Abstract

Chunjiao Xu, Michael CW Yip, Mary NB Cheung and Wings TY Loo*

ABSTRACT

Tai Chi Chuan (TCC) is a traditional Chinese exercise, its movement is slow in order to achieve a state of relaxation and balance of both body and mind. TCC shows positive effects in relieving symptoms in patients with chronic diseases and malignant diseases after treatment. Research has proven that TCC helps improve the quality of life in breast cancer patients who had undergone surgery and chemotherapy. Studies have also demonstrated that TCC may exert its effects psychologically and physiologically. In order to document current researches of TCC in a scientific way, we tried to evaluate the changes of biological markers in breast cancer survivors who has been practicing TTC and its potential benefits in reducing treatment-related adverse effects, improving immunity and personal wellbeing. Cancer survivors suffer from a variety of psychological responses including depression, sadness, anxiety, fear and adverse effects from surgery and chemotherapy. Some studies confirmed that cancer survivors’ physical and psychological functions can be improved by regular exercises. Many studies have shown that regular physical exercises are particularly important in reducing the incidence and recurrence of breast cancer, prolonging the survival of patients and even improving the side effects during and after the treatment. It has also been linked to a better quality of life (QoL) for breast cancer survivors. After surgery, the shoulder function of breast cancer survivors would be impaired and their arms would show signs and symptoms including diminished tactile sensation in the arm or armpit, weakness, stiffness and lymphedema of the surgical sided arm. Conventional exercises such as running and/or swimming involves rigorous arm movements which require full mobility of the arms and legs. Such exercises are not recommended immediately following surgery. TCC exercises may help regain upper limb functional mobility for breast cancer survivors by slow and continuous movement of upper limb. Practicing TCC in a smooth and relaxed way will lessen tension and promote relaxation which may alleviate stress, depression and anxiety. TCC has been demonstrated in improving psychological well-being of breast cancer survivors by reducing anxiety or depression through stabilizing the level of cortisol and serotonin. Studies showed that TCC improves immunity in breast cancer survivors by means of hematological markers and cytokines. In this review, there were only four randomized controlled trials have made use of biological markers to monitor the effects of TCC in breast cancer survivors although most researchers tend to assess by means of aerobic capacity, muscular strength, and flexibility, as well as QOL. None of the studies investigated the relationship between TCC and treatment-related adverse effects or immunity through changes in biological markers. Therefore, researchers could develop the use of more cytokines, stressors (melatonin), activated natural killer cells, free radicals, biochemical markers or c-miRNAs to determine the effects of TCC.