Effects of Qigong Therapy on Alleviating Symptoms in Cancer Patients: An Overview
5.1 Introduction
The World Health Organization estimates that 84 million people will die in the next ten years by cancer if action is not taken (World Health Organization 2006 ) . Most cancer patients experience multiple symptoms related to either the cancer itself or late treatment effects. Cancer patients therefore often turn towards complementary or alter- native therapies (Wong et al. 2001 ) . Several surveys reported a prevalence range of complementary and alternative medicine (CAM) in cancer from 53 to 88% (Richardson et al. 2000 ; Dy et al. 2004 ; Frenkel et al. 2005 ) and showed that CAM is usually combined with conventional treatments (Richardson et al. 2000 ) . One form of CAM frequently used by cancer patients is mind-body medicine and energy medicine includ- ing Qigong (National Center for Complementary and Alternative Medicine 2012 ) .
According to ancient Chinese thought, Qi denotes both essential substances of the human body that maintain its vital activities, and the functional activities of organs and tissues (Xinnong 1987 ; Shin 2002 ) (Fig. 5.1 ). Qi is commonly viewed as vital energy or the life force, and is the source of vitality and strength (Fig. 5.2 ). Qi acts extensively in the human body by permeating all parts. The meridians in the body are the main pathways through which Qi, or life force energy, moves, and fl ows. In fact, all of nature, including humanity, is dependent upon this vital force. When Qi fl ows smoothly, all of life’s processes operate rhythmically and harmoniously. If Qi is weak, unbalanced and blocked, the human body succumbs to illness and enters a diseased state. Ultimately, the cause of all disease derives from energetic imbalances. A practi- cal extension of these basic ideas is to diagnose the disease before it manifests in the physical body by measuring the energetic imbalances, and to treat the disease (with energy) by normalizing the energetic imbalances. Therefore, sustaining Qi is more important than anything else in order to keep the body strong and healthy.
Qigong (pronounced chee-gong) is a therapy which maybe belongs to both mind-body medicine and energy medicine. Qigong is an Eastern healing art that uses gentle, focused exercises for the mind and body to increase and restore the fl ow of Qi with the aim of promoting the healing process, preventing disease and prolonging life (Fig. 5.3 ). The word Qigong is a combination of two Chinese ideograms: Qi (vital energy) and gong (skill, work, and achievement) (Chen 2007 ) . Thus, Qigong has been described as a way of working with life energy. Qigong aims to restore health by removing Qi blockages. Qigong is intended to be harmonious with the natural rhythms of the environment.
Internal and external Qigong can be distinguished. Internal Qigong is self-directed and involves the use of movements and meditation. It can be performed with or
Fig. 5.1 The diagram of the bodily contour and inner organs of Donguibogam (registered as Memory of the World). The diagram is in the part of internal medicine of Donguibogam . The internal medicine part contains the section of physical shape, essence, Qi, and spirit deals with subjects pertaining to the relationship between the body and nature, as well as the body itself. The diagram visualized the view of nature and the model of the human body of Korean Medicine including the elements of essence, Qi and spirit, together with the fi ve viscera and six bowls.
