Acupuncture versus reflexology for cancer-related pain in palliative care: a pragmatic study.

CONTEXT AND

OBJECTIVE

Integrative oncology (IO) provides evidence-based therapies addressing symptoms and wellbeing. We compared acupuncture to reflexology for pain and wellbeing among oncology patients.

METHODS

This comparative effectiveness observational study examined patients undergoing 8 weekly IO treatments with either acupuncture or reflexology, based on patient preference. Symptoms and wellbeing were assessed using the Measure Yourself Concerns and Wellbeing (MYCAW); Edmonton Symptom Assessment Scale (ESAS); and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).

RESULTS

Of 136 treated patients, 45 (33.1%) chose acupuncture and 91 (66.9%) reflexology. Most were female (111;81.0%), aged 59.7±14.3 years, and Jewish (125; 91.9%). A third had metastatic cancer (45; 34.4%), most undergoing adjuvant treatment (63; 48.1%). Metastatic disease was more prevalent in reflexology-treated patients (OR=2.86; p=0.018; 95%CI=1.20-6.84). Both treatments were associated with within-group improvement on ESAS fatigue, appetite; Total ESAS; and EORTC fatigue, pain and physical, emotional and social function. Only acupuncture was associated with within-group improvement on ESAS pain; and only reflexology on ESAS wellbeing and EORTC Global Health/QoL, nausea/vomiting and insomnia. Reflexology showed a between-group advantage for appetite and cognitive function.

CONCLUSIONS

Both acupuncture and reflexology were associated with reduced within-group EORTC pain and ESAS and EORTC fatigue and appetite, physical, emotional and social function; only acupuncture with reduction of ESAS pain; and only reflexology improved wellbeing, somnolence and insomnia, with a between-group advantage for EORTC appetite and cognitive function. Further research is needed to confirm the findings within larger and more diverse patient populations.