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ARTICLE PREVIEW

 * Abstract
 * Introduction
 * Section snippets
 * References (25)
 * Cited by (5)
 * Recommended articles (6)


COMPLEMENTARY THERAPIES IN MEDICINE

Volume 23, Issue 4, August 2015, Pages 612-616




A CASE-CONTROL, MONO-CENTER, OPEN-LABEL, PILOT STUDY TO EVALUATE THE FEASIBILITY
OF THERAPEUTIC TOUCH IN PREVENTING RADIATION DERMATITIS IN WOMEN WITH BREAST
CANCER RECEIVING ADJUVANT RADIATION THERAPY

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panelJawaidYounusaPersonEnvelopeMichaelLockbOlgaVujovicbEdwardYubJitkaMaleccDavidD'SouzacLarryStittd
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https://doi.org/10.1016/j.ctim.2014.11.003Get rights and content




SUMMARY


BACKGROUND

Therapeutic touch (TT) is a non-invasive commonly used complementary therapy. TT
is based on the use of hand movements and detection of energy field congestion
to correct imbalances. Improvement in subjective symptoms in a variety of
clinical trials has been seen with TT. The effect of TT during radiotherapy for
breast cancer is unknown.


METHODS

Women undergoing adjuvant radiation for Stage I/II breast cancer post
conservative surgery were recruited for this cohort study. TT treatments were
administered three times per week following radiation therapy. Feasibility was
defined as an a priori threshold of 15 of 17 patients completing all TT
treatments. The preventive effectiveness of TT was evaluated by documenting the
‘time to develop’ and the ‘worst grade of radiation’ dermatitis. Toxicity was
assessed using NCIC CTC V3 dermatitis scale. Cosmetic rating was performed using
the EORTC Breast Cosmetic Rating. The quality of life, mood and energy, and
fatigue were assessed by EORTC QLQ C30, POMS, and BFI, respectively. The
parameters were assessed at baseline, and serially during treatment.


RESULTS

A total of 49 patients entered the study (17 in the TT Cohort and 32 in the
Control Cohort). Median age in TT arm was 63 years and in control arm was 59
years. TT was considered feasible as all 17 patients screened completed TT
treatment. There were no side effects observed with the TT treatments. In the TT
Cohort, the worst grade of radiation dermatitis was grade II in nine patients
(53%). Median time to develop the worst grade was 22 days. In the Control
Cohort, the worst grade of radiation dermatitis was grade III in 1 patient.
However, the most common toxicity grade was II in 15 patients (47%). Three
patients did not develop any dermatitis. Median time to develop the worst grade
in the control group was 31 days. There was no difference between cohorts for
the overall EORTC cosmetic score and there was no significant difference in
before and after study levels in quality of life, mood and fatigue.


CONCLUSION

This study is the first evaluation of TT in patients with breast cancer using
objective measures. Although TT is feasible for the management of radiation
induced dermatitis, we were not able to detect a significant benefit of TT on
NCIC toxicity grade or time to develop the worst grade for radiation dermatitis.
In addition, TT did not improve quality of life, mood, fatigue and overall
cosmetic outcome.


INTRODUCTION

Therapeutic Touch (TT) is the current term used for an ancient practice called
the “laying of hands” commonly used in a variety of settings. However, this is a
misnomer since the intervention does not necessarily require any direct patient
touching. It is based on a belief that every living organism has an energy field
around it that produces an aura. This energy field can go unbalanced when the
living organism is sick and healers can feel and manipulate this energy field by
movement of hands over the patient's body just like massaging the air few inches
above the patient's body. This process usually lasts 10–20 min depending on the
practitioner's ability to detect these imbalances and the amount of areas with
energy congestion.1 This primal life energy imbalance can be corrected according
to TT practitioners. Furthermore, this channeling of vital energy can assist
healing; a concept common in Ayurvedic medicine and healing systems found in
India, China, Japan, and Greece where it is called prana, chi, ki, or pneuma,
respectively.1, 2

According to the Cochcrane Collaboration, TT was first popularized by Dr.
Krieger, a research nursing professor at New York University. A literature
search using the MESH heading ‘therapeutic touch’ identifies 847 articles with
178 published within the last 5 years.3 TT at present is taught in 75 schools
and universities and at 95 health care facilities in North America.4 Training is
available in over 70 countries through institutions such as The American Nurses
Association.4

There are no known side effects related to the use of TT. Most of the previous
trials on TT have demonstrated subjective symptom improvement in a variety of
clinical situations, including anxiety, pain and other related symptoms. The
rationale for this study stemmed from clinical trials, which demonstrated
improvement in wound healing with TT.2, 5

Relative to many alternative therapies, the demonstration of a quantifiable
objective response is an interesting and impressive aspect of TT that calls for
further investigation. Radiation induced dermatitis is a common problem in a
significant proportion of patients treated with radiation. In addition, it is a
quantifiable complication, easily observed and graded according to National
Cancer Institute criteria for toxicity. Therefore, we opted to investigate TT to
assess its ability to prevent radiation dermatitis associated with adjuvant
radiation therapy for early breast cancer.


