Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines

Author: Lin Yang1,2,3, Kerri Winters-Stone4, Benny Rana1, Chao Cao5, Linda E Carlson2,6, Kerry S Courneya7, Christine M Friedenreich1,2,3, Kathryn H Schmitz8
1 Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.
2 Departments of Oncology, University of Calgary, Calgary, Canada.
3 Departments of Community Health Sciences, University of Calgary, Calgary, Canada.
4 School of Nursing and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.
5 Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA.
6 Department of Psychosocial Oncology, Alberta Health Services, Calgary, Canada.
7 Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada.
8 Penn State Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Conference/Journal: Cancer Med
Date published: 2021 Sep 17
Other: Special Notes: doi: 10.1002/cam4.4273. , Word Count: 257

To manage acute, long-term, and late effects of cancer, current guidelines recommend moderate-to-vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment-free, multicomponent mind-body exercise performed at light-to-moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient-reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty-six reports from 14 trials (one non-randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low-level evidence emerged to support the benefits of 40-60 min of thrice-weekly supervised Tai Chi for 8-12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling-up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer-related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre-treatment and end of life phases.

Keywords: Tai Chi; cancer survivor; cancer treatment; exercise; systemic review.

PMID: 34533284 DOI: 10.1002/cam4.4273