Tai Chi and Breast Cancer Survivors Introduction
As I am examining Janelsins et al.’s (2011) paper1, I cannot help but develop a clear vision of a middle-aged woman, lets call her Evalyn, moving gracefully about with slow, deliberate, mindful movements. How did we get to this tranquil picture of Tai Chi Evalyn?
The inner struggle of staying a breast cancer survivor without worrying herself senseless probably adds a considerable amount of pressure to Evalyn’s daily routines. I can only imagine the many burning questions that could be hurrying through Evalyn’s head. These enigmas most likely hurled Evalyn into self-education on staying a long-term breast cancer survivor.
Factors Contributing to Quality of Life in Breast Cancer Survivorhsip
She might have found out that weight gain in breast cancer survivors is of notable concern. Weight gain after diagnosis with breast cancer has negative effects on quality of life1. In the process of educating herself, Evalyn might have discovered that weight gain after diagnosis of breast cancer can lead to increased risk of all-cause mortality2.
Other factors contributing to the recurrence and survival of breast cancer are insulin levels and cytokines. This is essential for Evalyn to know. She just found another piece of this daunting breast cancer survivorship puzzle. Increased insulin levels allow cells to divide rapidly3, as a breast cancer survivor, unquestionably something Evalyn desires to avoid.
Cytokines, however, drive inflammation. In acute maladies, this is an absolute essential healing response. Chronic inflammation is, however, an extra area of concern for a breast cancer survivor. Researchers affirm that chronic inflammation, driven by cytokines, contributes to cancer development, cancer progression, and recurrence4.
For Evalyn, it is essential to understand all this information. Most likely, Evalyn probably feels pretty overwhelmed at times with all the talk of body mass ratios, body mass bioelectrical impedance analysis, cytokines, inflammation, and breast cancer recurrence. Downright scary! She probably is curious if cytokines, inflammation, weight gain, and insulin levels are all out of her control.
What could she do to support lean muscle mass and body fat at an ideal ratio? Is there a way to keep insulin levels in check? How about the pro-inflammatory cytokines she knew nothing about only a little while ago? Surely, Evalyn can do something about that? Now, the pieces of the puzzle are dropping into place. Evalyn discovers that she is not as helpless as it seems.
Benefits of Tai Chi for Breast Cancer Survivors
As Evalyn becomes proactive in her health care, she finds a few options within the realm of mind-body medicine. Tai Chi being one of them. This brings us to the peaceful image of a gracefully moving Tai Chi Evalyn. As Evalyn completes her twelfth and final weekly 50-minute session of 15-move short form Yang-style Tai Chi, let’s zoom to the microscopic level and see what has happened in Evalyn’s tissue for the last three months.
- Benefit 1: Compared to a non-Tai Chi, psychosocial support group only, Tai Chi enabled Evalyn to drop her body weight and fat mass, where the non Tai Chi group saw increases in both1.
- Benefit 2: Tai Chi enabled Evalyn to keep her insulin levels stable while the non-Tai Chi group saw their insulin levels spike almost to double the levels at study end, when compared to beginning insulin levels1. This is a desirable outcome since high insulin levels can lead to increased cancer recurrence and reduced survival in breast cancer patients5.
- Benefit 3: Tai Chi shifted the relationships between cytokines (interleukin-6 and interleukin-2), fat mass, and fat-free mass. This change is indicative of Tai Chi mediated changes in cytokines beneficial to maintain a desirable body weight in breast cancer survivors.
- Benefit 4: Switch of the cytokine interleukin-6 from a pro-inflammatory to anti-inflammatory action. This is possible because interleukin-6 is a pleiotropic cytokine. Pleiotropic simply means capable of producing more than one effect. Just a quick reminder; in chronic inflammation, the pro-inflammatory action of interleukin-6 can lead to growth factor promotion that promotes survival of cancer cells6.
