Mind-body practice of qigong can ease fatigue from cancer

Catherine Kerr, the late director of translational neuroscience at Brown's Contemplative Studies Initiative, was instrumental in investigating the healing effects of qigong with cancer survivors. (Credit: Kate Talerico)

In a new study, people with cancer-related fatigue who practiced qigong, a mind-body movement practice, showed clinically significant improvements in fatigue.

The researchers also found the practice was as effective at reducing fatigue as a more energy-intensive exercise and nutrition program.

Fatigue is a common, debilitating, and often long-term side effect of cancer as well as its treatment.

For the new study, published in Cancer Therapies, the researchers analyzed the effects of a regular qigong practice on cancer-related fatigue and compared the results to fatigue treatments involving exercise.

As many as 45% of cancer survivors report moderate to severe fatigue even years after stopping treatment. The researchers note that this fatigue can be more burdensome and disruptive to daily life than ongoing pain, nausea, and depression.

While studies show that exercise can help improve fatigue, there is not yet enough evidence to recommend a particular type of exercise or regimen. In addition, a moderate-to-vigorous exercise program may feel too intense or overwhelming for some patients with fatigue.

“Our study is important because it is the first randomized clinical trial to directly compare qigong practice to the best standards of care for fatigue—namely, exercise,” says Stephanie R. Jones, an associate professor of neuroscience at Brown University.

“It would have been hard to predict that people who perform gentle non-aerobic intentional movements would show the same level of improvement as those who go through moderate strength training and aerobic exercise. It is exciting that our findings establish that this is indeed the case.”

Qigong improved more than fatigue

The study included 24 female participants who had completed cancer treatment (including surgery, radiation, and/or chemotherapy) at least eight weeks prior to the research, all of whom reported cancer-related fatigue and agreed to participate in 10 weeks of classes.

The researchers assigned half of the group to take classes in qigong, a Chinese mind-body practice that involves sequences of gentle, rhythmic, and repetitive movements as well as meditation. The other half participated in a class focused on healthy living that incorporated both physical exercise (Pilates-like core movements as well as resistance training and aerobic exercise) and general health and nutrition education.

All classes were held twice a week, for about two hours per session, at the Miriam Hospital in Providence, Rhode Island. For both groups, researchers analyzed changes in participants’ fatigue, emotional health, and stress before and after the intervention.

The findings showed that both interventions significantly improved cancer-related fatigue. The improvement levels were more than double the established “minimal clinically important difference,” which is the minimal change in score considered relevant by patients and physicians.

The results from the qigong group were comparable to those from the exercise and nutrition group. The participants in the qigong group also reported significant improvements in mood, emotion regulation, and stress, while those who had completed the exercise and nutrition program reported significant improvements in sleep and fatigue levels.

Mind and body

Mind-body approaches, which include qigong as well as yoga, mindfulness, and tai-chi, are receiving increasing attention for their potential to affect physical, emotional, and cognitive health—all of which may be helpful for those with cancer-related fatigue, Jones says.

Importantly, the researchers note that a gentle, low-intensity practice like qigong may offer some of the same physical benefits of exercise without requiring the same level of physical effort, which can be difficult for someone who has recently been through an experience like cancer.

Jones and her team are now studying how qigong might affect a person’s perception of fatigue.

“We are currently also examining changes in electrophysiological measures of brain and muscle activity that occur with practice in each group,” Jones says. “We’re testing the hypothesis that the treatment efficacy is related to modulation of brain-muscle communication that may be distinct in each group due to the different techniques.”

Jones notes that this study of 24 women was relatively small, and that future research could study the effects of mind-body interventions for cancer-related fatigue with larger and more diverse study populations.

The work underpinning this study was initiated by Catherine Kerr, who before her death in 2016 directed translational neuroscience at the Contemplative Studies Initiative at Brown University.

Diagnosed with multiple myeloma in 1995, Kerr benefited from qigong practice and sought a better understanding of why—that interest led to the current study, which was supported by funding from the Berkman-Landis Family Fund.

“We hope that this study, which was conceived by our colleague, the late Dr. Catherine Kerr, in her cancer journey, sets a foundation for further scientific inquiry on the healing trajectories promoted by qigong,” Jones says.

Source: Brown University