Respectful Insolence

Quackademic medicine involving reflexology

Reflexology is quackery. It’s based on magical thinking that views every major organ in the body as somehow mappable to specific points on the soles of the feet or the palms of the hands and posits that somehow massaging these areas can have therapeutic effects on the organs in question. Claims regularly made for reflexology include that it can “detoxify” the body, increase circulation, assist in weight loss, and improve the health of organs. Other conditions for which quacks claim reflexology is efficacious include earaches, anemia, bedwetting, bronchitis, convulsions in an infant, hemorrhoids, hiccups, deafness, hair loss, emphysema, prostate trouble, heart disease, overactive thyroid gland, kidney stones, liver trouble, rectal prolapse, undescended testicles, intestinal paralysis, cataracts, and hydrocephalus. It’s amazing what something that so many miraculous therapeutic effects can be attributed to what is basically a foot and/or hand massage. I mean, I like a foot massage as much as the next person, but I don’t labor under any delusions that by paying attention to specific parts of my foot a reflexologist is treating any condition.

That’s why I was disappointed when I saw a press release and news stories based on the press release floating around the Internet, morphing and making claims, as so many press releases for quackademic studies of various “alternative therapies” do. It was from a home state school, Michigan State University, and it touted reflexology as a “complementary therapy” in cancer patients. Given that I’m a cancer doctor, I really detest studies of this type. Even though its proponents try to call it “integrative medicine,” what it is doing is “integrating” quackery and pseudoscience into science-based medicine. As my good buddy Mark Crislip put it, “If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.” Make no mistake about it. Reflexology is the cow pie to medicine’s apple pie here, and “integrating” it into cancer care does not make cancer care better.

Of course, that’s not what MSU wants you to think:

A study led by a Michigan State University researcher offers the strongest evidence yet that reflexology – a type of specialized foot massage practiced since the age of pharaohs – can help cancer patients manage their symptoms and perform daily tasks.

Funded by the National Cancer Institute and published in the latest issue of Oncology Nursing Forum, it is the first large-scale, randomized study of reflexology as a complement to standard cancer treatment, according to lead author Gwen Wyatt, a professor in the College of Nursing.

“It’s always been assumed that it’s a nice comfort measure, but to this point we really have not, in a rigorous way, documented the benefits,” Wyatt said. “This is the first step toward moving a complementary therapy from fringe care to mainstream care.”

Reflexology is based on the idea that stimulating specific points on the feet can improve the functioning of corresponding organs, glands and other parts of the body.

What it should say is that reflexology is based on a prescientific idea of how the body works, complete with vitalistic references to “energy” flowing through the body between the feet and various organs. Particularly depressing, also, is that the NCI funded this nonsense. I mean, I’d expect dubious studies like this from the National Center for Complementary and Alternative Medicine (NCCAM), but not the NCI. On the other hand, the NCI does have the Office of Cancer Complementary and Alternative Medicine (OCCAM), which not only has the most unfortunate acronym ever but also a budget that is roughly equal to that of NCCAM. So, sadly, NCCAM is not the only government entity funding quackademic medicine. I wish it were, but it’s not.

I first learned that four years ago at the AACR meeting, when I visited the NCI booth on the convention floor because I knew there was going to be a representative from OCCAM there. My confidence in the scientific rigor of the entire OCCAM enterprise was not boosted by the conversation I had there. In brief, after a brief (and neutral) conversation about what OCCAM does, I gently challenged the OCCAM representative regarding alternative medicine by pointing out that there really isn’t that much evidence for much of it and asking him if he could point me in the right direction. In particular, I asked him why one would think that a mixture of herbal medicines would do better than pharmaceuticals. He then began to pontificate about “royal herbs” and couldn’t provide a good rationale why anyone should conclude that impure mixtures of compounds would be more effective or reliable than pharmaceuticals. When he started going on about “emperor” herbs, “minister” herbs, and “assistant” herbs, I couldn’t take it anymore and looked for an opportunity to politely excuse myself.

