Updated: Mar 19
In a randomized controlled trial to evaluate the effects of reflexology on quality of life in women with early breast cancer, 183 women were divided into three groups, at 6 weeks post-breast surgery. The women in the reflexology group received one reflexology session per week, for eight weeks. Results were tracked at 18 weeks and again at 24 weeks post-surgery. At 24 weeks - a full 10 weeks after reflexology treatments had finished - women who had received the reflexology treatments had better outcomes on the Trial Outcome Index (TOI) of the Functional Assessment of Cancer Therapy, breast cancer version (FACT-B), and also had better outcomes for relaxation as measured by the Mood Rating Scale (MRS). (1)
That reflexology leads to a better sense of relaxation is no surprise, but how is quality of life measured? To get a better idea, here are the categories of the FACT-B questionnaire that the women reported on. The first category measures four domains of well-being: physical, social/family, emotional, and functional; the second category is a specific domain for breast cancer, with questions about the breast cancer itself, and questions about related arm health. The conclusions of the study support that both reflexology and massage have statistically significant effects - and, for reflexology specifically, "clinically worthwhile" effects - on quality of life following surgery for early breast carcinoma.
In other words, reflexology was deemed to have outcomes that are meaningful and useful, with positive effects big enough to make the therapy worthwhile for breast cancer patients.
But can reflexology help with late stage breast cancer care? Lets look to this longitudinal, randomized clinical trial: "Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer." In thirteen community-based medical oncology clinics across the Midwestern United States, 385 predominantly Caucasian women with advanced-stage breast cancer receiving chemotherapy and/or hormonal therapy were divided into three groups: the reflexology group, and two control groups - foot massage, and conventional care. Four consecutive weeks of 30-minute reflexology (deep thumb–walking pressure to the nine essential breast cancer–specific reflexes*) or foot massage compared to conventional care alone was examined for the outcomes of breast cancer–quality of life, physical functioning and symptoms, using baseline interviews and post-intervention interviews at weeks 5 and 11. (2)
Findings revealed no adverse events, with significant improvements in physical functioning for the reflexology group, related to reduction in severity of dyspnea (labored breathing), thus concluding that reflexology may be added to existing evidence-based supportive care to improve quality of life for patients with advanced-stage breast cancer during chemotherapy and/or hormonal therapy. The implications for nursing is that "reflexology can be recommended for safety and usefulness in relieving dyspnea and enhancing functional status among women with advanced-stage breast cancer (3)."
Similarly, in a medical/oncology unit in a hospital in the southeastern United States, reflexology was given to twenty-three inpatients with breast or lung cancer to determine its effect on pain and anxiety. The foot reflexology protocol was to work both feet for 30 minutes total by a certified reflexologist, as compared to a control condition for each patient (with at least a two-day break). No changes were made in patients' regular schedule or medications. Following reflexology, all patients reported a significant decrease in anxiety, and patients with breast cancer reported a significant decrease in pain. This quasi-experiment thus concluded that - since professionals and lay people can be taught reflexology, it can be performed anywhere, it requires no special equipment, it is noninvasive, and it does not interfere with patients' privacy - positive implications for nursing care exist. (4)
The Reflexology Protocol
* The reflexology protocol for breast cancer stimulated reflexes corresponding to associated concerns and symptoms, as presented by patients in treatment: nervous system, lung and diaphragm, breast or chest, kidney and adrenal, spleen, and intestinal area. (5)
1. European Journal of Cancer. 2010 Jan;46(2):312-22.
2, 3. Oncology Nursing Forum. 2012 Nov;39(6):568-77.
4. Oncology Nursing Forum. 2000 Jan-Feb;27(1):67-72.
5. Oncology Nursing Forum. 2012 Nov;39(6):568-77.
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