Assessing the Feasibility of a Remotely-Delivered Tai Chi Intervention for Older GI Cancer Patients Experiencing Chemotherapy-Induced Peripheral Neuropathy

About This Grant

Project Abstract In addressing the escalating challenges posed by chemotherapy-induced peripheral neuropathy (CIPN) in gastrointestinal (GI) cancer patients, especially in the older patients, this study seeks to adapt and enhance a Tai Chi intervention for individuals aged 65 and above dealing with CIPN. Approximately 30% of global cancer cases are attributed to GI malignancies, with an increasing incidence and mortality linked to advancing age. CIPN, characterized by persistent numbness, tingling, and pain, significantly impairs physical function, elevates fall risks, and negatively impacts quality of life. With an estimated 60% of individuals aged 65 and above expected to be diagnosed with cancer, this study aims to identify strategies for symptom mitigation and fall prevention. While conventional treatments like Duloxetine show limited universal effectiveness, nonpharmacological interventions like Tai Chi, a weight-bearing mind-body movement therapy, have shown promise in reducing peripheral neuropathy and recommend as the most effective fall prevention among older patients. This multisite study, following the ORBIT framework, comprises Phase I focusing on refining interventions through an iterative mixed-methods approaches and Phase II conducting a Proof of Concept RCT. In Phase I, 12 GI patients (65+) with CIPN will participate in focus groups and a one-week usability testing to provide feedback on the overall study design and refine the TaiChi4NerveEase intervention. Phase II will involve 60 GI patients (65+) randomly assigned to either the TaiChi4NerveEase or AC group for 12 weeks, with a post-intervention and 3-month follow-up. Evaluation metrics include feasibility benchmarks such as a 70% consent rate, 80% attendance in online sessions, 75% assessment completion rate and 90% treatment fidelity across two sites. The study aims to achieve 90% participant satisfaction and will conduct postintervention interviews to identify implementation barriers and facilitators. Unmanaged CIPN remains a significant challenge in oncology, especially among older cancer patients, emphasizing the need for tailored interventions. This pioneering study serves as a crucial initial step in preparing for a definitive TaiChi4NerveEase trial, offering a scalable, non-pharmacological solution for alleviating CIPN and addressing critical unmet needs in a rapidly growing older cancer patient population, aligning with NCI priorities.