Qigong in cancer care: a systematic review and construct analysis of effective Qigong therapy
- 803 Downloads
This review (a) assesses the strength of evidence addressing Qigong therapy in supportive cancer care and (b) provides insights for definition of effective Qigong therapy in supportive cancer care.
This mixed-methods study includes (a) a systematic review of randomized clinical trials (RCTs) following PRISMA guidelines and (b) a constant-comparative qualitative analysis of effective intervention protocols.
Eleven published randomized clinical trials were reviewed. A total of 831 individuals were studied. Geographic settings include the USA, Australia, China, Hong Kong, and Malaysia. Qigong therapy was found to have positive effects on the cancer-specific QOL, fatigue, immune function, and cortisol levels of individuals with cancer. Qigong therapy protocols varied supporting a plurality of styles. Qualitative analyses identified common programming constructs. Content constructs included exercise (gentle, integrated, repetitious, flowing, weight-bearing movements), breath regulation, mindfulness and meditation, energy cultivation including self-massage, and emphasis on relaxation. Logistic constructs included delivery by qualified instructors, home practice, and accommodation for impaired activity tolerance.
There is global interest and a growing body of research providing evidence of therapeutic effect of Qigong therapy in supportive cancer care. While Qigong therapy protocols vary in style, construct commonalities do exist. Knowledge of the common constructs among effective programs revealed in this research may be used to guide future research intervention protocol and community programming design and development.
KeywordsCancer Qigong Tai chi Review Qualitative Construct analysis Content analysis
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
- 1.de Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, et al. (2013) Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev 70:561–570. [PMC free article] PMID 23535024 [PubMed]Google Scholar
- 2.Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD006145. doi: 10.1002/14651858.CD006145.pub3
- 3.Markes M, Brockow T, Resch KL. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD005001. doi: 10.1002/14651858.CD005001.pub2.
- 4.Salakari MR, Surakka T, Nurminen R, Pylkkänen Salakari MR, Surakka T, Nurminen R, Pylkkänen L (2015) Effects of rehabilitation among patients with advances cancer: a systematic review. Acta Oncol 54(5):618–28. doi: 10.3109/0284186X.2014.996661. Epub 2015 Mar 9
- 5.Fisher A, Wardle J, Beeken RJ, Croker H, Williams K, Grimmett. (2015) Perceived barriers and benefits to physical activity in colorectal cancer patients. Supportive Care in Cancer. Aug 14:1–8 [Epub ahead of print] PMID: 26268781Google Scholar
- 6.Winters-Stone K (2014) Tai Ji Quan for the aging cancer survivor: mitigating the accelerated development of disability, falls, and cardiovascular disease from cancer treatment. J Sport Health Sci 3(1):52–57. PMID: 25285233 Free PMC ArticleGoogle Scholar
- 7.Chodzko-Zajko W, Jahnke R. (2005) Working Group. National expert meeting on qigong and tai chi: consensus report. Urbana, Il: University of Illinois at Urbana-Champaign; Nov. 2005. Available from: http://healerwithinfoundation.org/National_Expert_Meeting/. Accessed 10 Oct 2015
- 8.Adler R, Felten DL, Cohen N (2007) Psychoneuroimmunology, 4th edn. Academic Press, San Diego CA. ISBN 978-0-12-088576-3Google Scholar
- 9.Benson H (2000) The relaxation response: updated and expanded. HarperCollins e-pub ID 9780380815951, 0380815958Google Scholar
- 10.Jwing-Ming Y (1997) The essence of taiji qigong, 2nd edn. YMAA Publication Center, Boston, MA. ISBN 1-886969-63-9Google Scholar
- 11.Picard G (2009) Heal yourself with qigong. Spiral Graphics, Canada. ISBN 978-0-0865155-0-7Google Scholar
- 12.Yang G-Y, Wang L-Q, Ren J, et al. (2015) Evidence base of clinical studies on Tai Chi: a bibliometric analysis. Scherer RW, ed. PLoS ONE. 2015;10(3):e0120655. doi: 10.1371/journal.pone.0120655. Free PMC Article
- 13.Zeng Y, Luo T, Xie H, Huang M, Cheng AS (2014) Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complement Ther Med 22(1):173–86. doi: 10.1016/j.ctim.2013.11.010. Epub 2013 Dec 18. Review. [PubMed]
- 14.Pan Y, Yang K, Shi X, Liang H, Zhang F, Lv Q, (2015) Tai chi quan exercise for patients with breast cancer: A systematic review and meta analysis. Evid Based Complement Alternat Med. 2015;2015:535237. doi: 10.1155/2015/535237. Epub 2015 Feb 22. Review. PMID: 25793000 Free PMC Article
- 17.Lee MS, Choi TY, Ernst E (2010) Tai chi for breast cancer patients: a systematic review. Breast Cancer Res Treat Apr;120(2):309–16. doi: 10.1007/s10549-010-0741-2. Epub 2010 Feb 2