SECTION SNIPPETS


PATIENT SELECTION

A single institution, ethics review board approved, prospective case-cohort
study was conducted in patients with histo-pathologically or cytologically
confirmed diagnosis of breast cancer, scheduled to receive adjuvant tangent
radiation therapy as outpatients at the London Regional Cancer Program, London,
Ontario. Female patients between 18 and 80 years of age at the time of
enrollment and who had completed lumpectomy and sentinel lymph node biopsy or
axillary lymph node dissection were


RESULTS

From a total of 49 patients, the TT group comprised of 17 patients with the
median age of 63 years, while 32 patients were included in the control group
with median age of 59 years. All patients in both groups had lumpectomy. The
details on tumor size, lymph node evaluation, hormone receptor and Her-2Neu
status are summarized in Table 1. The Eastern Cooperative Oncology Group (ECOG)
performance status was 0–1 in all the patients.

Our primary objective was feasibility of introducing this


DISCUSSION

Therapeutic touch was brought to mainstream medical attention by Dolores
Krieger, Ph.D., R.N., a faculty member at New York University's Division of
Nursing, who began TT in the early 1970s. Soon afterwards TT was learned and
used by nurses as an adjunct to patient care. Interestingly, the first phase of
research began in the 1960s with studies examining the effects of TT on plant
growth and wound healing in mice.21 However in the 1970s Dora Kunz and Dolores
Krieger were among the first to use


CONCLUSIONS

This study is the first evaluation of TT in patients with breast cancer using
objective measures. Introduction of this alternative therapy into a
comprehensive cancer clinic was feasible and acceptable. While there were no
side effects observed, we were not able to detect a significant benefit of TT on
NCIC toxicity grade or time to develop radiation dermatitis. In addition, TT did
not improve quality of life, overall mood, fatigue and overall cosmetic outcome.


CONFLICT OF INTEREST

This is to certify that all authors have seen and approved the manuscript
submitted and have no conflicts of interest.




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Navigate DownView more references


CITED BY (5)


 * EFFECT OF THERAPEUTIC TOUCH ON SLEEP QUALITY AND ANXIETY IN INDIVIDUALS WITH
   CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED CONTROLLED TRIAL
   
   2021, Complementary Therapies in Clinical Practice
   Show abstractNavigate Down
   
   The purpose is to determine the effect of therapeutic touch (TT) on the sleep
   quality and anxiety of individuals with chronic obstructive pulmonary (COPD)
   disease.
   
   103 patients were randomized in to the two groups: the experimental group,
   and the control group. In this randomized control study, the patients with
   COPD in the experimental group were given TT for 10 min between 18:00 and
   20:00, one session every day for three consecutive days.
   
   When the experimental group was compared to control group following the
   intervention, the decrease in the levels of anxiety (p < 0.001) and increase
   in the sleep quality (p < 0.001) were found to be significant.
   
   As a result of the study, it was determined that TT reduced anxiety level and
   improved sleep quality in individuals with chronic obstructive pulmonary
   disease. The Clinical Trial Registration Number: NCT04842903.


 * EFFECT OF THERAPEUTIC TOUCH ON DAYTIME SLEEPINESS, STRESS AND FATIGUE AMONG
   STUDENTS OF NURSING AND MIDWIFERY: A RANDOMIZED SHAM-CONTROLLED TRIAL
   
   2021, Complementary Therapies in Clinical Practice
   Show abstractNavigate Down
   
   This study was conducted to assess the effect of therapeutic touch on stress,
   daytime sleepiness, sleep quality and fatigue among students of nursing and
   midwifery.
   
   96 students were randomized into three groups: the therapeutic touch (TT)
   group, the sham therapeutic touch (STT) group, and the control group. In this
   randomized sham-controlled study, the TT group was subjected to therapeutic
   touch twice a week for four weeks with each session lasting 20 min.
   
   When the TT group was compared to the STT and control groups following the
   intervention, the decrease in the levels of stress (p < 0.001), fatigue
   (p < 0.001) and daytime sleepiness (p < 0.001), and the increase in the sleep
   quality (p < 0.001) were found to be significant.
   
   It was found that TT, which is one form of complementary therapy, was
   relatively effective in decreasing the levels of stress, fatigue and daytime
   sleepiness, and in increasing the sleep quality of university students of
   nursing and midwifery.


 * A RAPID EVIDENCE ASSESSMENT OF RECENT THERAPEUTIC TOUCH RESEARCH
   
   2021, Nursing Open
   
   


 * WHAT INFLUENCE DOES THE THERAPEUTIC TOUCH HAVE ON BREAST CANCER?
   
   2021, Medicina Interna de Mexico
   
   


 * PREDICTORS AND QUALITY OF LIFE IN PATIENTS WITH RADIODERMATITIS: A
   LONGITUDINAL STUDY
   
   2021, ACTA Paulista de Enfermagem
   
   


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