Patients with breast cancer often report deficits in quality of life (QOL), including fatigue and cognitive dysfunction, that persist after treatment ends. One of the CAM modalities that breast cancer patients choose is the Traditional Chinese Medicine (TCM) based practice of Qigong. We propose to test potential effects of a set of Medical Qigong practices on fatigue, and other symptoms, in fatigued survivors of Stage I or II breast cancer, age 40-70. Patients who are 6 months to 5 years past treatment for breast cancer and meeting eligibility criteria for fatigue will be randomized to a 3-month intervention, either (a) a series of gentle Medical Qigong (MQ) exercises developed and supervised by a Doctor of Oriental Medicine/Master of Qigong and specifically designed for women recovering from breast cancer or (b) Restful Movement (RM), a series of stretches and movements loosely based on the Lebed method of rehabilitation and lymphedema-preventative exercises for breast cancer patients, 30 participants in each group. The Restful Movement protocol will not be designed to emphasize movement of Qi (that is, will not include breath training nor teach about cultivating Qi, a central feature of Qigong practice). Primary endpoints will be assessed using (a) the Fatigue Sympton Inventory and FACT-COG and (b) objective measures of cognitive performance including Digit-Span and Letter/Number Sequencing tests of attention and working memory. Secondary measures include sleep quality, depression, and general quality of life.
Specific Aim 1. To test whether Medical Qigong (MQ) practiced with conscious breathing techniques, visualization and intent to balance Qi is more effective than Restful Movement (RM) for improving symptoms in women after treatment for breast cancer. Hypothesis One: MQ will improve levels of fatigue in breast cancer survivors more than RM. Hypothesis two: MQ will improve cognitive function in breast cancer survivors more than RM.
Specific Aim 2. To examine (a) mechanisms possibly associated with purported effects of MQ and (b) alternate explanations for effects. Blood analyses for all participants will examine lymphocyte counts, T cell subsets, and serum cytokines. If findings are positive, results will be used to plan an RO1 proposal to test Medical Qigong against both RM and a usual care control, powered for significance, including more extensive tests for mechanisms of action potentially influencing outcomes related to Qigong practice on fatigue, cognitive function and immune/inflammation markers, and track disease progression outcomes.
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