Bioenergy therapies as a complementary treatment: a systematic review to evaluate the efficacy of bioenergy therapies in relieving treatment toxicities in patients with cancer

PURPOSE

Bioenergy therapies are among the popular alternative treatment options for many diseases, including cancer. Many studies deal with the advantages and disadvantages of bioenergy therapies as an addition to established treatments such as chemotherapy, surgery, and radiation in the treatment of cancer. However, a systematic overview of this evidence is thus far lacking. For this reason, the available evidence should be reviewed and critically examined to determine what benefits the treatments have for patients.

METHODS

In June 2022, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning the use, effectiveness and potential harm of bioenergy therapies including Reiki, Therapeutic Touch, Healing Touch and Polarity Therapy on cancer patients.

RESULTS

From all 2477 search results, 21 publications with 1375 patients were included in this systematic review. The patients treated with bioenergy therapies were mainly diagnosed with breast cancer. The main outcomes measured were anxiety, depression, mood, fatigue, quality of life (QoL), comfort, well-being, neurotoxicity, pain, and nausea. The studies were predominantly of moderate quality and for the most part found no effect. In terms of QoL, pain and nausea, there were improved short-term effects of the interventions, but no long-term differences were detectable. The risk of side effects from bioenergy therapies appears to be relatively small.

CONCLUSION

Considering the methodical limitations of the included studies, studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.

"Is the Pain a Sign of Healing?": Cancer Patients' Experiences of Energy Healing in a Pragmatic Trial

The use of complementary and alternative medicine has increased, most markedly among cancer patients. Previous research on energy healing is inconclusive, but qualitative studies have mainly reported positive healing experiences, whereas positive results from trials are scarce. Considering the apparent discrepancy between qualitative and quantitative studies, we aimed to describe the interpretation processes of the patients receiving energy healing. We followed the interpretation processes of a subsection of cancer patients who participated in a pragmatic trial on energy healing, including patients in the control groups. No significant differences between the groups were found in the quantitative part of the trial, but the majority of patients in both the intervention and control groups reported subjective improvements. A subset of 32 patients from the trial was selected for this qualitative sub-study to gain insight into their interpretation processes. These 32 patients recruited from the trial were followed with qualitative interviews before, during, and after the treatment period, using a cultural-phenomenological approach. Most patients who received energy healing changed their perception of bodily experiences, and they perceived a wider variety of signs as indicative of healing than the patients in the control groups. After receiving energy healing, the patients also perceived signs that from a medical perspective are regarded as symptoms, as signs of healing. The changes in perception of illness and healing affected decision-making dynamics and should be considered when producing information and communication strategies for health promotion.

Pain Improvement After Healing Touch and Massage in Breast Cancer: an Observational Retrospective Study

BACKGROUND

Healing Touch (HT) and Oncology Massage (OM) are nonpharmacologic pain interventions, yet a comparative effectiveness study has not been conducted for pain in breast cancer.

PURPOSE

This breast cancer subgroup analysis compared the effectiveness of HT vs. OM on pain.

SETTING

The research occurred at an outpatient setting at an academic hybrid, multi-site, community-based cancer institute and Department of Supportive Oncology across four regional locations.

PARTICIPANTS

Breast cancer outpatients along the cancer continuum who experienced routine clinical, nonexperimentally manipulated HT or OM.

RESEARCH DESIGN

The study was an observational, retrospective, comparative effectiveness post hoc subanalysis of a larger dataset. Patients reporting pain < 2 were excluded. Pre- and posttherapy pain scores and differences were calculated. Logistic regression modeled posttherapy pain by modality, adjusting for pretherapy pain. The proportions experiencing ≥ 2-point (clinically significant) pain reduction were compared with chi-square tests.

INTERVENTION

The study focused on the first session of either HT or OM.

MAIN OUTCOME MEASURES

Pre- and posttherapy pain (range: 0 = no pain to 10 = worst possible pain).

