Several alternative medical therapies — especially bodywork and Chinese acupressure and acupuncture — are associated with a significant reduction in pain and anxiety among cancer patients, according to a study conducted by a team of Allina Health researchers at Abbott Northwestern Hospital in Minneapolis.
The study found that cancer patients who received an alternative therapy along with traditional treatment (a so-called integrative approach to medicine) reported, on average, a 47 percent drop in their levels of pain and a 56 percent drop in their levels of anxiety immediately after receiving the alternative therapy.
The findings suggest, say the Allina researchers, that alternative therapies may have a role to play in reducing the use of powerful and potentially addictive opioid medications for the treatment of cancer pain.
“We think they work together, synergistically and physiologically,” said Jeffrey Dusek, the research director for the Penny George Institute for Health and Healing, which is located within Abbott, in a phone interview earlier this week. “That’s our goal: to maximize the benefit for patients and to decrease any risk from other therapies that are used to reduce pain and anxiety.”
The study was published Tuesday in the Journal of the National Cancer Institute (JNCI) Monographs.
Self-reported questionnaires
For the study, Dusek and his colleagues analyzed data collected from more than 1,800 cancer patients who had received an alternative therapy along with standard therapy at least once while hospitalized at Abbott between July 1, 2009 and December 31, 2012. The patients had a variety of cancers, including lymphoma and cancer of the breast, prostate, lung, bronchus and trachea.
The alternative therapies used in the study included bodywork (head massage, body massage and reflexology), mind-body and energy therapies (meditation and guided imagery) and traditional Chinese medicine (acupressure, acupuncture and Korean hand therapy). These services were offered at no charge to the patients, as they are to all hospitalized cancer patients at Abbott, said Dusek.
Immediately before and after each alternative therapy session, the patients filled out questionnaires in which they rated both their pain and anxiety levels on a 10-point scale, with 0 being “no pain (or anxiety)” and 10 being “worst pain (or anxiety) imaginable.”
Key findings
The study found, as already noted, that patients’ pain levels dropped an average of 46.9 percent and their anxiety levels dropped an average of 56.1 percent after the alternative therapy sessions. Patients with lung, bronchus and trachea cancer reported the biggest decline in pain, while patients with prostate cancer reported the biggest decline in anxiety.
For reducing pain, therapeutic body massage, reflexology, acupressure and acupuncture were most effective. For reducing anxiety, no significant difference was found among the therapies.
The data also revealed that women and younger patients were most likely to receive the therapies, and that body massage was the one most commonly chosen.
“These findings are really important as we start moving into a patient-centered realm of how medical care is provided,” said Dusek. “We’re trying to do the best for patients clinically with all the best that Western medicine can provide, but the psychosocial and emotional parts of the patients are also important.”
“We’re thrilled that these are low-toxic, low-risk and relatively low-cost solutions to managing pain and anxiety in an acute care setting, which is very challenging,” he added.
Caveats
This is an observational study, which means it can’t prove that the alternative therapies themselves are what caused the observed drop in pain and anxiety. Other factors, not yet identified, may explain the study’s findings.
One of those factors could be a bias in the selection of patients who took part in the study. Dusek points out, however, that he and his colleagues carefully examined the data for selection bias. “If there was a bias in the people who were referred for [alternative] services and those who were not, we could not find it,” he said.
Of course, the findings may also be yet another example of the placebo effect, which has been demonstrated in numerous studies to reduce pain (and other symptoms) associated with a variety of illnesses. Dusek acknowledges that the placebo effect may have played a part in his study’s results, but he also points out that the alternative therapies resulted in an average drop of 1.8 to 2.0 points on the 10-point pain scale — similar to the 2.0 drop that cancer patients report after receiving an opioid medication.
“So if we have to worry about the placebo effect, then the pharmaceutical companies also have to worry about it,” he said.
“We’re not proselytizing,” he added. “Our goal is to find out which therapies, which patients, which time line is the best way to augment the great work the rest of our team — the Western medicine folks — are doing every day.”
The researchers will next be investigating how long the alternative therapies reduce pain and anxiety. The research is being funded by a grant from the National Institutes of Health.
You can read the study in full on the JNCI Monographs website.
