Comment 

Cancer therapy remains one of the most challenging areas in medicine. However, despite vigorous research in recent decades, 5-FU remains the most effective agent for treating adenocarcinoma and - especially - colon cancer since its synthesis by Dr. Charles Heidelberger in 1957.

This case demonstrated how a patient with metastatic colon carcinoma achieved a complete response to 5-FU and qigong therapy only 3 months after the qigong treatment was initiated, and remains in good health more than 3 years later. It is conceivable that qigong practice played an important complementary role in achieving this response. 

To evaluate the effect on mind-body practice - in this case qigong therapy - remains a very difficult task. Research about qigong has been done in China in areas such as cancer, aplastic anemia, hypertension, chronic gastritis, diabetes, and stroke. Many of these students have shown favorable results. Several considerations must be addressed regarding qigong's correct concept and context. The selection of particular types of qigong and the proper practice are especially important in clinical studies. 

First of all, the term "qigong" is rather misleading, even in the Chinese language. Too much emphasis has been placed on the words qi and gong, which roughly mean "breath", "air", "work", "skill", and so on. Qigong is a term that has become popular only in the 20th century, and actually refers to a larger group of ancient Chinese healing arts that have been called many things over thousands of years. The foundation of these healing arts lies in the cosmic concept and naturalism of Daoism, in which the concepts and philosophy of Confucianism and Buddhism were incorporated. These concepts were further elaborated and enriched in theory the methods by many ingenious healers, scholars, and physicians throughout the dynasties of China. 

Qigong is not a knowledge, a "skill", or a king of "work". It is a never-ending practice and pursuit to attain harmony of mind and body through persistent physical, mental, moral and spiritual training methods. There are more than 5000 styles of "qigong" counted by the Chinese government, and each has its own history and training methods for specific purposes. some emphasize visualization, others use movements. Not everyone applies "breathing method". The Tientsin Chinese Medicine Academy has suggested applying different styles of qigong for different medical conditions. (Selecting a proper style of qigong would therefore be the first step in designing a study or even a specific practice or application.)

Considering the complexity of this ancient healing art, it is important that an instructor have the required knowledge and background to teach qigong. most qigong "masters" claim that they are of Daoist lineage to appear more "authentic" and "mystic". The distinction between "Dao-Jia" (Daoism as a philosophy) and "Dao-Jiao" (Daoism as a religion) must be understood, because in English they are both called "Daoism". Even in Chinese, the general public often confuses them.

Dao-Jia (Daoism as a philosophy) is a school of philosophy created by Lao-Tzu (ca 580 BCE - 500 BCE). The famous Dao Te Jing (Classic of Daoism) was thought to be compiled by his disciples. Lao-Tzu's philosophy (the original Daoism) has influenced every aspect of Chinese culture and penetrated into everyday life. A large portion of Dao Te Jing was written as guidance for rulers. His thought has been studied by scholars as "philosophy". On the other hand, the term "Dao-Jiao" (Daoism as a religion) developed after Lao-Tzu's time. It is a "religion" largely based on ancient Chinese shamanism. Because Dao Te Jing described shamanistic phenomena and practices, and its cosmic view and philosophy were compatible with the shamanistic belief of Dao-Jiao, Dao Te Jing was adopted by Dao-Jiao as the fundamental text for the religion, and, naturally, Lao-Tzu was regarded as the head master of the religion.  

In fact, qigong is not the only thing Daoist monks practice. Around the fourth and fifth centuries, alchemy was feverishly practiced by these monks who hoped to "live forever." Even today, Daoist monks still practice spiritual healing, changing incantations, and writing Fu, which sometimes is burned and swallowed for healing purposes, worn as a charm for protection, or posted in necessary locations to ward off evil spirits. (Fu is a special type of writing on specially prepared paper. It is written by a Daoist monk after he performs the ritual ceremony, during which time he would receive messages from the spirits.) 

The practice of qigong is a commitment and an ongoing life process. Its meaningful effect can only be seen after a considerable amount of time and effort. It usually requires hours of practice every day. In qigong traditions, it is often said: "Keep it in you, think about it, practice it at all times." In the case presented here, one can see the important factor in qigong. The direct healing effect (qi emission 9-11) from the instructor to the patient obviously bears some importance in the outcome, but its effect varies from instructor to instructor - another variable clinical investigators must consider.   

References

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Qigong Therapy in the Treatment of Metastatic Colon Cancer 

By Shi-Hong Loh, MD

This article was published in July, 1999, in the Journal of Alternative Therapies in Health and Medicine 

In July, 1995, a 60-year-old man developed pain in the right lower quadrant of his abdomen. He underwent a colonoscopy on April 22, 1996, and was found to have a 4-cm circumferential mass at the hepatic flexure. A biopsy of the mass showed adenocarcinoma. The man's medical history included pericarditis in his 30's as we as knee surgery and shoulder surgery. A computer tomography (CT) scan of the abdomen on April 29,1996, showed 2 ill-defined hypo-attenuated lesions and para-aortic nodes were noted. The largest one measured approximately 3.0 cm and the smaller one 2.0 cm x 1.5 cm at its widest diameter. The CT scan of the neck showed a lobulated soft tissue mass in the left supraclavicular region, measuring approximately 4.5 cm x 2.0 cm at its widest diameter, as well as a lobulated soft tissue fullness in the left lateral pharyngeal wall. 

The patient underwent a laparotomy on May 2, 1996. A right hemicolectomy was performed.The operative report revealed a tumor measuring approximately 7/0 cm in diameter at the hepatic flexure of the right colon. Enlarged lymph nodes in the mesentery area extending to and over the body of the adenocarcinoma, which was invasive through the muscularis and into the pericolonic adipose tissue. Four out of the 10 pericolonic lymph nodes were positive for metastatic carcinoma. The resected margins were free of tumor. It was was recommended that the patient receive systemic chemotherapy for metastatic colon carcinoma. 

Systemic chemotherapy began on June 4, 1996, and was initially planned for 1 year. Chemotherapy agents included 5-fluorouracil (5-FU) and leucovorin calcium weekly for 6 weeks, followed by 2 weeks rest, after which the cycle was repeated. The patient considered discounting chemotherapy because he could not cope with the increasing anxiety he experienced with each treatment. He received a total of twenty-eight 5-FU treatments. 

In July 1996, qigong therapy was added to the patient's treatment. He received qigong healing by the author each time he came for chemotherapy and was taught to practice qigong at home. The type of qigong the patient practiced was a Daoist form called Pai Jer Tsuh Jih Gong (meaning "building the foundation in 100 days"), which belongs to the Nei-Gong (i.e., internal gong) category and emphasizes specific types of meditation and breathing with specific visualization. The patient practiced this basic yet profound type of Nei-Gong at least 4 hours each day.

In September 1996 a follow-up CT scan of the patient's chest, abdomen, and pelvis was negative. Previously described lesions in the liver and para-aortic retrocrural lymph nodes disappeared. Blood tests were all normal, except the aspartate transaminase, which was slightly elevated before chemotherapy. In March 1997 the patient discontinued chemotherapy. A repeat CT scan of the chest, abdomen, and pelvis remained negative for any lesions. 

In May 1997, a follow-up colonoscopy showed a colonic polyp and hemorrhoids, but the pathology report of the polyp was negative for malignancy. In June 1997, Pa Tuan Jin, a form of moving qigong, was added to the patient's daily practice. The patient moved out of state in February 1998. As of the last telephone communication in May 1999, the patient is still practicing Nei-Gong and Pa Tuan Jin at least 4 hours every day and is still enjoying good health.