Tai Chi Chuan, Health-Related Quality of Life and Mediators of Inflammation in Breast Cancer Survivors

Abstract

Breast cancer patients experience dimished health-related quality of life (HRQOL) because of side-effects from cancer and its treatments. Dysregulated inflammatory profiles are associated with increased side-effect severity. Exercise produces a self-regulating inflammatory response which may lead to reduced side-effects and improved HRQOL. PURPOSE: The purpose of this pilot study was to explore the influence of standard support therapy (ST) and Tai Chi Chuan (TCC) exercise on HRQOL and the associations between changes in HRQOL and mediators of inflammation. METHODS: Breast cancer survivors (N=21) within 30 months of completing standard cancer treatments were randomly assigned to ST and TCC for 12 weeks (3x's/wk; 60 min/session). Inflammatory markers (IGF, IL8, IGFBP1, glucose, and cortisol) were measured pre and post intervention. HRQOL and sub-domains (physical functioning (PF), mental health (MH), role limitations-physical (RLP), role limitations-emotional (RLE), social function (SF), vitality) were assessed via the MOS SF-36 at baseline (T1), 6 (T2) and 12 (T3) weeks. Independent t-tests using mean change scores (CS) and Pearson correlations were used to assess group differences in HRQOL and associations between changes in HRQOL and changes in inflammatory markers. RESULTS: Analyses revealed differences between groups in PF (T1-T3; CS TCC=1.9, CS ST=-.20; p<.05) and MH (T1-T2; CS TCC=2.70, CS ST=-.70; p<.05) with trends towards differences between groups in RLP (T2-T3; CS TCC=20, CS ST=-1.0; p<.10) and HRQOL (T1-T2; CS TCC=11.68, CS ST=3.16; p<.10). Analyses demonstrated an inverse relationship between changes in IGF and HRQOL (r=-.56;p<.05), RLP (r=-.68;p<.05), SF (r=-56;p<.05), and a trend for vitality (r=-.44;p<.10). Changes in IGFBP1 were directly correlated with changes in RLP (r=.60;p<.05). Changes in cortisol were directly associated with changes RLP (r=.74;p<.05) and vitality (r=.46;p<.05). Changes in IL8 were directly correlated with changes in RLE (r=.59;p<.05) and inversely correlated with changes in glucose (r=-.70;p<.05). CONCLUSION: TCC may improve HRQOL by regulating inflammatory responses associated with side-effects from cancer and its treatments. Future research is warranted. Funded by NCI R25CA102618, K07CA120025 and Sally Schindel Cone Fund