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Qigong in cancer care: a systematic review and construct analysis of effective Qigong therapy

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  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]

  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: 26268781

  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 Article

  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 978-0-12-088576-3

    Google Scholar 

  9. Benson H (2000) The relaxation response: updated and expanded. HarperCollins e-pub ID 9780380815951, 0380815958

  10. Jwing-Ming Y (1997) The essence of taiji qigong, 2nd edn. YMAA Publication Center, Boston, MA. ISBN 1-886969-63-9

    Google Scholar 

  11. Picard G (2009) Heal yourself with qigong. Spiral Graphics, Canada. ISBN 978-0-0865155-0-7

    Google 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

  15. Yan J-H, Pan L, Zhang X-M, Sun C-X, Cui G-H (2014) Lack of efficacy of tai chi in improving quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pac J Cancer Prev 15(8):3715–3720. doi:10.7314/APJCP.2014.15.8.3715

    Article  PubMed  Google Scholar 

  16. Oh B, Butow P, Mullan B, Hale A, Lee MS, Guo X, Clarke S (2012) A critical review of medical qigong on quality of life, immune function and survival in cancer patients. Integrative Cancer Therapies 11(2):101–110. doi:10.1177/1534735411413268

    Article  PubMed  Google Scholar 

  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: 17653892

  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

  25. Irwin MR, Olmstead R, Breen EC (2014) Tai chi, cellular inflammation, and transcriptome dynamics in breast cancer survivors with insomnia. J Natl Cancer Inst Monogr 2014(50):295–301. doi:10.1093/jncimonographs/lgu028

    Article  PubMed  PubMed Central  Google Scholar 

  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 Kong

  27. Larkey LK, Roe DJ, Weihs KL, Jahnke R, Lopez AM, Rogers CE, Oh B, Guillen-Rodriguez J (2015) Randomized controlled trial of qigong/Tai Chi easy on cancer-related fatigue in breast cancer survivors. Ann Behav Med 49(2):165–176

    Article  PubMed  PubMed Central  Google 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 Article

  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

  32. Wang R, Liu J, Chen P, Yu D (2013) Reguar tai chi exercise desreases the percentage of type 2 cytokine-producing cells in postsurgical non-small cell lung cancer survivors. Cancer Nurs 36(4):E27–E34. doi:10.1097/NCC.0b013e318268f7d5

    Article  PubMed  Google Scholar 

  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

  35. Robins JLW, Elswick RK, McCain NL (2012) The story of the evolution of a unique Tai Chi form: origins, philosophy, and research. J Holistic Nur 30(3):134–146. doi:10.1177/0898010111429850

    Article  Google Scholar 

  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]

  39. Liu X, Clark J, Siskind D, Williams GM, Byrne G, Yang JL, Doi SA (2015) A systematic review and meta-analysis of the effects of Qigong and Tai Chi for depressive symptoms. Complementary Therapies in Medicine 23(4):516–534

    Article  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: 15285273

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Klein, P.J., Schneider, R. & Rhoads, C.J. Qigong in cancer care: a systematic review and construct analysis of effective Qigong therapy. Support Care Cancer 24, 3209–3222 (2016). https://doi.org/10.1007/s00520-016-3201-7

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  • DOI: https://doi.org/10.1007/s00520-016-3201-7

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