Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial

Abstract

Objectives Sleep disturbances and fatigue are common in prostate cancer patients undergoing radiotherapy. Prior research suggests mind-body techniques may improve these outcomes. We conducted a randomized-controlled trial of qigong/tai chi (QGTC) in men with prostate cancer undergoing radiotherapy. Methods Men with prostate cancer starting definitive radiation were randomized to one of three groups: (1) QGTC; (2) light exercise (LE); or (3) wait list control (WLC). Sleep disturbances (PSQI) and fatigue (BFI) were assessed at baseline, mid-radiotherapy (T2), during the last week of radiotherapy (T3) and at 1 (T4) and 3 months (T5) after the end of radiotherapy. Patients in the QGTC and LE groups attended three 40-minute classes per week throughout radiotherapy. Results Ninety patients were randomized to the three groups (QGTC=26; LE=26; WLC=24). QGTC group reported longer sleep duration at mid-XRT (QGTC=7.01 hours; LE=6.42; WL=6.50; p=0.05) but this difference did not persist over time. There were no group differences in other domains of sleep or fatigue. Exploratory analyses conducted to examine the effect of health-related QOL (EPIC and AUA score) on sleep and fatigue showed significant correlations across multiple domains. Conclusions QGTC during radiation for prostate cancer resulted in superior sleep duration midway through radiation, but this effect was not durable and there were no differences in other domains of sleep or fatigue. Exploratory analysis demonstrated that both sleep and fatigue were highly correlated with prostate cancer related physical symptoms. Future mind-body intervention studies should incorporate multi-modal therapy focused on improving physical symptoms in this population.

The Effect of Nutrition Therapy and Exercise on Cancer-Related Fatigue and Quality of Life in Men with Prostate Cancer: A Systematic Review

“…A total of 20 studies met the inclusion criteria; including 19 randomised controlled trials [ 16 , 17 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], and one prospective controlled trial [ 62 ] informed this systematic review. One study included a diet only intervention [ 56 ], three studies included combined diet and exercise interventions [ 16 , 17 , 52 ], and sixteen included exercise only interventions [ 45 , 46 , 47 , 48 , 49 , 50 , 51 , 53 , 54 , 55 , 57 , 58 , 59 , 62 ]. Two exercise only interventions were described as two separate studies, both by Galvao et al [ 47 , 48 , 60 , 61 ].…”

“…All of the studies specified eligibility criteria and all but four studies [ 17 , 56 , 57 , 62 ] provided point estimates and measures of variability. Despite the generally high methodological quality of the included interventions, an intention to treat approach was either not conducted or adjusted in seven of the 18 interventions [ 17 , 49 , 50 , 52 , 58 , 59 , 62 ].…”

“…The average age of participants ranged from 64.7 [ 49 ] to 73.1 years [ 46 ]. Eight studies included men receiving ADT only [ 16 , 17 , 45 , 48 , 52 , 53 , 54 , 56 ], seven studies included men receiving both ADT and radiation therapy [ 46 , 47 , 51 , 55 , 57 , 58 , 62 ], two studies included men receiving radiation therapy only [ 50 , 59 ], and one intervention included men who had either undergone surgery (radical prostatectomy), radiation therapy, or ADT [ 49 ]. Eleven studies reported the average duration that the participants had been receiving ADT at the time of enrolment, which ranged from 5.6 days [ 45 ] to 39.0 months [ 57 ].…”

Massage therapy decreases cancer‐related fatigue: Results from a randomized early phase trial

“…A Cochrane Review found that methylphenidate was the only agent that caused a significant, albeit small, improvement in CRF . There are a growing number of studies investigating nonpharmacologic treatments for CRF; for example, data suggest that exercise causes a small to moderate decrease in CRF . The psychosocial interventions studied have reported small but significant reductions in fatigue .…”

“…13 There are a growing number of studies investigating nonpharmacologic treatments for CRF; for example, data suggest that exercise causes a small to moderate decrease in CRF. [14][15][16][17][18][19] The psychosocial interventions studied have reported small but significant reductions in fatigue. 14,20,21 Overall, methodology and design challenges continue to limit the impact of this work.…”