The fruits of this sort of magical thinking can be seen in studies like the one that inspired all these press releases. I located the actual grant that was used to fund this study. It’s entitled Home-based symptom management via reflexology for advanced cancer patients, and its principal investigator is Gwen Carolyn Wyatt, who is on the faculty of MSU College of Nursing. Even worse, it’s not just an exploratory R21 grant, but it’s a full-fledged RO! grant (5 R01 CA157459). Even more than that, it has a budget of over $500,000 per year, which, subtracting indirect costs, leaves a spendable budget for the PI of around $333,000. This is serious money, more than most R01s, probably because it’s being used to run a clinical trial, Home-Based Symptom Management Via Reflexology for Breast Cancer Patients that will running for at least three more years. The first paper that resulted from this study is the topic of the MSU press release, Health-Related Quality-of-Life Outcomes: A Reflexology Trial With Patients With Advanced-Stage Breast Cancer published in the Oncology Nursing Forum journal.

The study itself is no great shakes. It’s basically a three-arm randomized study of nearly 400 patients that does not appear to be blinded. (I have to go by the abstract, given that my university doesn’t carry this particular journal.) The three arms include (1) reflexology (N=95); (2) lay foot manipulation (LFM) in which a non-reflexologist gives what is basically a foot massage (N=95); and (3) conventional care control (N=96). Subjects were interviewed for breast cancer-specific quality of life measures and other metrics related to quality of life. Notice how the results are reported:

No adverse events were reported. A longitudinal comparison revealed significant improvements in physical functioning for the reflexology group compared to the control group (p = 0.04). Severity of dyspnea was reduced in the reflexology group compared to the control group (p < 0.01) and the LFM group (p = 0.02). No differences were found on breast cancer-specific HRQOL, depressive symptomatology, state anxiety, pain, and nausea.

Notice something? There’s no difference in all the primary measures that the investigators were planning to look at before the study, save one, dyspnea (shortness of breath). What this means, who knows? It stands out as being different from all the other resoundingly negative results. In fact, as this excellent editorial about this study from my alma mater’s newspaper points out, what has been left out of many reports of this study are these very important results. These included no significant differences in health-related quality of life, symptoms of depression or anxiety, pain or nausea relief. Moreover, just as we see with studies of acupuncture that include a sham acupuncture control, the group of women who received a regular foot massage showed a significant improvement in fatigue relief that wasn’t matched by the reflexology group. There’s no physiological reason why “sham reflexology” should result in improved fatigue relief, while “real” reflexology can reduce dyspnea. More likely, what we’re seeing is the sorts of random noise that we see in clinical trials. Moreover, these are all subjective results; I didn’t see any evidence that the researchers did objective lung function, which would be necessary to determine whether there really was a physiological effect, rather than dueling placebo effects between the “sham reflexology” and reflexology.

To be fair, it’s actually not true that these sorts of results weren’t mentioned, at least in the MSU press release:

They found that those in the reflexology group experienced significantly less shortness of breath, a common symptom in breast cancer patients. Perhaps as a result of their improved breathing, they also were better able to perform daily tasks such as climbing a flight of stairs, getting dressed or going grocery shopping.

Wyatt said she was surprised to find that reflexology’s effects appeared to be primarily physical, not psychological.

“We didn’t get the change we might have expected with the emotional symptoms like anxiety and depression,” she said. “The most significant changes were documented with the physical symptoms.”

Also unexpected was the reduced fatigue reported by those who received the “placebo” foot massage, particularly since the reflexology group did not show similarly significant improvement. Wyatt is now investigating whether a friend or family member can successfully deliver reflexology after being trained by certified reflexologists to perform the nine specific steps used in the study.

Reflexology did not appear to reduce pain or nausea, but Wyatt said that could be because the drugs for combating those symptoms are generally quite effective, so the women may not have reported them to begin with.

