Is reflexology safe during cancer treatment?
Source – June Reflexions 2022
Author – Peter Mackereth and Paula Maycock
Reflexions is the AoR members’ quarterly magazine, providing the latest reflexology insights. It is written by Reflexologists for Reflexologists. Our June 2022 Reflexions focused on The Immune System, and we are delighted to share one of the articles with you. If you would like to receive our magazine and become part of our reflexology community, click here to Join today
Peter Mackereth and Paula Maycock explore the role of reflexology for clients living with cancer
Our intention in writing this article is to examine some of the questions about providing reflexology to a person with cancer. First, we cannot state that reflexology is always safe for all people at all times. For example, if the patient has sepsis and is clinically unstable. Second, we refute claims that reflexology can diagnose, treat, or cure cancer – such views have no basis in science and are indefensible in a court of law. What we agree with is that ‘adapted’ reflexology, provided by skilled therapists, can help with wellbeing, and may ease symptoms. Indeed, there is a growing body of research/evaluation work that suggests that certain approaches to reflexology can help with lymphatic drainage, fatigue, chemotherapy-induced peripheral neuropathy, and other cancer-related concerns.
Patients during and beyond treatment may be immunocompromised, often exacerbated after a cycle of chemotherapy or during radiotherapy. Importantly, patients with metastatic disease can be on long-term chemotherapy and/or have palliative radiotherapy and even surgery. When running cancer care courses for reflexologists, past students have raised questions about safety issues or even see a ‘cancer’ diagnosis as an absolute contraindication. We would argue that with cancer awareness training and the application of adapted techniques, these concerns can be ameliorated. Importantly, the patient decides whether to proceed once any questions have been answered to their satisfaction.
For us, the science of psychoneuroimmunology (PNI), which seeks to examine the links between mind and body, may help those delivering reflexology to maximize its benefits. The Ph.D. work completed by Peter was based on the theory of PNI and sought to investigate the effects of reflexology compared to relaxation training for people living with multiple sclerosis (MS). Key measures were salivary cortisol, anxiety and depression questionnaires, and heart rate and blood pressure recordings. Over a series of six weekly reflexology treatments, these measures improved, with evidence from audiotapes to suggest that the therapeutic relationship provided a supportive space for disclosures of worry and concerns.
When someone is experiencing stress, adrenaline and/or noradrenaline are released depending on the emotional state and the action taken (see Box 1). Cortisol rises to protect the body (primarily an anti-inflammatory effect), this is meant to be temporary. For those who are overwhelmed by the situation, cortisol levels can become elevated over the longer term, which can, in turn, lead to lowered immunity, weight gain, insomnia, raised blood sugar, etc. For someone living diagnosed with cancer and experiencing challenging treatments there may be extended periods of high stress (e.g., following a recurrence of disease). If we believe that reflexology can provide respite and an enjoyable interlude, then it should follow that cortisol levels, along with other stress markers, such as anxiety levels, sleep disturbance, digestive problems, etc., have a potential to be reduced. When cortisol levels normalise, there is also potential for the immune system to recover, allowing the person to better respond physically and emotionally from health challenges such as a cycle of chemotherapy.
BOX 1 – MODEL PHYSIOLOGICAL REACTIONS TO STRESS
HenryJ P (1986) Neuroendocrine patterns of emotional response. In: Emotion: theory, research, and experiences. Academic Press, San Diego
What we know from PNI research is that raised cortisol levels can reduce immunity and increase vulnerability to infection. Providing relief of stress through therapeutic interventions, such as reflexology, can enable the body
to recharge and build resilience. There is also growing evidence that humour and enjoyable exercise can also reduce stress levels (e.g. mindfulness,
dance, Tai Chi, etc). The million-dollar question for reflexologists is: How
can we maximise wellbeing within our reflexology practice? For us, a starting point is to ensure our package of care seeks to always promote relaxation
and calm. Anything that undermines this approach does not have a place in the care of people who are immunocompromised.
Our engagement with patients must put them centre stage – seek always to do no harm. For example, we would not want to increase stress by providing a painful treatment –
there is no room for the “no gain without pain” view. Indeed, we must seek to facilitate the support of the immune system of the patient, which comprises of hormones (see Box 1), immunological cellular processes (e.g., the work of various white blood cells) and circulatory systems (e.g., lymphatic drainage system). If what we do promotes parasympathetic (relax and calm)
rather than sympathetic (fight or flight) responses, then we know it is of therapeutic value – so look for signs of relaxation in your clients: Are they drifting off? Are they
producing saliva (you may see occasional swallowing)? Are they wanting to yawn and stretch at the end of a treatment? Do you hear stomach gurgling? … are we
experiencing signs of relaxing too? – it helps us to cultivate our own calmness!
In conclusion, our article has sought to address some of the concerns about working with people affected by cancer, but we suggest remaining ever curious by asking: What do I need to put in place to avoid harm and maximise their wellbeing? Importantly, we encourage you to look after your own wellbeing, essential to your resilience in supporting others.
Finally, a patient with progressive disease recently said after receiving reflexology:
…it is like taking a holiday from my cancer…I feel so relaxed … like being pampered at a spa … pass the Prosecco … sorry I mean water [laughter].
