Biobehavioral effects of Tai Chi Qigong in men with prostate cancer: Study design of a three-arm randomized clinical trial

Abstract

Fatigue is often one of the most commonly reported symptoms in prostate cancer survivors, but it is also one of the least understood cancer-related symptoms. Fatigue is associated with psychological distress, disruptions in sleep quality, and impairments in health-related quality of life. Moreover, inflammatory processes and changes related to the hypothalamic-pituitary-adrenal (HPA) axis and/or autonomic nervous system may also play a role in cancer-related fatigue. Thus, effective treatments for fatigue in prostate cancer survivors represent a current unmet need. Prior research has shown that Tai Chi Qigong, a mind-body exercise intervention, can improve physical and emotional health. Herein, we describe the protocol of the ongoing 3-arm randomized controlled Health Empowerment & Recovery Outcomes (HERO) clincal trial. One hundred sixty-six prostate cancer survivors with fatigue are randomized to a modified Tai Chi Qigong intervention (TCQ), intensity-matched body training intervention (BT), or usual care (UC) condition. Guided by biopsychosocial and psychoneuroimmunology models, we propose that TCQ, as compared to BT or UC will: i) reduce fatigue (primary outcome) in prostate cancer survivors; ii) reduce inflammation; and iii) regulate the expression of genes from two major functional clusters: a) inflammation, vasodilation and metabolite sensing and b) energy and adrenergic activation. Assessments are conducted at baseline, the 6-week midpoint of the intervention, and 1 week, 3 months, and 12 months post-intervention. If our findings show that TCQ promotes recovery from prostate cancer and its treatment, this type of intervention can be integrated into survivorship care plans as the standard of care. The study's findings will also provide novel information about underlying biobehavioral mechanisms of cancer-related fatigue.Trial registration numberNCT03326713; clinicaltrials.gov.

Longitudinal Changes in Sleep: Associations with Shifts in Circulating Cytokines and Emotional Distress in a Cancer Survivor Population

“…Sleep disturbance is prevalent in cancer patients and survivors, and understanding of its connection with the PNI could produce more effective interventions and improve QOL. Although a few groups have published extensive studies on stress and sleep in the context of cancer [ 2 , 68 – 71 , 72 – 74 ], few studies have examined the relationship of sleep, distress, and immunity in cancer patients [ 75 – 77 ] or cancer survivors [ 2 , 78 , 79 ], and none have been focused on cervical cancer patients or survivors.…”

Molecules of Silence: Effects of Meditation on Gene Expression and Epigenetics

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“…Similarly, differential expression of genes related to type I interferon response and inflammation was reported following daily Yoga in a population of breast cancer survivors ( Bower et al, 2014 ). In addition, a number of microarray studies revealed transcription profile changes following Tai Chi, involving pathways of inflammation, antiviral response, energy and adrenergic activation, in PBMCs ( Irwin et al, 2014 , 2015 ; Kinney et al, 2019 ).…”

Tai Chi, Qigong and the Treatment of Cancer

“…Kinney, et al [135] found that tai chi qigong promotes recovery from prostate cancer. They combined various qigong movements with simplified tai chi movements, such as Tai Chi Ruler [136], Cloud Hands [137][138][139] and Wild Goose [140]. McQuade, et al [141] studied the effects of tai chi and qigong on fatigue and quality of sleep for prostate cancer patients undergoing radiotherapy.…”