Non-pharmacologic integrative medicine approaches such as aromatherapy and reflexology can dramatically reduce the pain and anxiety associated with cervical radiation therapy, according to a clinical study currently underway at The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James).
In an interview with Oncology Nursing News®, Lisa Blackburn, MS, APRN, clinical oncology nurse specialist at The OSUCCC—James and principal investigator of the study, discussed the study and what its results mean, and how nurses can implement them in their practice.
Because standard radiation treatment can damage healthy tissue, brachytherapy is an alternative that uses an implanted device to focus the radiation as close to the tumor as possible and spare normal tissue. However, this treatment comes with a downside, particularly in cervical cancer, Blackburn said.
In fact, previous studies have shown that up to 40% of women experienced such significant anxiety and pain because of cervical radiation therapy that they developed post-traumatic stress disorder.
To see if aromatherapy and reflexology could mitigate this anxiety, Blackburn and her team randomly assigned 50 women undergoing brachytherapy to one of 2 groups: a control group and an experimental group that received aromatherapy with 3 essential oils to choose from (peppermint, lavender, and lemon), in an adjustable fan diffuser, along with a 30-minute foot reflexology session during the downtime after the device was placed and before treatment.
Researchers first measured each patient’s baseline anxiety level on a scale of 0-10, then measured pain levels and re-checked anxiety levels at 5 times throughout the treatment when pain and anxiety were highest: upon arrival to the procedure area; at applicator placement; after placement and before treatment; during treatment; and finally during the applicator removal.
The researchers then averaged each patient’s score and factored in the amount of pain and anxiety medication they required throughout treatment. When comparing the control group to the experimental group, the researchers reported preliminary results that show a 60% reduction in reported pain, along with a 20% decrease in anxiety.
When asked why aromatherapy and reflexology are so effective in reducing these negative side effects, Blackburn says the answer is simple: “They relax people.”
“Whether you’re having symptoms or not, they [aromatherapy and reflexology] make you feel better, especially in these patients.”
In addition to avoiding another pill or procedure, these noninvasive tools also help to distract patients and give them a sense of control, said Blackburn.
“A lot of times with cancer patients, we virtually take all of their control away, especially when they’re in active treatment. And this is something that, as we’re doing it, we’re teaching it to them.”
While more research is needed on all integrative therapies, Blackburn is hopeful they can become a standard of care in a broader patient base. “I’ve been doing studies for a long time and it looks to me like they could absolutely be used in any patient with cancer.” she said.
To make this happen, Blackburn explains, education is key—especially for nurses.
At the OSUCCC—James, Blackburn explained how nurses are being taught to use and introduce these therapies to their patients with basic bedside resources called Comfort Kits, which contain items like aromatherapy bracelets and electric massagers that patients can take with them to continue these therapies at home.
While not all institutions offer resources like these, self-education on the basics of integrative therapies is just as important.
“You don’t have to be a Level 3 Reiki master to teach somebody how to use breathing techniques. We have to expand our toolkits and offer so much more to nurses to teach them how to be the best advocate they can be for their patients,” said Blackburn.
“I really think that, in the end, any patient that is offered an opioid for pain management should also be offered integrative therapies. If we’re giving them pharmacological interventions, we ought to give them the benefit of at least introducing them to the non-pharmacological options.”
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