Qigong Improves Fatigue in Prostate Cancer Survivors

RCT Includes Active Control Group

Nick Mulcahy

November 06, 2013

The practice of Qigong significantly improves fatigue in older men with prostate cancer, compared with a stretching regimen, according to a new study.

The favorable outcome adds to a small but growing body of evidence indicating that the ancient Chinese practice is uniquely suited to improve this vexing cancer symptom — especially in elderly patients.

Qigong consists of "slow, flowing movements, coordinated with deep breathing, and a meditative focus to balance the flow of 'Qi' or life energy for overall well-being," write the study authors, led by Rebecca Campo, MD, from the Huntsman Cancer Institute at the University of Utah in Salt Lake City.

The study was published online October 30 in the Journal of Cancer Survivorship.

Dr. Campo and colleagues randomized 40 men (average age, 74 years) to hour-long classes of either Qigong or stretching twice a week. At baseline, all of the men had "significant fatigue" and a lifestyle classified as sedentary.

At the end of the 12-week trial, the Qigong group had significantly greater improvements in the primary outcome of fatigue than the stretching group (P = .02). There were also greater improvements in the Qigong group in the secondary outcome of distress, measured on the somatization, anxiety, and Global Severity Index subscales of the Brief Symptom Inventory 18 (P < .05 for all).

This study is the first to assess Qigong for fatigue in older prostate cancer survivors, the authors note. The results are "consistent" with results from previous studies indicating that the practice improves fatigue in breast cancer patients and a variety of other types of cancer survivors, they report.

"Cancer patients are very, very good candidates for Qigong," according to Olga Gonzalez, MSTOM, LAc, an acupuncturist in private practice in New York City, who was not involved in the study. She is also a certified teacher of Wild Goose Qigong, a particularly ancient form of the practice that has roots in Taoism.

"Qigong is one of the branches of Chinese medicine and is considered to be as healing as acupuncture," she told Medscape Medical News in an interview.

 
Qigong is...considered to be as healing as acupuncture.
 

Qigong can be practiced from a seated or standing position, she explained. "No matter what your ability is, you can start."

When Qi increases and/or flows, blood flow is generated, which is helpful with blood deficiencies and blood stagnation, both of which contribute to fatigue, insomnia, irritability, dry skin, hair loss and thinning, headache, and other symptoms in cancer patients, she said.

Gonzalez explained that, ideally, Qigong should be practiced outdoors. If practicing indoors, windows should be open to enhance the flow of Qi from nature. The practice provides a connection to one's self, one's community, and nature. "It's all one," said Gonzalez. "Nature will regenerate itself, if given a chance. It's the same thing with the body."

Notably, Control Subjects Were Active

A large proportion (69%) of the Qigong group had a "minimally important" difference in fatigue (at least 3 points), whereas only 31% of those in the stretching group did, the authors report. In other words, meaningful improvement in the Qigong group was seen in most of the men.

This study is distinguished from other studies of Qigong in cancer patients because it had an active control group, the authors point out.

The structure of the control group's stretching class was the same as that of the Qigong class in terms of length of time, frequency, days of the week, and group format. In addition, both classes consisted of sitting and standing exercises, and all participants were given DVDs of their intervention to encourage home practice.

Class attendance was significantly better in the Qigong group than in the stretching group (P = .04). The study retention rate was also better in the Qigong group (80% vs 65%).

It was not surprising that Qigong was more satisfying and appealing to the men than stretching, said Gonzalez. Stretching is an "external exercise" in which the breath is typically not consciously worked with, as it is in Qigong, she noted.

"If you do stretching that is not in tune with the energy you have, you might overdo it and expend more energy than you generate, which is unhealthy," Gonzalez explained.

Qigong literally means working with energy. "You want it to flow, you want it to increase," she said.

This study was partially funded by a National Institutes of Health National Center for Complementary and Alternative Medicine Research Fellowship in Complementary and Alternative Medicine, a University of Utah Center on Aging Pilot Award, the Huntsman Cancer Foundation, Shared Resources, and the Linda B. and Robert B. Wiggins Wellness-Survivorship Center at the Huntsman Cancer Institute.

The study authors and Ms. Gonzalez have disclosed no relevant financial relationships.

J Cancer Surviv. Published online October 30, 2013. Abstract

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