Researchers from the University of Texas M.D. Anderson Cancer Center have found that (Guo Lin) qigong, an ancient Chinese mind-body practice, reduces symptoms and improves quality of life in women undergoing radiotherapy for breast cancer.
Lorenzo Cohen, professor in M.D. Anderson's Departments of General Oncology and Behavioral Science and director of the Integrative Medicine Program, is the corresponding author on the study, which was recently published in the journal Cancer.
The study is the first to examine qigong in patients actively receiving radiation therapy and to include a follow-up period to assess benefits over time.
In the study, Cohen and his colleagues tracked 96 Chinese women in Shanghai with Stage 1-3 breast cancer as they underwent a five- to six-week course of radiation. About half the women were randomized into a qigong group, while the other half received standard care. Patients in the qigong group reported a steady decline in depressive symptoms at the end of radiation. The most dramatic results came for women who reported high depressive symptoms at the beginning of their treatment.
The possible effect of qigong practice on patients' stress and depressive symptoms was a guiding concern of the study. "It is important for cancer patients to manage stress because it can have a profoundly negative effect on biological systems and inflammatory profiles," Cohen said.
Such a study is at the heart of the work done at the Integrative Medicine Program at M.D. Anderson, which combines traditional Western practices of fighting disease with effective complementary therapies that often derive from ancient health systems from other cultures. The program's research focuses on practices like yoga and acupuncture, as well as the use of plants and other natural compounds to treat cancer and cancer-related symptoms.
Qigong, yoga and acupuncture are ancient practices that derive from medical systems originating thousands of years ago in China and India. While wildly divergent in their details, the Chinese and Indian systems rest on certain premises about the human body, one of which is that the body is fundamentally an energy system. Energy – called "pra
na" in Indian ayurvedic medicine or "qi" in Chinese medicine – moves throughout the body but can become blocked or misdirected resulting in disease or symptoms of sickness. Practices like acupuncture, structured breathing, various movements and postures, and meditative techniques are designed to restore the energy's proper movement, thus restoring health and wellness.
Qigong, especially the variety used for medical purposes, combines slow, rhythmic movements with meditation and structured breathing. A peaceful, centered mindset, it is believed, can impact the body with lowered levels of stress or other symptoms of disease.
The distinctions between alternative, complementary and integrative medicine are important, according to Cohen. Alternative medicine – which is not practiced at M.D. Anderson – uses unproven treatments in place of traditional care, he said.
Complementary medicine, he said, involves making use of a nonstandard treatment modality for which there may not be much evidence of benefit, but it is safe enough to use alongside conventional care to offer a possible benefit.
Integrative medicine is more of a philosophy of care and a way of practicing that focuses on the whole person. "We focus on the relation between the practitioner and the patients, and we are informed by evidence – we don't want to be prescribing things to our patients for which there is no evidence of safety or of benefit," he said. "Also, in integrative medicine we seek to make use of all possible avenues for healing that may work."
Surprisingly to some, things like diet and exercise are not part of standard care in oncology. Why not? "Because the majority of the evidence exists in the epidemiology stage of the disease," Cohen said. In other words, the evidence does not yet suggest direct, causal links between diet, exercise, yoga, acupuncture and so forth, on the one hand, and a measurable lowered risk for cancer. All the current evidence that highlights better outcomes for people who don't drink, who aren't overweight and who manage stress are observational – not strictly causal or correlative.
The qigong study is an attempt to begin to connect the dots causally so that eventually such integrative treatments are part of standard care.
Cohen said he envisions a time when mind-body practices and a psycho-spiritual perspective are part of medical teams – and considered part of standard care covered by insurance.
"Ideally, we would work at the whole level," he said. "We would work to get that person's body that has become hospitable to cancer to be as inhospitable as possible going forward."
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