Reduce Fatigue and Improve Sleep in Cancer Survivors with Tai Chi

Reduce Fatigue and Improve Sleep in Cancer Survivors with Tai Chi


By John M. de Castro, Ph.D.


“tai chi may help to increase strength, balance, flexibility, heart and lung function, feelings of well-being” –


Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But surviving cancer carries with it a number of problems. Anxiety, depression, fatigue, and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.


Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depressionTai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. They are very gentle and safe practices. The research on the effectiveness of Tai Chi training for cancer patients is accumulating. So, it makes sense to take a step back and summarize what has been learned.


In today’s Research News article “Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines.” (See summary below or view the full text of the study at: ) Yang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled clinical trials of the effectiveness of Tai Chi training for the well-being of cancer survivors. They identified 26 published studies.


They report that the published research found that 8 to 12 weeks of Tai Chi practice produce significant decreases in fatigue and increases in sleep quality in cancer patients. The published studies were generally of low methodological quality and small number of patients. So, there is a need for future studies employing high quality methodologies with large groups. Nevertheless, it is reasonable to conclude that Tai Chi practice is beneficial for cancer survivors reducing fatigue and improving sleep.


So, reduce fatigue and improve sleep in cancer survivors with Tai Chi.


participation in Tai Chi had a positive influence on quality of life and psychological health for cancer survivors.” – Catherine Stifter


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are available on Twitter @MindfulResearch


Study Summary


Yang, L., Winters-Stone, K., Rana, B., Cao, C., Carlson, L. E., Courneya, K. S., Friedenreich, C. M., & Schmitz, K. H. (2021). Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines. Cancer medicine, 10(21), 7447–7456.



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.


Minority and Low Education Groups are Less Likely to Practice Mindfulness

Mindfulness minority2 - Olano

By John M. de Castro, Ph.D.


“Despite increased attention to diversity issues, ethnic minorities are still underrepresented in the field of psychology. Baseline knowledge on the effectiveness of treatments for ethnic minority groups is limited.”Janice Ya Ken Cheng


Mindfulness practices have gone mainstream in western culture. This has not been driven by theoretical, philosophical, or religious reasons but by pragmatic ones. Mindfulness practices have been found to be very beneficial to the practitioner of all ages from children, to adults, to the elderly. They have been shown to improve the psychological and physical health of otherwise healthy individuals and to be helpful in treating both mental and physical illnesses. A variety of mindfulness techniques have been shown to be effective including meditation, mindfulness based stress reduction (MBSR), mindfulness based cognitive therapy (MBCT), Acceptance and Commitment therapy (ACT), mindful movement practices such as tai chi and qigong, and yoga. It is no wonder that these practices have spread rapidly in modern western culture.


At present, it is not known whether these practices have spread uniformly through the population of have been adopted primarily by specific subgroups. For the most part, mindfulness practices require a teacher, at least initially, and thus can incur costs. This suggests that there may be socioeconomic barriers to participation. In addition, because mindfulness practices have spread through the printed media, education level may be a factor in their adoption. To help promote the adoption of these healthy techniques it is important to know which groups are not currently participating in large numbers and what might be the barriers for participation.


In today’s Research News article “Engagement in Mindfulness Practices by U.S. Adults: Sociodemographic Barriers.” See:


or below or view the full text of the study at:

Olano and colleagues studied the ethnic, educational, and socioeconomic characteristics of participants in various mindfulness practices from the responses reported in the 2002, 2007, and 2012 National Health Interview Survey (NHIS). This survey included questions regarding participant characteristics and participation in various mindfulness practices.


They found that over 13% of the population participated in one or more mindfulness practices. Meditation and yoga were practiced about equally being engaged in by 7.6% and 7.5% of the population of the U.S. respectively, while tai chi and qigong were much less commonly practiced, 1.2% and 0.3% of the population respectively. Gender made a difference as men were half as likely as women to engage in any of the practices and more than three times less likely to practice yoga. Education level made a large difference with education beyond high school highly predictive of engagement in mindfulness practices. Race and ethnicity was also important with white and Asian Americans much more likely to practice than black or Hispanic Americans. Interestingly, income level only made a very slight difference in participation.


These results are very interesting as the characteristics of participants in mindfulness practices track health statistics for these groups. Low education level and being a member of a minority group are strong predictors of poor health outcomes and males live on average 7 years less than females. These results do not demonstrate that engagement in mindfulness practices are the sole reason for health disparities, as they are still present for non-practitioners. But, it is known that mindfulness practices promote good mental and physical health. So, the lack of practice in male, minority, and low education groups suggests that they are not taking advantage of the benefits of practice which may contribute to the health disparities.


These results strongly suggest that greater efforts should be made to bring mindfulness practices to these vulnerable populations and thereby improve health and well-being. The results of the current study suggest that income level is not a problem. This is important as it suggests that these practices can be spread at low relative cost. Given their very positive impacts on health, mindfulness practices would appear to be a very safe and cost effective means of improving health and addressing prevalent health disparities in the population.


“Researchers and clinicians who are interested in ethnic minority research in general and acceptance- and mindfulness-based treat­ments in particular must face the fact that ethnic minority psycholo­gists are persistently underrepresented, despite different efforts having been made to promote the recruitment and retention of ethnic minor­ity professionals in psychology.” –  Janice Ka Yan Cheng


CMCS – Center for Mindfulness and Contemplative Studies


Study Summary

Olano, H. A., Kachan, D., Tannenbaum, S. L., Mehta, A., Annane, D., & Lee, D. J. (2015). Engagement in Mindfulness Practices by U.S. Adults: Sociodemographic Barriers. Journal of Alternative and Complementary Medicine, 21(2), 100–102.



Objective: To examine the effect of sociodemographic factors on mindfulness practices.

Methods: National Health Interview Survey Alternative Medicine Supplement data were used to examine sociodemographic predictors of engagement in meditation, yoga, tai chi, and qigong.

Results: Greater education was associated with mindfulness practices (odds ratio [OR], 4.02 [95% confidence interval [CI], 3.50–4.61]), men were half as likely as women to engage in any practice, and lower engagement was found among non-Hispanic blacks and Hispanics.

Conclusion: Vulnerable population groups with worse health outcomes were less likely to engage in mindfulness practices.