Cancer patients often experience a reduced quality of life due to symptoms such as anxiety, stress, depression, fatigue, pain, and sleep disturbances. Mind-body therapies like Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong have been shown to alleviate distress, but little is known about their comparative efficacy. Additionally, it remains unclear whether allowing patients to choose their preferred treatment leads to better outcomes than assigning them randomly. 

Carlson et al. [Journal of Clinical Oncology] compared the efficacy of MBCR and Tai Chi/Qigong and examined whether treatment outcomes differ between patients who receive their preferred treatment and those who are randomly assigned by study protocol.

The researchers enrolled 587 cancer patients (average age=61 years; 75% female) from two Canadian cancer treatment centers. The most common diagnoses were breast, prostate, and gastrointestinal cancers, and half were in early disease stages 0-II. At baseline, 64% of participants expressed a preference for one of the available treatments. Those who expressed a treatment preference were assigned to their chosen intervention but were randomly assigned to begin immediately or be placed on a waitlist. Patients without a preference were randomly assigned to either immediate or waitlisted MBCR or Tai Chi/Qigong. 

The MBCR program followed the structure that was similar to Mindfulness-Based Stress Reduction, consisting of  nine weekly 105-minute group sessions and a six-hour retreat. The Tai Chi/Qigong program involved 11 weekly 90-minute sessions and a 4-hour retreat. It incorporated the Cheng Man Ching Yang-style short form of Tai Chi and emphasized flowing movements, breath and body awareness, focused attention, and imagery. Both treatments recommended 30 to 40 minutes of daily home practice. 

Participants completed assessments of mood at baseline and after the intervention using the Profile of Mood States. The primary outcome included a total mood score and subscale scores for tension-anxiety, depression, anger-hostility, vigor-activity, fatigue, and confusion.

Results showed that the MBCR group, including both those assigned to their preferred treatment and those randomized, showed significantly reduced total mood scores compared to MBCR waitlist controls (d=0.44). The Tai Chi/Qigong group (also combined) showed reduced total mood scores (d=0.25) compared to Tai Chi/Qigong waitlist controls; this effect was significant in the as-treated analysis but only trended toward significance in the intention-to-treat analysis.

There was no significant difference in the overall size of improvement in total mood scores between the group assigned to their preferred treatment and those randomly assigned. 

When comparing the two treatment groups, Tai Chi/Qigong produced greater improvements in vigor-activity and greater reductions in anger-hostility and depression. MBCR was more effective in reducing tension-anxiety. The effect sizes of group contrast for subscale improvements were in the small-to-moderate range. For example, the effect sizes for differences between active and waitlisted treatments on vigor-activity for randomized participants ranged from d=0.24 to d=0.53. Similar differences for depression ranged from d=0.37 to 0.40.

This large trial shows that both MBCR and Tai Chi/Qigong treatments modestly improved mood in cancer patients, regardless of whether participants received their preferred treatment or were randomly assigned by the research protocol.

Notably, because no patient was assigned to a treatment they did not prefer (those with a preference received it, and those without preference were randomized), this study did not assess the impact of being assigned to a non-preferred treatment. This design feature may account for the difference between these findings and previous studies suggesting that patient preference influences treatment effectiveness.

Reference:

Carlson, L. E., Jones, J. M., Oberoi, D., Piedalue, K.-A., Wayne, P. M., Santa Mina, D., Lawal, O. A., & Speca, M. (2025). Mindfulness and Tai Chi for Cancer Health (MATCH) Study: Primary Outcomes of a Preference-Based Multisite Randomized Comparative Effectiveness Trial. Journal of Clinical Oncology. 

Link to study