Caregiver Reflexology: Beneficial for Cancer Patients

How much can cancer patients benefit from reflexology provided by friend and family caregivers? A lot according to a study headed by Dr. Gwen Wyatt of Michigan State University. Symptom severity was reduced significantly when reflexology was provided to women with advanced breast cancer by caregivers such as spouses.

Most interesting: results were obtained with little training to the caregivers and the number of sessions was few. The first visit was a training visit by a study reflexologist. The first weekly 30 minute caregiver session was observed and coached by the reflexologist. During the second weekly session, the caregiver was observed and received any needed adjustments in technique. Two further unsupervised weekly sessions were provided by the caregiver.

Significant reduction in symptom severity began for the cancer patients were seen at the second week and continued to the fifth week with results reduced at the 11 week mark. The caregiver-provided reflexology group saw significant reductions in: pain, fatigue, nausea, disturbed sleep, distress, shortness of breath, difficulty remembering, decreased appetite, drowsiness, dry mouth, sadness, vomiting, numbness/tingling.

The importance of the study is seen as the now proven ability to manage symptoms (see below) at home for the advanced cancer patient. 

• Previous studies have shown that unmanaged symptoms lead to a reduced health-related quality of life. Management of symptoms can improve quality of life.
• “more than 80% of women with breast cancer turn to complementary and integrative health (CIH) therapies for symptom management” with foot or hand reflexology as one of the most common choices
• Home-based symptom management allows patients to receive interventions when needed (Such a conclusion was also drawn in a previous study of caregiver provided reflexology for pain relief of cancer patients.) 
• Home-based symptom management allows patients to avoid “scheduling appointments for some time in the future with practitioners” (and as noted above receive immediate attention for symptoms) 
• Home-based symptom management “minimizes the financial expenses and potential exposure to outside contaminants (experienced during a visit to a health care facility) for immunocompromised patients with advanced disease.”

The decision to research results of caregiver reflexology in the current study followed observations of 2010 research by Dr. Wyatt et al. During that study an unexpected result was the positive results obtained for cancer patients by research staff with no reflexology training.

Further research is planned to explore mechanisms of action at work. “The finding of the stable social relationship in this study points to the need to consider other potential mechanisms of action of reflexology, such as underlying biology. To date, the potential physiologic mechanisms suggested in the literature include: activation of receptors to release oxytocin for its positive effects on well-being [52]; facilitation of optimum circulation, which in turn eliminates toxins and supports immune, nervous, and glandular systems [53]; activation of the relaxation response [22, 54]; and complex inputs and processing via neuromatrices in the central nervous system [20, 55]. These theoretical mechanisms may or may not be the active ingredient in reflexology, and further research is needed on the pathways that may explain symptom reduction due to reflexology.” 

20. Stephenson N, Swanson M, Dalton J, Keefe FJ, Engelke M (2007) Partner-delivered reflexology: Effects on cancer pain and anxiety. Oncol Nurs Forum 34 (1):127-132
22. Sharp DM, Walker MB, Chaturvedi A, et al. (2010) A randomized, controlled trial of the psychological effects of reflexology in early breast cancer. Eur J Cancer 46 (2):312-322
52. Cronfalk BS, Strang P, Ternestedt BM (2009) Inner power, physical strength and existential well-being in daily life: Relatives' experiences of receiving soft tissue massage in palliative home care. J Clin Nurs 18 (15):2225-2233 53. Wilkinson S, Lockhart K, Gambles M, Storey L (2008) Reflexology for symptom relief in patients with cancer. Cancer Nurs 31 (5):354-360
54. McVicar AJ, Greenwood CR, Fewell F, et al. (2007) Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals. Complement Ther Clin Pract 13 (3):137-145
55. Stephenson N, Dalton J (2003) Using reflexology for pain management. J Holist Nurs 21 (4):179-191 

Gwen Wyatt, RN, PhD, FAAN, Alla Sikorskii, PhD, Irena Tesnjak, PhD(c), Dawn Frambes, PhD, RN, MSA, Amanda Holmstrom, PhD, Zhehui Luo, PhD, David Victorson, PhD, Deimante Tamkus, MD, “A Randomized Clinical Trial of Caregiver-delivered Reflexology for Symptom Management during Breast Cancer Treatment,” Journal of Pain and Symptom Management, 2017 Jul 22. pii: S0885-3924(17)30301-9. doi: 10.1016/j.jpainsymman.2017.07.037

Abstract: https://www.ncbi.nlm.nih.gov/pubmed/28743659

(Note from Editor: The meaning of “management” of symptoms became clear to this writer when she accompanied her 96 year old mother to a semi-annual physical. Oh, you’re managing your symptoms, said the doctor when my mother described her successful efforts to care for her problems with acid reflux. Her description of another health situation evoked the same response. The value of managing one’s health? My mother has the blood work (blood sugar, cholesterol etc. levels) of “a twenty-year old,” according to the doctor. He also describes her as amazing.)

Further research- 

Medical applications of Reflexology:: Findings in Research about Cancer Care