What the Evidence Says About Qigong in Patients With Cancer
By Jyothirmai Gubili, MS, Stacie Corcoran, RN, MS, and Shelly Latte-Naor, MD
Qigong is a mind-body practice that originated in China nearly five millennia ago. It integrates movement, meditation, and breath regulation to improve physical and emotional health. The actions are slow, gentle, flowing, repetitious, and weight-bearing and can be adapted or practiced while sitting, standing, or walking. Qigong styles and forms vary widely (https://doi.org/10.1007/s00520-016-3201-7), depending on the school of thought and philosophy.
What the Research Reveals
Several studies have assessed the therapeutic effects of qigong. Researchers conducting a meta-analysis of 19 trials involving 559 healthy subjects and 976 with conditions, including type 2 diabetes, cancer, Parkinson disease, hypertension, knee osteoarthritis, and chronic fatigue syndrome-like illness, reported improvements (https://doi.org/10.1155/2017/4548706) in sleep quality, balance, and overall quality of life.
In an early randomized trial of 162 patients with different types of cancers, qigong practice was associated (https://doi.org/10.1093/annonc/mdp479) with significant improvements in fatigue, overall quality of life (p < 0.001), mood disturbance (p = 0.021), and inflammation (p < 0.044) compared with usual care. The authors also suggested that the practice may provide long-term physical benefits via reduced inflammation.
Researchers conducting other systematic reviews involving patients with a range of cancers found improvements (https://doi.org/10.1016/j.ctcp.2017.09.005) in fatigue and overall quality of life (22 studies, N = 1,751) as well as positive effects (https://doi.org/10.1007/s00520-016-3201-7) on immune function, cortisol levels, fatigue, and cancer-specific quality of life (11 randomized trials, N = 831).
Some analyses (https://doi.org/10.1016/j.ctim.2013.11.010) group (https://doi.org/10.1016/j.parkreldis.2017.05.019) qigong and tai chi because both practices incorporate gentle movement, regulated breathing, and meditation. Data from one such review involving 22 studies (N = 1,571) showed (https://doi.org/10.1007/s11764-017-0665-5) statistically significant and clinically meaningful improvements in fatigue and sleep measures, smaller but statistically significant changes in depression and quality of life, and a statistically nonsignificant reduction in pain scores.
However, the majority of qigong studies are limited by small sample size, risk of bias, lack of active control groups, and variation in qigong practices and dosage. Larger, well-designed trials are needed for definitive conclusions and to determine the practice’s long-term benefits.
The specific mechanisms underlying qigong’s effects have yet to be identified, but some studies have elucidated the likely pathways that movement (https://doi.org/10.1016/j.clbc.2017.01.006) and meditation (https://doi.org/10.1097/01.psy.0000074003.35911.41) salutary effects. Similar to these interventions, qigong has also been reported (https://doi.org10.1016/j.psyneuen.2015.11.017) to increase telomerase activity, which is a known marker of cellular aging and psychological risk. Further research will help scientists understand the implications of this finding in cancer care.
What Oncology Nurses Need to Know
Developing strategies to improve fatigue, sleep disturbance, depression, balance, and mood is critical to support the estimated (https://www.cancer.org/research/cancer-facts-statistics/survivor-facts-figures.html) 20 million U.S. cancer survivors expected by 2026. Based on current evidence, qigong appears to be a safe, noninvasive, and promising supportive approach for symptom management and enhanced quality of life. In contrast to other movement practices, the slow, controlled, and upright practice of qigong makes the modality accessible and safe to a wide range of performance levels. Because it is typically practiced in groups, qigong also provides psychosocial support.
As educators and navigators in a wide variety of practice settings, oncology nurses are integral in raising patient awareness and understanding of the potential benefits of approaches such as qigong. A low-risk intervention that may be incorporated at any point across the cancer care trajectory, qigong may improve symptoms and overall health from diagnosis through long-term follow-up care.