As they say, it’s not what’s mentioned and what isn’t mentioned. It’s the spin. Considerable verbiage (for a press release) is spent on describing the finding of less shortness of breath in the reflexology group, along with an explanation that claims that because of this less dyspnea subjects were able to do more. Again, what we’re looking at are all basically subjective symptoms. So there’s a lot of room for placebo effects, particularly given that the abstract mentions nothing about blinding, although it would be necessary for me to read the entire abstract to figure out if they really blinded at least the subjects. Normally if a study is double blind, it’s at least mentioned in the abstract because it’s a very important piece of information that speaks to the rigor of the trial; so I’d be shocked if this study were more than single blind. Even if this study is blinded, there’s also the issue of how good the blinding was and whether the patients guessed which group they were in. Methodological details like this are why in general I don’t like to blog about abstracts. I like to have the full paper in hand because without it I can sometimes be burned. However, before writing this I had appealed to everyone I knew for a copy of this article, and no one came through. The article annoyed me enough; so I took that risk.

My minor travails aside, when the investigators are forced to acknowledge that reflexology didn’t help pain or nausea, notice how they do a lot of handwaving to excuse this failure. Modern drugs are effective; so the women in the study didn’t have much of a problem with nausea and pain. If that’s the case, then why bother with reflexology? More likely, reflexology was, as basic science would predict, utterly useless for these indications. The authors just don’t want to admit it.

Yes, it’s your tax dollars at work, and there’s a fair amount of cash your government has still to spend on this study. But it’s all OK, because this is totally ancient, man! Wyatt tells us so:

Although health researchers only recently have begun studying reflexology in a scientifically rigorous way, it’s widely practiced in many parts of the world and dates back thousands of years.

“Reflexology comes out of the Chinese tradition and out of Egypt,” Wyatt said. “In fact, it’s shown in hieroglyphics. It’s been around for a very long time.”

If you look at the evidence that reflexology dates back to ancient Egypt, you will find it thin gruel indeed, a couple of hieroglyphics inscriptions and a passage written by Aulus Cornelius Celsus seem to be about it for historical evidence before 1913, when William H. Fitzgerald, M.D. and Dr. Edwin Bowers introduced it into the U.S.

As I said before, reflexology is quackery. There’s no good evidence that it’s of any use for any disease or condition. Wyatt’s study certainly doesn’t break that losing streak. None of this means that a foot massage might not be worthwhile. Certainly it can feel very good and help a person relax. Unfortunately, reflexologists have delusions of grandeur and think that they can use a foot massage to heal disease.

And your government is spending a half a million dollars a year for a few years in order to study this question.

Comments

  1. #1 elburto
    November 27, 2012

    There’s no physiological reason why “sham reflexology” should result in improved fatigue relief,

    The um… Qi, yeah that’s it, the Qi is intelligent and was boosted to the energy centres.

    Nah, I’ve got nothing.

    I can’t believe perception of dyspnea was measured, as opposed to lung function. Relaxation from the massage could account for feeling like breathing is easier. Ask anyone with respiratory issues. In fact,wasn’t there a terrible sCAM asthma study that did the same?

    Just as a side note, my government isn’t giving money to this study, my minimal tax pounds are safe. Also, thanks to the Cancer Act, it’s illegal to promote “treatments” that aren’t, so this kind of study wouldn’t be worth pennies.

  2. #2 david
    November 27, 2012

    “It’s basically a three-arm randomized study …The three arms include (1) reflexology … (2) …basically a foot massage (N=95); and (3) conventional care control ”

    Great image: a three-arm trial of foot massage.

  3. #3 naturocrit
    November 27, 2012

    Oh, that MSU…

    There’s also the other MSU, Minnesota!!!

    And boy they love touting nonsense as “science-based”:

    http://www.takingcharge.csh.umn.edu/explore-healing-practices/naturopathy

    I particularly love the false labeling of homeopathy as “science” there.

    And this other MSU loves their reflexology also:

    http://www.takingcharge.csh.umn.edu/explore-healing-practices/reflexology

    -r.c.

  4. #4 Composer99
    http://composer99.blogspot.ca
    November 27, 2012

    Oh, come on, of course universities have to study this stuff on the back of citizens’ contributions to tax revenues.

    Why? Because FREEDOM, that’s why!

    (How’d I do?)

