Effect of Tai Chi Chuan on serotonin and cortisol for monitoring stress and quality of life in post-treatment breast cancer patients

doi:10.3877/cma. j. issn.1674-0807.2014.04.008

Objective

Immediate physical exercise has been recommended for patients in the recovery phase to improve survival and quality of life (QOL) and reduce recurrence of disease. The new NCCN Guidelines for Survivorship also highlighted the role of exercise in post-cancer health, encouraging patients to perform light physical activity following treatment. The aim of our study is to effect of Tai Chi Chuan (TCC) on serotonin and cortisol for monitoring stress and QOL in post-treatment breast cancer patients.

Methods

Totally 85 post-treatment breast cancer patients were enrolled in this study to observe the effects of practicing TCC on recovery,as well as stress and happiness which are indicators of QOL of in patients. Peripheral blood was drawn from study subjects to analyze the levels of serotonin,cortisol and high sensitive C-reactive protein(HS-CRP) at baseline, and at 3,6 and 12 months of TCC practice. Blood was drawn from healthy subjects only at baseline.A QOL questionnaire was administered to study subjects at three time points throughout the study, and once for healthy controls. The data were processed by analysis of variance of repeated measurement.

Results

At 3, 6 and 12 months time points following regular TCC exercise, WBC, RBC, hemoglobin in blood samples showed a statistically significant difference (F = 161.55, 172.14, 289.73; all P = 0.00) ; the level of serotonin(biomarker for well-being), cortisol (indicator of stress) and HS-CRP (biomarker for inflammation) showed a statistical improvement (F=307.46, 182.85, 102.23; all P=0.00). After 3, 6 and 12 months of regular TCC exercise, according to the results of QOL questionnaire, the indicators including quality of sleep,perceived hunger, fatigue, contentment, stress and social interaction presented a significant difference (F=312.98,222.64,543.90,46.05,28.10,78.92, all P＜0.05), while there was no statistical difference in life dissatisfaction (F=56.61, P=0.166)

Conclusions

TCC physical activity for post-treatment breast cancer patients improved QOL and overall well-being, leading to improved mental, physical and psychological functioning. Regulated levels of serotonin and cortisol mediated by TCC exercises are proved to be vital for continued good health.

关键词: Tai Ji, Breast neoplasms, Quality of life, Serotonin

Table 1 Blood biomarker parameters of healthy controls at baseline, and patient group at baseline,3,6 and 12 months of Tai chi chuan exercises (±s)

Groups	n	White blood cells(10⁹/L)	Red blood cells(10¹²/L)	Hemoglobin(g/L)	Serontonin(ng/ml)	Cortisol(nmol/L)	C-reactive protein(pg/ml)
Healthy group
Baseline	43	7.80±0.95	4.85±0.55	139.00±25.00	149.42±6.49	256.50±15.30	0.46±0.25
Patient group
Baseline	80	3.00±0.88	2.99±0.65	90.00±16.60	45.32±5.77	615.50±28.44	3.10±0.85
3 months^a	80	4.12±0.43	4.05±0.99	122.20±18.90	88.57±7.57	566.42±56.70	2.06±0.42
6 months^a	80	6.02±0.78	4.22±0.92	130.00±13.50	99.48±5.21	424.20±25.86	1.85±0.15
12 months^a	80	7.01±1.12	4.54±1.05	138.50±15.00	108.28±9.85	305.20±50.68	0.86±0.52
F value		161.55	172.14	289.73	307.46	182.85	102.23
P value		0.00	0.00	0.00	0.00	0.00	0.00

Table 1 Blood biomarker parameters of healthy controls at baseline, and patient group at baseline,3,6 and 12 months of Tai chi chuan exercises (±s)

Groups	n	White blood cells(10⁹/L)	Red blood cells(10¹²/L)	Hemoglobin(g/L)	Serontonin(ng/ml)	Cortisol(nmol/L)	C-reactive protein(pg/ml)
Healthy group
Baseline	43	7.80±0.95	4.85±0.55	139.00±25.00	149.42±6.49	256.50±15.30	0.46±0.25
Patient group
Baseline	80	3.00±0.88	2.99±0.65	90.00±16.60	45.32±5.77	615.50±28.44	3.10±0.85
3 months^a	80	4.12±0.43	4.05±0.99	122.20±18.90	88.57±7.57	566.42±56.70	2.06±0.42
6 months^a	80	6.02±0.78	4.22±0.92	130.00±13.50	99.48±5.21	424.20±25.86	1.85±0.15
12 months^a	80	7.01±1.12	4.54±1.05	138.50±15.00	108.28±9.85	305.20±50.68	0.86±0.52
F value		161.55	172.14	289.73	307.46	182.85	102.23
P value		0.00	0.00	0.00	0.00	0.00	0.00

Table 2 Scores on physical and psychological functioning according to quality of life questionnaire for healthy controls at baseline, and for patient group at baseline,3,6 and 12 months of Tai chi chuan exercises (±s)

Groups	n	Physical functioning			Psychological functioning
Groups	n	Quality of sleep	Perceived hunger	Fatigue	Contentment	Stress	Social interaction	Life dissatisfaction
Healthy group
Baseline	43	8.10±0.40	7.90±0.77	1.90±0.60	7.50±0.54	5.60±0.94	8.60±0.50	2.10±0.82
Patient group
Baseline	80	2.10±0.00	3.20±0.95	7.90±1.00	4.50±0.39	7.30±1.15	5.50±0.82	4.00±0.18
3 months	80	2.85±0.20	4.10±0.05^a	7.15±0.80	5.20±0.82^a	7.00±1.39	7.00±0.15^a	3.20±0.09^a
6 months	80	3.60±0.40	5.00±0.74^a	6.40±1.20^a	6.14±0.54^a	6.40±1.63^a	7.50±0.55^a	2.40±0.18^a
12 months	80	6.80±0.30^a	6.90±0.73^a	3.20±0.70^a	6.90±0.52^a	6.00±1.27^a	7.60±0.63^a	2.10±0.13^a
F value		312.98	222.64	543.90	46.05	28.01	78.92	56.61
P value		0.006	0.007	0.000	0.013	0.006	0.014	0.166

Groups	n	Physical functioning			Psychological functioning
Groups	n	Quality of sleep	Perceived hunger	Fatigue	Contentment	Stress	Social interaction	Life dissatisfaction
Healthy group
Baseline	43	8.10±0.40	7.90±0.77	1.90±0.60	7.50±0.54	5.60±0.94	8.60±0.50	2.10±0.82
Patient group
Baseline	80	2.10±0.00	3.20±0.95	7.90±1.00	4.50±0.39	7.30±1.15	5.50±0.82	4.00±0.18
3 months	80	2.85±0.20	4.10±0.05^a	7.15±0.80	5.20±0.82^a	7.00±1.39	7.00±0.15^a	3.20±0.09^a
6 months	80	3.60±0.40	5.00±0.74^a	6.40±1.20^a	6.14±0.54^a	6.40±1.63^a	7.50±0.55^a	2.40±0.18^a
12 months	80	6.80±0.30^a	6.90±0.73^a	3.20±0.70^a	6.90±0.52^a	6.00±1.27^a	7.60±0.63^a	2.10±0.13^a
F value		312.98	222.64	543.90	46.05	28.01	78.92	56.61
P value		0.006	0.007	0.000	0.013	0.006	0.014	0.166

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