function in survivors of cancer. ASCO Educational Book 2009(1):570–574Google Scholar
  16. 16.
    Roberts RO, Geda YE, Knopman DS et al (2010) Metabolic syndrome, inflammation, and nonamnestic mild cognitive impairment in older persons: a population-based study. Alzheimer Dis Assoc Disord 24(1):11–18. doi:10.1097/WAD.0b013e3181a4485c PubMedCrossRefGoogle Scholar
  17. 17.
    Seruga B, Zhang H, Bernstein L et al (2008) Cytokines and their relationship to the symptoms and outcome of cancer. Nat Rev Cancer 8(11):887–899PubMedCrossRefGoogle Scholar
  18. 18.
    Onem Y, Terekeci H, Kucukardali Y et al (2010) Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes. Arch Gerontol Geriatr 50(1):56–59PubMedCrossRefGoogle Scholar
  19. 19.
    Seeman TE, McEwen BS, Singer BH et al (1997) Increase in urinary cortisol excretion and memory declines: MacArthur studies of successful aging. J Clin Endocrinol Metab 82(8):2458–2465PubMedCrossRefGoogle Scholar
  20. 20.
    Jim H, Small B, Patterson S et al (2010) Cognitive impairment in men treated with luteinizing hormone-releasing hormone agonists for prostate cancer: a controlled comparison. Supportive Care Cancer 18(1):21–27. doi:10.1007/s00520-009-0625-3 CrossRefGoogle Scholar
  21. 21.
    Ahles TA, Saykin AJ, Noll WW et al (2003) The relationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy. Psychooncology 12(6):612–619PubMedCrossRefGoogle Scholar
  22. 22.
    Ahles TA, Saykin AJ (2007) Candidate mechanisms for chemotherapy-induced cognitive changes. Nat Rev Cancer 7(3):192–201PubMedCrossRefGoogle Scholar
  23. 23.
    Silverman D, Dy C, Castellon S et al (2007) Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5–10 years after chemotherapy. Breast Cancer Res Treat 103(3):303–311PubMedCrossRefGoogle Scholar
  24. 24.
    Oh B, Butow P, Mullan B et al (2009) Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol 21:608–614PubMedCrossRefGoogle Scholar
  25. 25.
    Kemoun G, Thibaud M, Roumagne N et al (2010) Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord 29(2):109–114PubMedCrossRefGoogle Scholar
  26. 26.
    Etnier J, Johnston R, Dagenbach D et al (1999) The relationships among pulmonary function, aerobic fitness, and cognitive functioning in older COPD patients*. Chest 116(4):953–960PubMedCrossRefGoogle Scholar
  27. 27.
    Colcombe AM, Kramer AF, Irwin DE et al (2003) Age-related effects of attentional and oculomotor capture by onsets and color singletons as a function of experience. Acta Psychologica 113(2):205–225PubMedCrossRefGoogle Scholar
  28. 28.
    Lautenschlager NT, Cox KL, Flicker L et al (2008) Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA 300(9):1027–1037PubMedCrossRefGoogle Scholar
  29. 29.
    Heikkila K, Ebrahim S, Rumley A et al (2007) Associations of circulating C-reactive protein and interleukin-6 with survival in women with and without cancer: findings from the British Women’s Heart and Health Study. Cancer Epidemiol Biomarkers Prev 16(6):1155–1159PubMedCrossRefGoogle Scholar
  30. 30.
    Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376PubMedCrossRefGoogle Scholar
  31. 31.
    Jacobs SR, Jacobsen PB, Booth-Jones M et al (2007) Evaluation of the functional assessment of cancer therapy cognitive scale with hematopoetic stem cell transplant patients. J Pain Symptom Manag 33(1):13–23CrossRefGoogle Scholar
  32. 32.
    Wagner L, Sweet J, Butt Z et al (2009) Measuring patient self-reported cognitive function: development of the Functional Assessment of Cancer Therapy—Cognitive Function instrument. J Support Oncol 7(6):W32–W39Google Scholar
  33. 33.
    Cella DF, Tulsky DS, Gray G et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579PubMedGoogle Scholar
  34. 34.
    Hwang SS, Chang VT, Kasimis BS et al (2003) A comparison of three fatigue measures in veterans with cancer. Cancer Investigation 21(3):363–373PubMedCrossRefGoogle Scholar
  35. 35.
    Carlson LE, Speca M, Patel KD et al (2004) Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology 29(4):448–474PubMedCrossRefGoogle Scholar
  36. 36.
    Mutrie N, Campbell AM, Whyte F et al (2007) Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ 334(7592):517PubMedCrossRefGoogle Scholar
  37. 37.
    Pierce BL, Ballard-Barbash R, Bernstein L et al (2009) Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol 27(21):3437–3444PubMedCrossRefGoogle Scholar
  38. 38.
    Noble JM, Manly JJ, Schupf N et al (2010) Association of C-reactive protein with cognitive impairment. Arch Neurol 67(1):87–92PubMedCrossRefGoogle Scholar
  39. 39.
    Yeh M, Lee T, Chen H et al (2006) The influences of Chan-Chuang Qi-gong therapy on complete blood cell counts in breast cancer patients treated with chemotherapy. Cancer Nurs 29(2):149–155PubMedCrossRefGoogle Scholar
  40. 40.
    Luo S, Tong T (1988) Effect of vital gate Qigong exercise on malignant tumor. First World Conference for Academic Exchange of Medical Qigong, Beijing, p 122Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Byeongsang Oh
    • 1
    • 2
    • 3
  • Phyllis N. Butow
    • 2
  • Barbara A. Mullan
    • 2
  • Stephen J. Clarke
    • 1
    • 3
  • Philip J. Beale
    • 1
    • 3
  • Nick Pavlakis
    • 3
  • Myeong Soo Lee
    • 4
  • David S. Rosenthal
    • 5
  • Linda Larkey
    • 6
  • Janette Vardy
    • 1
    • 2
  1. 1.Sydney Medical School, University of SydneyRoyal Prince Alfred Hospital & Concord Repatriation General HospitalSydneyAustralia
  2. 2.Centre for Medical Psychology and Evidence-based Decisionmaking (CeMPED), School of PsychologyUniversity of SydneySydneyAustralia
  3. 3.Department of Medical OncologyRoyal North Shore HospitalSt LeonardsAustralia
  4. 4.Brain Disease Research CenterKorea Institute of Oriental MedicineDaejeonSouth Korea
  5. 5.Dana–Farber Cancer InstituteHarvard Medical SchoolBostonUSA
  6. 6.Scottsdale Healthcare Chair of Biobehavioral Oncology Research, College of Nursing and Health InnovationArizona State UniversityTempeUSA

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