  5. #5 Krebiozen
    November 27, 2012

    A look at William FitzGerald’s style of reflexology, called ‘zone therapy’ proved interesting. Somehow a therapy used to induce anesthesia by putting clothes pins and rubber bands on people’s fingers and giving them electric shocks has morphed over time into an ancient holistic treatment based on the idea of the foot as a homunculus. How did that happen? And where did the idea that the foot, ear, eyes or other parts of the body represent the whole body like holograms come from? Isn’t this just medieval Hermeticism?

  6. #6 Recovering Shruggie
    La-la Land
    November 27, 2012

    I may as well go back to shrugging–the task of discrediting quackery is hopeless. It boggles the mind to think that anyone who has been to medical school would waste time on such nonsense–and the “argument from antiquity”–puleeeese! The Chinese bound women’s feet too, I always toss that in when the Chinese medicine/acupuncture garbage comes up. This is usually followed by a long pause–then comes the “shunning” of me by whatever group this is.

  7. #7 dingo199
    November 27, 2012

    I can never read anything about reflexology without thinking of one of Orac’s previous posts on the subject:
    http://scienceblogs.com/insolence/2010/12/13/pulling-reflexology-out-of-ones-nether/

  8. #8 Denice Walter
    November 27, 2012

    OT – but is criticism by those whose judgment is unobstructed by higher cortical functioning EVER truly OT @ RI?
    No, I didn’t think so.

    Today Mike Adams ( Natural News) tells us why mammography is a tool of the Devil brandished in order to
    maintain his H3llish Kingdom on Earth ( i.e. the Cancer Industry)- the latter being of course,
    ” a crime against women. It’s also a form of cultural mutilation of women, much like we’ve seen in Aztec, Mayan and various African cultures throughout history…Is the Cult of Komen a criminal operation? … nothing ‘scientific’ in the modern-day cancer industry other than the scientific manipulation of women’s fears and emotions”.

    Says the guy who brings you the straight, un-embellished facts.

  9. #9 Denice Walter
    November 27, 2012

    @ Recovering Shruggie:

    You should be thrilled that they shun you.

  10. #10 Calli Arcale
    November 27, 2012

    naturocrit — Quibble here, but the acronym for the University of Minnesota is not MSU. It’s the U of M. Minnesota State University is a completely different educational establishment. MSU Mankato has the Mavericks, and MSU Moorhead has the Dragons, but the U of M is home of the Golden Gophers.

    As far as the reflexology study goes, even to this software engineer it is transparently obvious that they found a very small benefit in a few fields which they weren’t even originally caring much about. Which tells me that when their study gave them a null result, they went fishing until they found something that looked sort of positive and spun it. And the way they talk about it makes their motives transparently obvious: they didn’t do this study to find out if reflexology works, but to get it integrated into mainstream practice.

    “It’s always been assumed that it’s a nice comfort measure, but to this point we really have not, in a rigorous way, documented the benefits,” Wyatt said. “This is the first step toward moving a complementary therapy from fringe care to mainstream care.”

    This study isn’t about testing reflexology. It’s only about documenting the benefits. And that is why they didn’t care that it failed to meet the standards they laid out at the beginning. They were operating from the presumption that it worked; they just wanted the paperwork to document a positive effect so they could go ahead and legitimize it.

  11. #11 Beamup
    November 27, 2012

    OK, let’s see. Laundry list of measurements. One of them statistically significantly different from the meaningful control (the “usual care” arm not really counting).

    The question that positively leaps to mind is whether they controlled for multiple comparisons. I suspect not, which would make the study straight-up negative.

  12. #12 Pareidolius
    Cloud 9.5
    November 27, 2012

    The little homunculi in my feet haz a sadz now that they no longer exist. As most of you have heard me prattle on with cautionary tales of my years in Wooville, I won’t bother you with excerpts from my forthcoming book, Tales of Reflexology Past. I will, however, heartily recommend a non-woo-based foot massage as a fantastic part of one’s self care regime. As luck would have it, I just had one this morning (okay, I married well) and while I started out the massage hale and hearty, I feel truly fantastic afterwards. It’s obvious why massage is the gateway woo. So few of us today are touched therapeutically (or otherwise), and most mammals require physical contact to stay sane. Watch your companion animal when you give it a good rubdown sometime. Pure bliss. If you don’t get regular massages, I think you’re missing out. The trick is to find a highly skilled, reality-based practitioner. Good luck with that . . .