RESULTS

A total of 407 patients reported pre- and posttherapy pain scores, comprised of 233 (57.3%) who received HT and 174 (42.8%) who received OM. Pretherapy mean pain was higher in HT (M=5.1, ± 2.3) than OM (M=4.3, ± 2.1) (p < .001); posttherapy mean pain remained higher in HT (M=2.7, ± 2.2) than OM (M=1.9, ± 1.7) (p < .001). Mean difference in pain reduction was 2.4 for both HT and OM. Both HT (p < .001) and OM (p < .001) were associated with reduced pain. Proportions of clinically significant pain reduction were similar (65.7% HT and 69.0% OM, p = .483). Modality was not associated with pain improvement (p = .072).

CONCLUSIONS

Both HT and OM were associated with clinically significant pain improvement. Future research should explore attitudes toward the modalities and potential influence of cancer stage and treatment status on modality self-selection.

Bioenergy and Breast Cancer: A Report on Tumor Growth and Metastasis

As many as 80% of the 296,000 women and 2,240 men diagnosed with breast cancer in the United States will seek out complementary and alternative medicine (CAM) treatments. One such therapy is Healing Touch (HT), recognized by the National Center for Complementary and Integrative Health (NCCIH) as a treatment modality. Using a multiple experimental groups design, fifty-six six- to eight-week-old Balb/c mice were injected with 4T1 breast cancer tumor cells and randomly divided into intervention and positive control groups. Five days after tumor cell injection, mice in the intervention groups received HT either daily or every other day for 10 minutes by one HT practitioner. At 15 days after tumor cell injection, tumor size was measured, and metastasis was evaluated by a medical pathologist after necropsy. Tumor size did not differ significantly among the groups (F(3,52) = 0.75, p value = 0.53). The presence of metastasis did not differ across groups (chi-square(3) = 3.902, p = 0.272) or when compared within an organ (liver: chi-square(3) = 2.507, p = 0.474; lungs: chi-square(3) = 3.804, p = 0.283; spleen: chi-square(3) = 0.595, p = 0.898). However, these results did indicate a moderate, though insignificant, positive impact of HT and highlight the need for continued research into dose, length of treatment, and measurable outcomes (tumor size, metastasis) to provide evidence to suggest application for nursing care.

Decreased Cortisol and Pain in Breast Cancer: Biofield Therapy Potential

Breast cancer is one of the leading causes of cancer death among women of all races. Pain is a common symptom associated with cancer; 75–90% of cancer patients experience pain during their illness and up to 50% of that pain is undertreated. Unrelieved pain leads to increased levels of the stress hormone cortisol. The purpose of this study was to examine the impact of bioenergy on fecal cortisol levels for mice injected with murine mammary carcinoma 4T1 in two separate pilot studies. Using a multiple experimental group design, six to eight week old female BALB/c mice were injected with tumor and randomly assigned, in groups of 10, to daily treatment, every other day treatment, and no treatment groups. Five days after tumor cell injection, bioenergy interventions were begun for a period of ten consecutive days. Fecal samples were collected for each study and ELISA analysis was conducted at the end of both studies. For both studies, cortisol levels were decreased in the every other day treatment groups but remained high in the no treatment groups. Future studies utilizing bioenergy therapies on cortisol levels in a murine breast cancer model can begin to describe pain outcomes and therapeutic dose.

Feasibility of energy medicine in a community teaching hospital: an exploratory case series

BACKGROUND

Energy medicine (EM) derives from the theory that a subtle biologic energy can be influenced for therapeutic effect. EM practitioners may be trained within a specific tradition or work solo. Few studies have investigated the feasibility of solo-practitioner EM in hospitals.

OBJECTIVE

This study investigated the feasibility of EM as provided by a solo practitioner in inpatient and emergent settings.

DESIGN

Feasibility study, including a prospective case series.

SETTINGS

Inpatient units and emergency department.

