Introduction
Due to advances in medical technology and cancer treatments, the prognosis associated with cancer has improved markedly. The estimated 5-year survival rate across all cancers has risen to about 66% (Zeng, Luo, Xie, Huang, & Cheng, 2014). These successes have been achieved largely as a result of aggressive interventions including surgery, chemotherapy, and radiation therapy. Diagnosis and treatment of cancer represent a major life stressor for any patient, posing both physical and psychological threats to the patient (Oh et al., 2010). Symptomatic problems in cancer vary extensively but often include pain, fatigue, weakness, anorexia, lack of energy, nausea, dry mouth, constipation, early satiety, dyspnea, vomiting ( Breen et al., 2009) all of which can have a significant impact on a cancer patient’s quality of life (Fong et al., 2013). Therefore, approaches to help patients effectively manage cancer symptoms form an important element of cancer care. Symptom management is to prevent or treat the symptoms of a disease, address the side effects caused by the treatment of disease, and reduce any psychological, social, and spiritual problems related to the disease as early as possible. Most cancer patients experience multiple symptoms related to either cancer itself or side effects of prolonged chemotherapy, radiotherapy, and/or surgical treatment. Cancer patients therefore often turn towards complementary or alternative therapies to manage such symptoms (Zeng et al., 2014). The frequently experienced and severe adverse events associated with such treatments lead patients to seek supportive complementary and alternative medicine (CAM) (Gillett, Ientile, Hiscock, Plank, & Martin, 2012).
Therapeutic Qigong or breathwork is an ancient Chinese discipline with origins in Eastern medicine. The purpose of its practice is for rejuvenation and healing. External Qigong involves the therapeutic transfer of energy from a skilled practitioner to another. Internal Qigong work, performed by the individual, involves both meditative postures and flowing, rhythmic movements incorporating breath regulation, mindful meditation (intent), and self-massage (Klein, Schneider, & Rhoads, 2016). Theoretical foundations of Qigong include (a) psychoneuroimmunology: the study of interactions among behavioral, neural and endocrine, and immunologic processes of adaptation (Kiecolt-Glaser, McGuire, Robles, & Glaser, 2002).; (b) relaxation response effect (Benson, & Klipper, 2000); and (c) Eastern theories of energy cultivation or breathwork, i.e., accumulation, storage, and circulation of Qi also known as vital energy within the bioelectric body (Picard, 2009).
Non-pharmacological interventions typically encompass a broad range of psychosocial, behavioral, and environmental strategies that may complement conventional treatment to manage symptoms and enhance QOL for cancer patients (Tong et al., 2014). Qigong as a complementary and alternative modality of traditional Chinese form is often used by cancer patients to manage their symptoms (Chen, & Yeung, 2002). Qigong has been developed and is often used in cancer treatment. Qigong consists of a series of simple, repeated practices including body posture or/and movements, breathing practice, and meditation performed in synchrony (Ernst, Pittler, Wider, & Boddy, 2008). These exercises consist mostly of gentle movements (with some vigorous and shaking movements in addition to quiet, stillness practice) designed to attain deeply relaxed states. Globally, Qigong is practiced in a variety of modern and traditional forms. Despite variation among the myriad styles, Qigong is health-oriented and emphasizes the same principles and practice elements. Although neither Qigong itself nor the mechanism of its effect is understood within the paradigm of medical science, there are increased reports of its effects on human health. In cancer care, there have been several studies that have explored the use of Qigong about symptom management (Chan et al., 2012). Many positive health-related impacts from the use of Qigong have been reported in the literature, such as: improving depression, fatigue, anxiety, appetite, nausea, and vomiting; and decreasing heart rate, decreasing blood pressure; lowering lipid levels, decreasing levels of circulating stress hormones, and improving immune function( Zeng et al., 2014). Several reviews claimed that Qigong offers therapeutic benefits for cancer patients. In a systematic review of controlled trials of Qigong in cancer patient care, two of nine trials indicated that Qigong may prolong the life of cancer patients (Lee, Chen, Sancier, & Ernst, 2007). A more recent systematic review of Qigong as a supportive measure for cancer patients included twenty-three trials and found some evidence that the immune function of patients was better than patients treated with conventional methods alone( Fong et al., 2013). Likewise, a review of the benefits of Qigong for cancer survivors showed that it has therapeutic effects and suggested that it may be beneficial for cancer patients (Wang et al., 2013).
