Researcher sees decrease in pain and anxiety among cancer patients who use reflexology

GREENVILLE, N.C. —   In a two-year study, an East Carolina University School of Nursing researcher saw significant decreases in pain and anxiety in cancer patients whose partners used reflexology or manual pressure applied to specific points on their feet.

The findings of Dr. Nancy L.N. Stephenson, associate professor in the school of nursing and principle investigator, were published in the January issue of Oncology Nursing Forum. Co-investigators include her colleagues in the nursing school, Dr. Melvin Swanson and Dr. Martha Engelke, as well as Dr. JoAnn Dalton at Emory University and Dr. Frances J. Keefe at Duke University. The study was funded for $279,000 by the National Cancer Institute of the National Institutes of Health.

Stephenson, a certified reflexologist, has applied for additional federal funding to continue her research into the effects of partner-delivered foot reflexology.

Eighty-six patients with different types of metastatic cancer and their partners were recruited from Pitt County Memorial Hospital, Carteret General Hospital, Lenoir Memorial Hospital and Craven Regional Medical Center to participate in the study which began in July 2003. The largest group, 23 percent, had lung cancer followed by breast, colorectal, head and neck and lymphoma. The mean age of patients was 58.3 years and 51 percent were female. The majority, 66 percent, had a high-school education or less. Of those, 58 percent were white, 40 percent were black and 1 percent was Filipino.

Patients were randomly placed in an experimental or control group. Partners in the experimental group were taught by Stephenson how to apply foot reflexology to the patient while in the hospital. A reflexology documentation form and protocol and a list of signs and symptoms of deep vein thrombosis were provided. Control group participants received usual care and a 30-minute reading session from their partner.

An immediate decrease in pain intensity and anxiety was seen in patients receiving reflexology. Relief was strongest for patients with moderate to severe levels of pain. Minimal changes were seen in the control group.

“We had positive responses particularly from spouses who felt like they were able to do something for the patient,” Stephenson said.

This is the fourth pilot study that Stephenson has conducted that demonstrated positive results. More research is needed to determine the duration of pain relief and whether repeated reflexology treatment would provide additional benefits, she said.

Reflexology is a complementary and alternative medicine therapy in which manual pressure is applied to specific points on the hand or feet thought to correspond with specific organs or parts of the body. It is one of several complementary and alternative medicine therapies seeing increased use in recent years. An exact number is unknown, but an estimated 90 percent of cancer patients use some form of alternative therapy such as massage or music therapy, biofeedback, yoga or acupuncture, which advocates say addresses the mind, body and spirit without side effects found with some medications or procedures. More than 1 million new cancer cases will be diagnosed this year, according to the American Cancer Society.

Graduate research assistants Lucinda McMillan, Carrie Young and Bobbie Perkins, who have since received their master’s degrees, worked with Stephenson on the project. Young and Perkins worked throughout the entire study, which ended in June 2005. “It was good to have that continuity,” Stephenson said.