Peer-Reviewed Research Review: Qigong & Cancer Treatment
A Comprehensive Evaluation of the Effectiveness of Qigong in Cancer Care
Introduction
The article "Qigong for Cancer Treatment: A Systematic Review of Controlled Clinical Trials" by Myeong Soo Lee, Kevin W Chen, Kenneth M Sancier, and Edzard Ernst, published in Acta Oncologica, presents a comprehensive evaluation of the effectiveness of qigong in cancer care. The review aims to summarize and critically assess the available clinical trial evidence on the use of qigong, an integrative mind-body exercise from traditional Chinese medicine, as a therapeutic intervention for cancer patients.
Methodology
The authors conducted an extensive literature search using multiple databases, including MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library, and several Korean and Chinese databases, from their inception through November 2006. The inclusion criteria focused on randomized clinical trials (RCTs) and non-randomized controlled clinical trials (CCTs) that involved cancer patients receiving qigong interventions, either alone or in combination with conventional treatments. The primary outcomes considered were the effectiveness of qigong in treating cancer symptoms and improving survival rates and quality of life.
Results
The review identified nine studies that met the inclusion criteria, comprising four RCTs and five CCTs. These studies varied greatly in their methodological quality, with most showing significant limitations. Key findings from the studies are as follows:
Sun and Zhao (1988): This CCT reported improvements in physical strength, appetite, and defecation among advanced cancer patients practicing qigong combined with drug therapy, compared to drug therapy alone.
Zheng (1990): This study indicated higher survival rates for late-stage cancer patients practicing qigong, although details on the type of qigong and control interventions were lacking.
Wang et al. (1993): An RCT showed improved health status and stable white blood cell counts in cancer patients receiving qigong combined with chemotherapy, compared to chemotherapy alone.
Fu and Wang (1995): This RCT suggested that qigong combined with herbal treatment reduced symptoms and improved immune function in elderly stomach cancer patients, though no significant difference in tumor size reduction was observed.
Fu (1996): Another RCT demonstrated better survival rates for cardiac adenocarcinoma patients receiving qigong combined with herbal treatment and surgery, compared to surgery alone or surgery with chemotherapy.
Wang and Ye (2002): This CCT reported reduced anxiety and depression among cancer patients practicing qigong during rehabilitation.
Hong (2003): This CCT indicated that qigong reduced fatigue and improved physical functioning and symptoms of chemotherapy side effects in advanced gastric cancer patients.
Lam (2004): An RCT on hepatocellular carcinoma patients found no significant differences in survival rates or quality of life between those receiving qigong combined with transcatheter arterial chemoembolization (TOCE) and those receiving TOCE alone.
Lee et al. (2006): This CCT showed that qigong reduced symptom distress in breast cancer patients receiving chemotherapy but did not significantly impact psychological distress.
Discussion
The review highlights several critical issues:
Methodological Limitations: Most studies included in the review exhibited poor methodological quality, lacking rigorous design and adequate reporting of essential details. Only four studies were RCTs, while the rest were CCTs or uncontrolled trials, increasing the risk of bias and false-positive results.
Inconsistent Results: The effectiveness of qigong varied across studies, with some showing positive outcomes in symptom management and survival rates, while others did not find significant benefits. The heterogeneity in therapeutic protocols and outcomes measured further complicates the interpretation of results.
Lack of Large-Scale RCTs: The absence of large-scale, high-quality RCTs limits the ability to draw definitive conclusions about the efficacy of qigong in cancer care. Future research should focus on designing robust trials with larger sample sizes and standardized interventions.
Potential Mechanisms
The authors discuss several hypothesized mechanisms by which qigong may benefit cancer patients, including:
Immune Function Enhancement: Qigong may improve immune function, which is often compromised in cancer patients.
Microcirculatory Function Improvement: Qigong may positively affect blood viscosity, elasticity, and platelet function, thereby improving microcirculatory function.
Pain Threshold and Relaxation Effects: Qigong may increase pain threshold and induce relaxation, contributing to symptom relief and improved quality of life.
Conclusion
The systematic review concludes that while qigong shows potential as a supportive therapy for cancer patients, the current evidence is insufficient to firmly establish its efficacy due to the methodological shortcomings of existing studies. The authors call for more rigorous, well-designed RCTs to provide conclusive evidence on the role of qigong in cancer treatment.
References
World Health Organization. Cancer control: Knowledge into action: WHO guide for effective programmes. Geneva: World Health Organization; 2006.
Wong R, Sagar CM, Sagar SM. Integration of Chinese medicine into supportive cancer care: A modern role for an ancient tradition. Cancer Treat Rev 2001; 27: 235-246.
National Center for Complementary and Alternative Medicine. Cancer and complementary and alternative medicine. Available at http://nccam.nih.gov/health/camcancer/. Accessibility verified January 11, 2007.
Dy GK, Bekele L, Hanson LJ, et al. Complementary and alternative medicine use by patients enrolled onto phase I clinical trials. J Clin Oncol 2004; 22: 4810-4815.
Frenkel M, Ben-Arye E, Baldwin CD, et al. Approach to communicating with patients about the use of nutritional supplements in cancer care. South Med J 2005; 98: 289-294.
Richardson MA, Sanders T, Palmer JL, et al. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 2000; 18: 2505-2514.
Original Reference:
Lee, M. S., Chen, K. W., Sancier, K. M., & Ernst, E. (2007). Qigong for cancer treatment: A systematic review of controlled clinical trials. Acta Oncologica, 46(6), 717-722.
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