Donguibogam is an encyclopaedia of medical knowledge and treatment techniques compiled in early seventeenth century Korea. Donguibogam is composed of 2 volumes of the tables of con- tents, 4 volumes of internal medicine and external appearances, 11 volumes of miscellaneous diseases, 3 volumes of herbal decoction, and 1 volume of acupuncture and moxibustion, totalling 25 volumes (Ahn 2008 )
Fig. 5.2 The Chinese character for Qi contains the radicals for both “steam” and “rice”. In its re fi ned forms, Qi moves and fl ows almost invisibly, like steam. In its denser aspect, it slows or coalesces into form, such as rice (Beresford-Cooke 1996 )
without a teacher (master) and actively engages people in their own health and well-being. It is best practiced daily to promote health maintenance and disease prevention. This self-practice is thought to facilitate balance and a free fl ow of energy, contributing to both physical and psychological well-being. There are three major categories of these Qigong forms: movement Qigong, standing pole Qigong, and static form or meditation (Chen 2007 ) . Movement Qigong uses guided physical movements to help practitioners concentrate and induce Qi fl ow in the body. Static Qigong is primarily meditation based and is used to increase internal power or consciousness stability. Standing pole Qigong falls between movement and static Qigong. Western models of relaxation response and psychoneuroimmunology mech- anisms have parallels with the practice of internal Qigong (Ader et al. 1991 ; Benson and Klipper 1977 ) . External Qigong, in contrast, is a form of energy healing in which a Qigong practitioner sends his Qi into a patient for the purpose of healing (Chen 2007 ) . In this process, a Qigong practitioner directs or emits his Qi to help disrupt Qi blockages in others and force the sick Qi out of the body to relieve pain, balance the Qi fl ow in the body, and remove disease (Chen 2007 ) . External Qigong can be prac- ticed through the use of either Qi (emitting vital energy) or Yi (consciousness or intentional therapy) or a combination of the two techniques (Chen 2007 ) .
Qigong consists of two main aspects: controlled breathing (or deep breathing), with slow body movements as an aerobic exercise, and relaxation (Ernst et al. 2007 ) . The Qigong exercises are physical stimuli with effects on the cardiovascular and mus- cular systems. In addition to adaptation processes at the nervous system level, these effects produce better cardiovascular function and may enhance balance and
Fig. 5.3 The ancient script of process of Qigong scripted in Jade (around BC 600). It consists of 36 Chinese characters (Chen 2007 ) . English translation is like following: “When you breathe deeply to a degree, internally re fi ned Qi will gather. When the re fi ned Qi is fully accumulated, it expands and descends downward (Dantian in the lower abdomen area). When the re fi ned Qi is reinforced to a certain level, it begins to rise up (along the spinal cord) to the head, and then falls down (to the Dantian) again. The internal Qi then circulates around the Ren Du meridians during your daily practice. The universal Qi becomes integrated. It comes in through the top of the head, with the earth Qi, which enters the body through the feet. Thus you will be healthier and more alive while you follow it, and more prone to the effects of aging and death when you don’t”
coordination. This stimulation and relaxation activates and modulates the neurohormonal system to improve the psychological state and enhance immune function.
Some in vitro studies (Lee et al. 2001, 2003 ; Yu et al. 2003 ) show that emitted Qi or the master’s intention affects the activity of natural killer cells, neutrophil func- tion, and human prostate cancer in a positive manner. In addition, it may be possible to store information about emitted Qi in media used for cell culture (Fukushima et al.
2001 ) . However, the true mechanism requires further study. Although neither the Qigong itself nor the mechanism of its effects is understandable or explicable within any paradigm of modern medical science, its effects on the human body are apparent, as is its effectiveness in many clinical and psychological illnesses (Chen 2007 ) .
Qigong has its underpinnings in Eastern medicine and philosophy. So far, it has not been explained scienti fi cally and, from a scienti fi c point of view, it must seem biologi- cally implausible. Despite the absence of a scienti fi c basis, Qigong has been submitted to numerous clinical trials and several systematic reviews (SRs) of these data have recently been published (Lee et al. 2011 ) . They are related to a wide range of condi- tions: cancer, pain, diabetes, Parkinson’s disease, hypertension, and any chronic con- dition (Lee et al. 2007a, b, c, 2009a, b, 2010 ; Choi et al. 2008 ; Lee and Ernst 2009 ) . The conclusions of the SRs tended to be equivocal or contradictory or based on a poor quality SR. The only exceptions are the two SRs on hypertension which both draw positive conclusions, but even these SRs are based on poor quality primary data.
Unfortunately their conclusions are far from uniform. This overview is aimed at criti- cally evaluating SRs of Qigong as a symptomatic treatment for cancer patients.