Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial © The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
Several studies have indicated that medical qigong (MQ) has many health benefits, such as decreased heart rate, decreased blood pressure, lowered lipid levels, decreased levels of circulating stress hormones and enhanced immune function. Within the cancer literature, several uncontrolled studies have indicated that MQ may also have an impact on survival.
A review of the literature conducted by Chen et al. indicated that MQ interventions can improve physical well-being (PWB) and psychological well-being in cancer populations and are cost effective because they can be run as group therapy. To our knowledge, our study is the first randomized controlled trial with adequate statistical power which has been used to measure the impact of MQ in patients with cancer.
The findings provide evidence for the impact of MQ on quality of life (QOL), fatigue, mood status and inflammation in patients with cancer, major issues for cancer patients. Another significant finding from this study was the positive effects of MQ on inflammation as measured by the inflammatory marker serum (CRP).
While the precise mechanism through which MQ is able to decrease inflammation is unclear, one possible pathway is through MQ’s effect on the immune system. A number of studies have indicated that MQ leads to improved immune function. These findings indicate a need for further research on the impact of MQ on biological changes, such as immune function, cytokines and inflammation, in order to more fully understand these effects.
In this study, patients in the MQ intervention group experienced significantly less cancer-related fatigue (CRF) than those in the usual care control group. A change of >3 points on the FACT-F measure of CRF is considered to represent a clinically important change in fatigue in a cancer population; patients in the MQ intervention group reported a 6.34-point change in CRF as measured by that scale. Thus, the reduction in CRF reported was clinically as well as statistically significant.
Physical exercise is also often recommended by cancer care professionals as a method of minimizing CRF and improving QOL. However, recent randomized controlled trials have reported that fatigue and QOL were not improved with physical exercise.
The current study finding indicates that management of CRF and QOL may be more effective if improvements in psychological and emotional functioning are targeted as well as physical functioning, as in the case of the MQ intervention. More research may be necessary to clarify the relationship between CRF, QOL, MQ and physical exercise.
Moreover, participation in the MQ intervention led to better total mood status among cancer patients, specifically reduced tension, anxiety and depression and increased vigor. This is supported by previous research which found an effect of MQ on mood in elderly patients with chronic illness, although another study found no impact of Qigong on mood in patients with cancer. There may be differences in the delivery of Qigong which account for these divergent results, emphasizing the need for very clear descriptions of intervention content in evaluation studies.
Finally, no adverse effects of MQ were reported by the cancer patients in this trial, which is reassuring. Safety of MQ practice for cancer patients is also supported by previous literature. The findings of this study are positive and provide evidence that MQ is safe and effective in improving QOL, fatigue, mood status and reducing symptoms, side-effects and inflammation in cancer patients.
Further studies examining long-term benefits of MQ, including a potential association between improvement in QOL and survival rate, may provide additional information that may assist patients with cancer and clinicians in providing optimal comprehensive cancer care.