  13. #13 elburto
    November 27, 2012

    The little homunculi in my feet haz a sadz now that they no longer exist.

    Treat them to some Kinoki footpads!

  14. #14 Todd W.
    http://harpocratesspeaks.com
    November 27, 2012

    a type of specialized foot massage practiced since the age of pharaohs

    Reading this, I felt I was embarking on some ride at Disney or Universal. Who writes this drek?

  15. #15 Narad
    November 27, 2012

    Who writes this drek?

    University press offices are notorious for unbridled enthusiasm in their task of puffery.

  16. #16 Eric Lund
    November 27, 2012

    This sounds like yet another example of spaghetti statistical analysis: throw a bunch of stuff against the wall and see what sticks.

    That the program funding this grant has the acronym OCCAM is reason #2783 why I do not write fiction. Be honest: if I wrote a story about a hypothetical agency along these lines, and I called that agency OCCAM, would you believe it? As acronyms go, this one is up there with Nixon’s 1972 campaign committee, CREEP (Committee to Re-Elect the President).

  17. #17 lilady
    Shaking head in disbelief
    November 27, 2012

    What a heaping load of steaming woo, this “study” is.

    I’ve already posted a few comments on Barry Belmont’s blog at The Michigan Daily:

    http://www.michigandaily.com/opinion/11-viewpoint-reflexology-bullshit-23

    Where’s MI Dawn? I’m certain she will have some opinions about this study.

  18. #18 Composer99
    http://composer99.blogspot.ca
    November 27, 2012

    Eric Lund:

    The present Conservative Party of Canada, during its intermediary phase as the “Canadian Alliance”, was, during its formation, briefly to be named the “Canadian Conservative-Reform Alliance Party” (CCRAP).

    That didn’t last long.

  19. #19 Militant Agnostic
    November 27, 2012

    @Composer99

    That didn’t last long.

    As a name perhaps, but the anti-science crap party unfortunately seems to have staying power as a government.

  20. #20 palindrom
    November 27, 2012

    This classic “Onion” parody will be familar to most people here, but if there’s even one who hasn’t read it, it’s worth reposting:

    http://www.theonion.com/articles/revolutionary-new-insoles-combine-five-forms-of-ps,759/

  21. #21 GDad
    http://cranialhyperossification.blogspot.com
    November 27, 2012

    My neighbor found a doctor in our small city that peddles this reflexology and herb nonsense for his various age and weight related maladies. He swears that the herbal nostrums and therapeutic reflexological foot rubs are better than those toxic pharmaceuticals he used to take. I find it hard to get words in edgewise, so I nod and smile a lot. I hope I can find the spine to recommend an actual doctor if he ever really needs one.

  22. #22 lilady
    November 27, 2012

    I’ve got a comment stuck in moderation…because the link to The Michigan Daily blog, where I posted a comment, contains the word “bullsh!t”.

  23. #23 lilady
    November 27, 2012

    Thanks Orac, for taking my first comment out of moderation. :-)

  24. #24 eli
    November 27, 2012

    well, last i heard, ‘medicine’ does not have the ability to ‘cure’ cancer – wait, I’m on a call right now, kids are dying and researchers say there is a statistical number that makes the situation ok, since random death does occur during clinical trials… i wish people with education could be open-minded and expend their intelligence and energy on finding solutions, rather than bashing other concepts they dont believe in personally.

  25. #25 THS
    November 27, 2012

    Looked at the blog, lilady & it looked to me like they Bowdlerized or otherwise censored your comment – it least the one I found. Still, you tell it.

  26. #26 naturocrit
    http://naturocrit.blogspot.com
    November 27, 2012

    @Calli:

    my mistake. I’m a netherworld away in New England.

    -r.c.

  27. #27 lilady
    November 27, 2012

    @ THS My comment was not Bowdlerized. I believe I got stuck in moderation here at RI, because the link I provided to The Michigan Daily blog, had “bullsh!t-23″ attached at the end.