- 18.Lee MS, Chen K, Sancier KM, Ernst E. (2007) Qigong for cancer treatment: a systematic review of controlled clinical trials ACTA Oncologica 46(6): 717–22. PMID: 17653892Google Scholar
- 19.Jahnke R, Larkey L, Rogers C, Etnier J, Lin F (2010) A comprehensive review of health benefits of qigong and tai chi. Am J Health Promo 2010 24(6):e1-e25. doi: 10.4278/ajhp.081013-LIT-248. Review. PMID: 20594090 Free PMC Article
- 20.Moher D, Liberati A, Tetzlaff J, Altman D. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Medicine, North America, 3, jul. 2009. Available at: http://www.openmedicine.ca/article/view/285/247. Date accessed: 23 Oct 2015
- 21.Glaser BG (2008) The constant comparative method of qualitative analysis. Grounded Theory Review. 07(3) nov, 2008. Available at http://groundedtheoryreview.com/2008/11/29/the-constant-comparative-method-of-qualitative-analysis-1/Date accessed: 26 Oct 2015
- 22.Campo RA, Light KC, O’Conner K, et al. (2015) Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial. J Cancer Surviv 9(1):115–25. doi: 10.1007/s11764-014-0395-x. Epub 2014 Aug 28 PMID: 25164513
- 23.Campo RA, Agarwal N, LaStayo PC, O’Connor K, Pappas L, Boucher KM, Gardner J, Smith S, Light KC, Kinney AY. (2014) Levels of fatigue and distress in senior prostate cancer survivors enrolled in a 12-week randomized controlled trial of Qigong. J Cancer Surviv. 2014 Mar;8(1):60–9. doi: 10.1007/s11764-013-0315-5. Epub 2013 Oct 30. PubMed PMID: 24170679; PubMed Central PMCID: PMC3945387. Free PMC Article
- 24.Chen Z, Meng Z, Milbury K, Bei W, Zhang Y, Thornton B, Liao Z, Wei Q, Chen J, Guo X, Liu L, McQuade J, Kirschbaum C, Cohen L (2013) Qigong improves quality of like in women undergoing radiotherapy for breast cancer: results of a randomized clinical trial. Cancer 119(9):1690–8. doi: 10.1002/cncr.27904. Epub 2013 Jan 25. PubMed PMID: 23355182; PubMed Central PMCID: PMC3852682 Free PMC Article
- 26.Lam, SWY (2004) A randomized, controlled trial of Guolin qigong in patients receiving transcatheter arterial chemoembolisation for unresectable hepatocellular carcinoma, Master dissertation Hong Kong, China, The University of Hong KongGoogle Scholar
- 28.Loh SY, Lee SY, Murray L (2014) The Kuala Lumpur Qigong trial for women in cancer survivorship phase-efficacy of a three-arm RCT to improve QOL. Asian Pac J Cancer Prev 15(19):8127–34. PMID: 25338995 Free ArticleGoogle Scholar
- 29.Oh B, Butow PN, Mullan BA, Clarke SJ, Beale PJ, Pavlakis N, Lee MS, Rosenthal DS, Larkey L, Vardy J (2012) Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial. Support Care Cancer 20(6):1235–42. doi: 10.1007/s00520-011-1209-6. Epub 2011 Jun 19
- 30.Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D (2010) Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol 21(3):608–14. doi: 10.1093/annonc/mdp479. Epub 2009 Oct 30. Free PMC Article
- 31.Robins JL, McCain NL, Elswick Jr RK, Walter JM, Gray PD, Tuck I (2013) Psychoneuroimmunology-based stress management during adjuvant chemotherapy for early breast cancer. Evid Based Complement Alternat Med 2013: ID 372908, 7 pages. Published online 2013 May 14. doi: 10.1155/2013/372908 PMCID: PMC3666296
- 33.Tai Chi Easy™. Available from http://www.taichieasy.org/Accessed 10 Oct 2015
- 34.Tai Chi Chih. Available from http://www.taichichih.org/Accessed 10 Oct 2015
- 36.Mishra SI, Scherer RW, Geigle PM, Berntanstein DR, Topaloglu O. (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012 Aug 15;8:CD008465. doi: 10.1002/14651858.CD008465.pub2. Review. PMID: 22895974
- 37.Umar A (2014) Cancer immunoprevention: a new approach to intercept cancer early. Canc Prev Reas 2014 7(11):1067–71 PMID: 25237055 [PubMed] doi: 10.1158/1940-6207
- 38.Chen K, Yeung R (2002) Exploratory studies of Qigong therapy for cancer in China. Integr Cancer Ther 2002 Dec;1(4):345–70. PMID: 14664729 [PubMed]Google Scholar
- 40.Schellekens MPJ, Jansen ETM, Willemse HHMA, van Laarhoven HWM, Prins JB, Speckens AEM. (2015) A qualitative study on mindfulness-based stress reduction for breast cancer patients: how women experience participating with fellow patients. Supportive Care in Cancer. 2016 Apr;24(4):1813–20. doi: 10.1007/s00520-015-2954-8. Epub 2015 Oct 8. PMID: 26446701
- 41.Wayne PM, Berkowitz DL, Litrownik DE, Buring JE, Yeh GY. (2014) What do we really know about the safety of Tai Chi?: A systematic review of adverse events reports in randomized trials. Arch Phys Med Rehabil. 95:2470–83. doi: 10.1016/j.apmr.2014.05.005 [PubMed]
- 42.Carande-Kulis V, Stevens JA, Florence CS, Beattie B, Arias I. (2015) A cost-benefit analysis of three older adult prevention interventions. (2015) J Safety Res 52:65–70 doi: 10.1016/j.jsr.2014.12.007. Epub 2015 Jan 6. PMID: 25662884
- 43.Chen KW. (2004) An analytic review of studies on measuring effects of external QI in China. Altern Ther Health Med. 2004 Jul-Aug;10(4):38–50. PMID: 15285273Google Scholar