Journal of Cancer Survivorship

, Volume 9, Issue 1, pp 115–125 | Cite as

Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial

  • Rebecca A. CampoEmail author
  • Kathleen C. Light
  • Kathleen O’Connor
  • Yoshio Nakamura
  • David Lipschitz
  • Paul C. LaStayo
  • Lisa M. Pappas
  • Kenneth M. Boucher
  • Michael R. Irwin
  • Harry R. Hill
  • Thomas B Martins
  • Neeraj Agarwal
  • Anita Y. Kinney



Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, and cortisol) are important in this population. Tai chi chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases.


Sixty-three senior female cancer survivors (M age = 67 years, SD = 7.15) with physical functioning limitations (SF-12 physical functioning ≤80 or role-physical ≤72) were randomized to 12-weeks (60-min, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention.


Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP, p = 0.002) and cortisol area-under-curve (AUC, p = 0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (ps > 0.05).


This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.

Implications for Cancer Survivors

Senior survivors’ have an increased risk for chronic diseases; however, TCC interventions may help reduce associated risk factors.


Senior cancer survivors Tai Chi Chih Randomized controlled trial Blood pressure Cortisol Inflammatory cytokines 



Preparation of this manuscript was funded by a National Institutes of Health National Center for Complementary and Alternative Medicine Research Fellowship in Complementary and Alternative Medicine (T-32 AT00378) at the University of North Carolina for the first author (R.A. Campo). The Health Education and Active Living in Surviving Seniors (HEALS) Project was funded by a grant from the National Cancer Institute (R21CA135250) awarded to Dr. Anita Kinney and by the Huntsman Cancer Foundation. Additional support was provided by the Shared Resources (P30 CA042014) for use of the Research Informatics Shared Resource and the Study Design and Biostatistics Center. Additionally, the Linda B. and Robert B. Wiggins Wellness-Survivorship Center at Huntsman Cancer Institute provided support for the study physical assessments. This content is solely the responsibility of the authors and does not necessarily represent the official views of the funding and supporting agencies. We thank the Associated Regional and University Pathologists’ Institute for Clinical and Experimental Pathology at the University of Utah and the Kirschbaum Biopsychology Laboratory at Technical University of Dresden, Germany for assays of the inflammatory cytokines and cortisol samples, respectively.

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rebecca A. Campo
    • 1
    Email author
  • Kathleen C. Light
    • 2
  • Kathleen O’Connor
    • 3
  • Yoshio Nakamura
    • 2
  • David Lipschitz
    • 2
  • Paul C. LaStayo
    • 4
  • Lisa M. Pappas
    • 5
  • Kenneth M. Boucher
    • 5
    • 6
  • Michael R. Irwin
    • 7
  • Harry R. Hill
    • 8
    • 9
  • Thomas B Martins
    • 8
    • 9
  • Neeraj Agarwal
    • 3
    • 10
  • Anita Y. Kinney
    • 3
    • 10
    • 11
    • 12
  1. 1.Program on Integrative Medicine, Department of Physical Medicine & RehabilitationUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of AnesthesiologyUniversity of UtahSalt Lake CityUSA
  3. 3.Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUSA
  4. 4.Department of Physical TherapyUniversity of UtahSalt Lake CityUSA
  5. 5.Study Design and Biostatistics Center, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUSA
  6. 6.Department of Oncological ScienceUniversity of UtahSalt Lake CityUSA
  7. 7.Psychoneuroimmunology, Semel Institute for NeuroscienceUniversity of CaliforniaLos AngelesUSA
  8. 8.ARUP Institute for Clinical and Experimental PathologyUniversity of Utah School of MedicineSalt Lake CityUSA
  9. 9.Department of PathologyUniversity of UtahSalt Lake CityUSA
  10. 10.Department of Internal MedicineUniversity of UtahSalt Lake CityUSA
  11. 11.University of New Mexico Cancer CenterAlbuquerqueUSA
  12. 12.Department of Internal MedicineUniversity of New MexicoAlbuquerqueUSA

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