2940 - Reflexology as an Integrative Approach to Improve Stress, Energy, and Pain in Women Receiving Radiotherapy for Breast Cancer

H. D. Zinkin¹, K. Kostroff², D. Dimisa², R. Hausen³, J. Christophers², D. McElligot⁴, M. Akerman⁵, and L. Potters⁶; ¹Department of Radiation Medicine, Northwell Health, Lake Success, NY, ²Northwell Health, Lake Success, NY, ³Department of Radiation Medicine, Northwell, Lake Success, NY, ⁴Northwell Health, Lake Sucess, NY, ⁵Biostatistics Unit, Office of Academic Affairs, Northwell Health, Lake Success, NY, ⁶Northwell, New Hyde Park, NY

Purpose/Objective(s): There are many standards of care which must be met for cancer program accreditation by the Commission on Cancer (CoC) and standard 5.2 mandates that programs implement a psychosocial distress screening process and report on its success and interventions. This standard can be challenging, and there is emerging data that integrative therapies can improve quality of life, treatment related toxicities and survival for cancer patients. We initiated this quality improvement study at a multi-office health system department and the pilot performed at one of our community facilities. Our hypothesis was that integrating reflexology with standard cancer therapy may improve energy and decrease stress and pain in patients undergoing radiotherapy for breast cancer. Materials/

Methods: A holistic nurse was present in the radiation oncology office once per week for a full workday for 21 months. All breast cancer patients undergoing radiotherapy were offered up to five private sessions with the nurse in an exam room which was transformed into a healing environment with dim lighting, flameless candles, and calming music. They received reflexology of their hands or feet for 15 minutes. Every patient completed a stress thermometer survey anonymously prior to and after each session. Descriptive statistics (mean ± standard deviation, median (25th, 75th percentiles), minimum and maximum values) were calculated for the pre-survey, post-survey, and difference in pre/post survey responses. The Wilcoxon signed rank test, the non-parametric counterpart to the paired t-test, was used to assess the overall difference in responses.
Results: For this interventional pre-post study, we tabulated 560 patient encounters from April 2022 through December 2023. Stress reduced by 40.0%, pain decreased by 24.0%, energy increased by 33.3 % and overall feeling of well-being improved by 33.3% (Wilcoxon signed rank test, p < 0.0001 for all measures). Many patients also reported improvement in chemotherapy induced neuropathic pain. The service was so well received by patients that the funding has been renewed.
Conclusion: This is one of the largest studies exploring the benefits of reflexology in an active radiation oncology practice which demonstrated statistically significant improvements in stress, pain, energy, and overall feeling of well-being in women undergoing radiotherapy for breast cancer. As a result, this program has been expanded to other radiation oncology sites across the health system. It is imperative that providers are educated, supportive, and continue to advocate for integrative therapies. With rising health care costs and expensive pharmaceuticals and technologies, empowering patients with lifestyle changes and culturally sensitive integrative care may improve patient satisfaction, treatment related adverse effects and survival.