For some cancer patients, those who are treated with brachytherapy, the pain and anxiety that accompanies treatment can be significant. Brachytherapy is used to treat cancers that occur deep within the body, such as cervical…
For some cancer patients, those who are treated with brachytherapy, the pain and anxiety that accompanies treatment can be significant. Brachytherapy is used to treat cancers that occur deep within the body, such as cervical or prostate cancer. For this treatment, the radiation source is positioned very close to the tumor itself in order to maximize the radiation dose to the cancer while decreasing exposure to normal body tissues.
Though we knew this treatment could be painful and invasive, at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, my colleagues and I noticed another concerning trend. While receiving ongoing treatments of brachytherapy, pain and anxiety seemed to sometimes get worse with each treatment. In order to address this, we found that integrative therapies, particularly aromatherapy and reflexology, could provide significant support.
Though many people are familiar with the use of aromatherapy in the home setting, it can also be a tool to help with symptom management in health care settings. Aromatherapy in this setting uses therapeutic-grade essential oils through inhalation to affect patient symptoms. When we breathe in a scent through the nose, it is carried directly to the olfactory bulb in the brain. This, in addition to previous experiences with a particular scent, can cause positive or negative associations, thereby affecting emotions and symptoms. In the case of aromatherapy, our previous studies have shown it to decrease symptoms such as nausea, depression and insomnia in cancer patients.
Reflexology is the use of touch and pressure — to specific areas on the foot in our study — to relax the patient and reduce symptoms. An experienced reflexologist can target areas to treat with specific thumb, finger and hand techniques. In our study, we combined aromatherapy and foot reflexology to maximize patient benefits because previous studies and evidence-based literature indicated that these integrative therapies could contribute to a reduction in both pain and anxiety.
Most of us are familiar with the zero to 10 pain assessment scale, with zero being no pain and 10 being the worst possible pain you can imagine. In our study, patients who did not receive integrative therapies reported their average pain rating at about five on the zero to 10 scale, while patients receiving aromatherapy and reflexology reported their average pain rating at a two. We know from years of experience treating patients in pain that a reduction in average pain rating of two to three points is clinically significant for the patient.
Being able to offer patients different evidence-based integrative therapies in this day and age is critical, especially in the midst of the opioid crisis. While opioids are necessary in many cases to treat pain, having an option other than medication is important also. Integrative therapies can actually synergize the effect of the medications, making them more effective and with virtually no side effects for most people. In this study, for example, brachytherapy patients who were given aromatherapy and reflexology required 40 percent less medication for their pain and anxiety than those who did not have this option. A win-win for health care practitioners and patients alike, integrative therapies in this instance helped patients have less pain and anxiety with less medication requirements and the associated side effects.
As we find new and improved treatments, some of which may even cure patients of their cancer, it is crucial that we also help them get through these treatments optimally. One way to do so is to involve nurses — familiar with and trained in integrative approaches — to assist patients with symptom management and improve their overall treatment experience. These therapies are important tools to have in our toolbox of strategies for any patient in pain.