The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial

Alex Molassiotis, Dau Van Vu, Shirley Siu Yin Ching, Alex Molassiotis, Dau Van Vu, Shirley Siu Yin Ching

Abstract

Background and purpose: Qigong is used by cancer patients, but its effect is not adequately evaluated to date. The aim of this study was to investigate the effects of Qigong for the management of a symptom cluster comprising fatigue, dyspnea, and anxiety in patients with lung cancer.

Methodology: A total of 156 lung cancer patients participated in this trial, and they were randomized to a Qigong group (6 weeks of intervention) or a waitlist control group receiving usual care. The symptom cluster was assessed at baseline, at the end of treatment (primary outcome), and at 12 weeks, alongside measures of cough and quality of life (QOL).

Results: There was no significant interaction effect between group and time for the symptom cluster overall and for fatigue and anxiety. However, a significant trend towards improvement was observed on fatigue (P = .004), dyspnea (P = .002), and anxiety (P = .049) in the Qigong group from baseline assessment to the end of intervention at the 6th week (within-group changes). Improvements in dyspnea and in the secondary outcomes of cough, global health status, functional well-being and QOL symptom scales were statistically significant between the 2 groups (P = .001, .014, .021, .001, and .002, respectively).

Conclusion: Qigong did not alleviate the symptom cluster experience. Nevertheless, this intervention was effective in reducing dyspnea and cough, and improving QOL. More than 6 weeks were needed, however, for detecting the effect of Qigong on improving dyspnea. Furthermore, men benefited more than women. It may not be beneficial to use Qigong to manage the symptom cluster consisting of fatigue, dyspnea, and anxiety, but it may be effective in managing respiratory symptoms (secondary outcomes needing further verification in future research). Future studies targeting symptom clusters should ensure the appropriateness of the combination of symptoms.

Trial registration: ClinicalTrials.gov Identifier: NCT02977845. Registered November 30, 2016. https://ichgcp.net/clinical-trials-registry/NCT02977845?term=Qigong&cond=Lung+Cancer&draw=2&rank=1.

Keywords: Qigong; anxiety; cough; dyspnea; fatigue; lung cancer; quality of life.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
CONSORT Flow Diagram showing the number of participants through the trial.
Figure 2.
Figure 2.
Changes in the symptom cluster of fatigue, dyspnea, and anxiety scores across time (composite score of FACT-F, CDS and DASS).
Figure 3.
Figure 3.
Changes in fatigue (FACT-F scale), dyspnea (CDS), and anxiety (DASS) scores across time (individual scales). Higher score indicates higher symptom burden for dyspnea and anxiety and lower for fatigue.
Figure 4.
Figure 4.
Changes in cough (MCLCS) scores across time.

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