OUTCOME MEASURES

To investigate the feasibility of EM, acceptability, demand, implementation, and practicality were assessed. Short-term clinical changes were documented by treating physicians.

PARTICIPANTS

Patients, employees, and family members were enrolled in the study only if study physicians expected no or slow improvement in specific symptoms. Those with secondary gains or who could not communicate perception of symptom change were excluded.

RESULTS

EM was found to have acceptability and demand, and implementation was smooth because study procedures dovetailed with conventional clinical practice. Practicality was acceptable within the study but was low upon further application of EM because of cost of program administration. Twenty-four of 32 patients requested relief from pain. Of 50 reports of pain, 5 (10%) showed no improvement; 4 (8%), slight improvement; 3 (6%), moderate improvement; and 38 (76%), marked improvement. Twenty-one patients had issues other than pain. Of 29 non-pain-related problems, 3 (10%) showed no, 2 (7%) showed slight, 1 (4%) showed moderate, and 23 (79%) showed marked improvement. Changes during EM sessions were usually immediate.

CONCLUSIONS

This study successfully implemented EM provided by a solo practitioner in inpatient and emergent hospital settings and found that acceptability and demand justified its presence. Most patients experienced marked, immediate improvement of symptoms associated with their chief complaint. Substantial practicality issues must be addressed to implement EM clinically in a hospital, however.

The Effects of Reiki Therapy and Companionship on Quality of Life, Mood, and Symptom Distress During Chemotherapy

This pilot study examined the effects of Reiki therapy and companionship on improvements in quality of life, mood, and symptom distress during chemotherapy. Thirty-six breast cancer patients received usual care, Reiki, or a companion during chemotherapy. First, data were collected from patients receiving usual care. Second, patients were randomized to either receive Reiki or a companion during chemotherapy. Questionnaires assessing quality of life, mood, symptom distress, and Reiki acceptability were completed at baseline and chemotherapy sessions 1, 2, and 4. Reiki was rated relaxing with no side effects. Reiki and companion groups reported improvements in quality of life and mood that were greater than those seen in the usual care group. Interventions during chemotherapy, such as Reiki or companionship, are feasible, acceptable, and may reduce side effects.

Complementary and alternative medicine therapies as symptom management strategies for the late effects of breast cancer treatment

Advancements in breast cancer treatment continue to improve the likelihood of survival. The increase in survival has come at a cost, however; the late effects of breast cancer treatment have remained a constant reminder to women of what they have endured and require holistic nursing's attention. One area of nursing practice that might improve the condition of breast cancer survivors once their treatment has ended is complementary and alternative medicine (CAM) therapies. To provide guidance to nurses working with breast cancer survivors, a focused review of the literature exploring the symptomatology and prevalence of breast cancer's late effects as well as the use of CAM therapies to improve those effects is presented. Evidence suggests that CAM therapies have sometimes been incorporated into symptom management strategies currently employed; however, the evidential claims as a whole have been generally inconclusive, especially for complete resolution of the late effects. Regardless, a number of studies demonstrate a reduction of negative symptoms experienced with few to no side effects of CAM therapies.

Biofield Therapies for Symptom Management in Palliative and End-of-Life Care

Terminally ill patients experience negative symptoms at end of life (EOL) that hinder well-being and quality of life (QOL). Current intervention strategies are not always effective or feasible. A focused literature review to evaluate the use of biofield therapies (ie, Therapeutic Touch, Healing Touch, and Reiki) to manage the symptoms in EOL revealed no studies on the use these therapies, specifically in this population. Evidence from studies on relevant populations (patients with cancer, elderly patients, and patients experiencing chronic pain), which addressed the outcomes relevant to palliative and EOL care (EOLC; pain levels, changes in psychological symptoms, well-being, and QOL), supports the use of biofield therapies in relieving pain, improving QOL and well-being, and reducing psychological symptoms of stress. Further research to assess the use of biofield therapies in EOLC is clearly needed.