Symptom response analysis of a randomized controlled trial of reflexology for symptom management among women with advanced breast cancer

Support Care Cancer. 2020 Mar;28(3):1395-1404. doi: 10.1007/s00520-019-04959-y. Epub 2019 Jul 2.


Purpose: To examine symptom responses resulting from a home-based reflexology intervention delivered by a friend/family caregivers to women with advanced breast cancer undergoing chemotherapy, targeted, and/or hormonal therapy.

Methods: Patient-caregiver dyads (N = 256) were randomized to 4 weekly reflexology sessions or attention control. Caregivers in the intervention group were trained by a reflexology practitioner in a 30-min protocol. During the 4 weeks, both groups completed telephone symptom assessments using the M. D. Anderson Symptom Inventory. Those who completed at least one weekly call were included in this secondary analysis (N = 209). Each symptom was categorized as mild, moderate, or severe using established interference-based cut-points. Symptom response meant an improvement by at least one category or remaining mild. Symptom responses were treated as multiple events within patients and analyzed using generalized estimating equations technique.

Results: Reflexology was more successful than attention control in producing responses for pain (OR = 1.84, 95% CI (1.05, 3.23), p = 0.03), with no significant differences for other symptoms. In the reflexology group, greater probability of response across all symptoms was associated with lower number of comorbid condition and lower depressive symptomatology at baseline. Compared to odds of responses on pain (chosen as a referent symptom), greater odds of symptom response were found for disturbed sleep and difficulty remembering with older aged participants.

Conclusions: Home-based caregiver-delivered reflexology was helpful in decreasing patient-reported pain. Age, comorbid conditions, and depression are potentially important tailoring factors for future research and can be used to identify patients who may benefit from reflexology.

Trial registration: Identifier: NCT01582971.

Keywords: Breast cancer; Reflexology; Symptom management; Symptom response.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Caregivers
  • Depression / therapy
  • Female
  • Humans
  • Massage / methods*
  • Middle Aged
  • Musculoskeletal Manipulations / methods
  • Pain
  • Pain Management / methods*
  • Palliative Care / methods*

Associated data