- Physical activity such as Tai Chi leads to a dramatic increase of interleukin-6 from muscle mass. Interestingly, yet paradoxically enough, the ensuing increase of muscle derived interleukin-6 has positive anti-inflammatory effects7,8.
- Benefit 5: T-cells produce interleukin-2, which build up in adipose tissue. Experts believe that interleukin-2 plays a key role in inflammation within adipose tissue. This may promote cancer progression. By exercising Tai Chi, Evalyn was able to drop her fat mass while building fat-free mass (i.e. lean muscle mass) which lead to lower levels of interleukin-2 in her adipose tissue. This reasonably decreases the risk of cancer progression1.
- Benefit 6: Tai Chi, being a mind-body medicine practice with a meditative part might have positive effects on Evalyn’s cognitive functioning, as well. The existential bind cancer survivors face touches every aspect of life. Because of cancer related emotional distress, changes in social relationships, body image, and functioning, cancer survivors often experience a loss of control and feelings of helplessness. The mind-body medicine part of Tai Chi provides an internal locus of attention, empowering cancer survivors to take a proactive stance by consciously directing their attention to present-moment experiences. This can lead to better coping with stress, support relaxation, and relieve physical uneasiness and emotional distress9.
What Can You Learn From Evalyn?
If nothing else, the main takeaway message might be the following. Hypothetically, by proactively practicing Tai Chi, Evalyn promotes anti-inflammatory processes that cut the overall inflammatory state of her body through the release of muscular interleukin-6. Tai Chi Evalyn is able to lower insulin levels. Lower insulin levels contribute to a normal rate of cell growth and division. This proactive approach helps Evalyn support a healthy body weight. A healthy body weight and reduced state of inflammation diminish her chances of breast cancer recurrence dramatically1.
Janelsin’s (2011) research shows that the question posed in the title of this post is not so far-fetched as one might think after all.
One last question remains. As a cancer survivor, could you benefit from a friend with such stunning benefits?
1. Janelsins, M. C. et al. Effects of Tai Chi Chuan on Insulin and Cytokine Levels in a Randomized Controlled Pilot Study on Breast Cancer Survivors. Clin. Breast Cancer 11, 161–170 (2011).
2. Nichols, H. B. et al. Body Mass Index Before and After Breast Cancer Diagnosis: Associations with All-Cause, Breast Cancer, and Cardiovascular Disease Mortality. Cancer Epidemiol. Biomarkers Prev. 18, 1403–1409 (2009).
3. Kleinberg, D. L., Wood, T. L., Furth, P. A. & Lee, A. V. Growth Hormone and Insulin-Like Growth Factor-I in the Transition from Normal Mammary Development to Preneoplastic Mammary Lesions. Endocr. Rev. 30, 51–74 (2008).
4. Aggarwal, B. B. & Gehlot, P. Inflammation and cancer: how friendly is the relationship for cancer patients? Curr. Opin. Pharmacol. 9, 351–369 (2009).
5. Goodwin, P. J. Fasting Insulin and Outcome in Early-Stage Breast Cancer: Results of a Prospective Cohort Study. J. Clin. Oncol. 20, 42–51 (2002).
6. DeNardo, D. G. & Coussens, L. M. Inflammation and breast cancer. Balancing immune response: crosstalk between adaptive and innate immune cells during breast cancer progression. Breast Cancer Res. 9, 212 (2007).
7. Pedersen, B. K. et al. The metabolic role of IL-6 produced during exercise: is IL-6 an exercise factor? Proc. Nutr. Soc. 63, 263–267 (2007).
8. Petersen, A. M. W. & Pedersen, B. K. The role of IL-6 in mediating the anti-inflammatory effects of exercise. J. Physiol. Pharmacol. Off. J. Pol. Physiol. Soc. 57 Suppl 10, 43–51 (2006).
9. Ott, M. J. Mindfulness Meditation for Oncology Patients: A Discussion and Critical Review. Integr. Cancer Ther. 5, 98–108 (2006).