Where Art & Science Intersect

When Mike Powers watches his students gliding slowly, gently through the ancient martial art of tai chi, he sees warriors fighting to take back their lives from cancer. Powers knows what doctors across the United States are increasingly considering: Tai chi offers mental and physical benefits that can aid cancer survivors’ battle for a better quality of life.

“It helps them relax and deal with their stress a lot better and has been known to boost the immune system,’’ says Powers, a certified tai chi instructor at The University of Texas M.D. Anderson Cancer Center’s Place of Wellness in Houston. “It very definitely increases muscle tone and improves balance.’’

Tai chi (pronounced “tie chee’’) dates to the 12th century, when it started in China as a practice for fighting or self-defense. Over time, it has become known more for its health benefits and is considered part of complementary and alternative medicine.

The practice is often called “moving meditation,’’ because participants put aside distracting thoughts and breathe deeply as they engage in a graceful series of movements, many of which imitate the actions of animals, such as the snake and crane.

Practitioners believe tai chi helps massage the body’s internal organs, aids the exchange of gases in the lungs, improves digestion and balance, combats fatigue, and produces a feeling of calmness and awareness.

Results published from a number of clinical research studies have suggested that tai chi benefits the elderly and others, says Patrick J. Mansky, MD, of the National Center for Complementary and Alternative Medicine at the National Institutes of Health in Bethesda, Maryland. But research is lacking on tai chi’s benefits to those who have had cancer.

This dearth of information has prompted at least two new studies seeking to document what effect the mind/body practice has on cancer survivors. (A listing of studies can be found at www.clinicaltrials.gov.)

One study, led by Mansky, compares the benefits of taking a tai chi class with riding an exercise bike at the gym. Researchers want to determine how well tai chi boosts aerobic capacity, muscle strength, and endurance in cancer survivors.

That is important, Mansky says, because of the heavy toll cancer treatments take on the body. Lower activity levels and fatigue during treatment lead to a loss of muscle tone. And chemotherapy and radiation can cause neurological and metabolic changes, heart problems, and fertility issues.

Cancer’s mental toll is another factor.

“We know that cancer survivors have lots of stress even further out beyond their treatment,’’ Mansky says, adding that it’s important to see whether tai chi can help alleviate that stress.

He is also interested in whether there is a psychological benefit from doing tai chi that goes beyond just reducing stress to helping people gain greater insight and inner strength, as can happen with those who practice meditation as part of a desire to reach beyond themselves. Perhaps tai chi can help people do that as well, Mansky says.

The study, which began in the fall and includes men and women ages 18 to 60, is expected to last two years. Mansky hopes the results will add weight to his belief that healthcare providers need to consider and promote options such as tai chi to cancer survivors.

Viola Chan, a breast cancer survivor from Houston, wasn’t advised by her physician to practice tai chi. She came to it on her own, suggesting in 1988 that her church, Chinese Baptist in Houston, begin offering a class once a week. She was among the first participants.

After her diagnosis in 1994, surgeons removed 14 lymph nodes on her left side, leaving her with numbness. When she was able, she returned to practicing tai chi and immediately saw an improvement.

"Tai chi helped me not to notice the numbness in my left arm as much,’’ says Chan, 77. “It’ll always be there. But now it doesn’t bother me as much.’’

The tai chi classes Chan now takes at a local senior center also help her put aside her worries about cancer.

"You always have that question in your mind: Will it come back; where will it come back?" she says. “With the tai chi, you don’t seem to think about it as much."

Whether tai chi can bring that sort of calm to cancer survivors with chronic insomnia is the focus of another new study, at the Cousins Center for Psychoneuroimmunology at UCLA’s Semel Institute for Neuroscience and Human Behavior.

The study, led by Michael Irwin, MD, professor of psychiatry at UCLA and director of the Cousins Center, seeks to determine whether doing tai chi can help cancer survivors with insomnia "reset" after becoming stressed so they can relax and go to sleep.

He says 70 percent to 80 percent of women with breast cancer have insomnia during treatment, with chronic sleeplessness persisting afterward for 25 percent to 30 percent.

The reasons for the insomnia, he says, are varied. First, there’s the stress of having the cancer diagnosis and treatment. Some people are more anxious in general, which contributes to insomnia. Demographics also play a role, with people who live alone or who are unmarried being more prone to chronic sleep disorders.

“Throughout the day, stress accumulates,’’ Irwin says. “We want to see if tai chi provides a mechanism or treatment a person can practice to center himself, quiet himself, have inner peace, that is something they can return to throughout the day.’’

The study of female breast cancer survivors is just getting under way, Irwin says. The women will do tai chi two times a week for 1½ hours each session. Researchers will evaluate their progress and track them for a year to assess benefits.

Powers, 63, the certified tai chi instructor at M.D. Anderson, says the discipline not only can help with stress but also allows many people to decrease the medications they need. One of his students—who had surgery at M.D. Anderson to remove a kidney with a tumor that turned out to be benign—was taking 13 medications a day two years ago to ease ailments that included asthma and rheumatoid arthritis, Powers says. Now, after taking up tai chi, she takes only three medications. “She just saw a tremendous benefit,’’ he says.

Still, it’s sometimes hard to get people excited about tai chi. “In the U.S. people think, ‘no pain no gain,’ ’’ he says. “The problem most people have with tai chi is it’s done very, very slow and relaxed. With tai chi, if you have pain, there’s no gain. It’s very unlike what Americans are geared to.’’

Suzy Chan of Orlando, says even her doctor was amazed at the benefits she saw from tai chi after her mastectomy 10 years ago. The surgery made it difficult to move her arms, and she lost elasticity and mobility in her hands, she says. She went home and did tai chi stretches and exercises, and when she went back to the doctor in a couple of weeks, he was astonished by her progress.

“So tai chi can really assist with healing,’’ says Chan, 59, who teaches tai chi at Wah Lum Kung Fu Tai Chi of USA, and has written a book titled The Tai Chi World of Suzy Chan that outlines how the practice helped in her breast cancer recovery.

She says tai chi must become a daily, lifelong habit for its benefits to be fully realized.

Lillian Lee, 74, who was found to have breast cancer 12 years ago, would agree with her. Doing tai chi has become a morning routine for Lee, who broke that pattern recently while she was gone for a few days deer hunting.

“I could sure tell a difference,’’ says Lee, a Houston resident.

Her cancer treatment included a lumpectomy followed by radiation and tamoxifen, and she says she has lingering pain in her shoulder.

“Tai chi really helps with the pain. It makes a difference.’’