    Bullshit (testing to see if I get stuck in moderation, again) :-)

  28. #28 Denice Walter
    November 27, 2012

    Idle thoughts:

    If reflexology REALLY worked,
    shouldn’t we to find expect to find some- possibly therapeutic- differences in people who use specific parts of their feet ( or hands) habitually or experience pressure on specific parts- some examples:

    you wear a shoe that rubs or has a seam at a certain locus,
    you wear shoes that cause you to have pressure in certain parts of your feet ( sky high heels, anyone?),
    your stocking has a seam,
    you follow your tennis instructor’s advice and stay on your toes most of the time,
    you’re a female ballet dancer,
    you wear a wrist watch,
    you wear a ring,
    you type for hours daily,
    you do other things with your hands frequently
    etc.

  29. #29 S
    November 27, 2012

    … nothing ‘scientific’ in the modern-day cancer industry other than the scientific manipulation of women’s fears and emotions”.

    Manipulation of fears and emotions? Yeah, so says the quacks that tell people they are destined to remain ill until they remember and make amends for their past-life transgressions.

  30. #30 JustNuts
    November 27, 2012

    @naturocrit: That Univ. of Minnesota “Center for Spirituality & Healing” is a real woo paradise. Dig deeper into the web pages and take a look at the staff, they’re mostly master’s and PhD RNs. I’ve noted over the years that more and more graduate degreed RNs drift out of upper management and float into these altie realms. I’m an RN with a master’s degree too but my study focus was in epidemiology, public health and environmental health. I wonder what they’re teaching these days in those MSN programs!

  31. #31 Composer99
    http://composer99.blogspot.ca
    November 27, 2012

    eli:

    That real medicine has limitations in treating some cancers does not make reflexology an effective therapy, no matter how open-minded one is. It simply isn’t a solution.

    Second, I would also reject your categorizations:
    (1) that medicine does not ‘cure’ cancer. There are many different cancers, some of which real medicine can indeed cure.
    (2) That people contributing to this blog are not also seeking solutions. Orac is a surgical oncologist who does breast cancer research, and others here are research medical scientists.

  32. #32 Christine (the public servant Christine)
    November 27, 2012

    @eli:

    We might be more inclined to not bash these practices if they showed major results in a number of areas, particularly in expected areas, and if they didn’t ignore unexpected results. This reflexology study did both.

  33. #33 TBruce
    November 27, 2012

    It’s also a form of cultural mutilation of women, much like we’ve seen in Aztec, Mayan and various African cultures throughout history

    But I thought that a procedure done by non-Western cultures throughout history would be a Good Thing. Apparently not – except when it is!

  34. #34 Christine (the public servant Christine)
    November 27, 2012

    And before we start singing the praises of the Egyptians, we should remember they thought the heart was the organ that controlled the body and thoughts, and that if you were judged unworthy in the afterlife (judgement carried out by a jackal-headed dude) you were eaten by a hippopotamus-alligator mutant creature.

  35. #35 MI Dawn
    November 27, 2012

    @lilady: I had a heck of a day today, so didn’t comment. Both Orac and I are U of M (Michigan, NOT Minnesota) grads – same year – so it’s nice to see OUR alma mater has a bit clearer look at the nonsense. Not that they don’t have their own, IIRC, Orac has posted about it.

    What’s sadder to me is that so many of these studies are done by nurses. And where they COULD be researching ways to care better for people, they waste time and money on woo. I will admit going through a brief woo period during my midwifery days – though mostly based on herbals (which at least have some documented action – I was a HUGE fan of the Lawrence Review of Natural Products). Never fell for any of the really out of the way (homeopathy, reflexology, reiki, chiropractice) woo.

    As for the study, well, I like a good foot massage as well as anyone. But if you try to tell me it’s going to cure my disease….well….my foot will probably hit some part of your anatomy, not be massaged.

  36. #36 S
    November 27, 2012

    Years ago, nurses were instructed in “comfort measures” such as back massages that were taught in nursing programs….and there wasn’t any nonsense that a massage would in any manner affect a patient’s nausea, pain and discomfort…or the disease course.

    @lilady, I disagree with the comment above, which you wrote on the other website. I would think, and have experienced (anecdotes, I know…) that massage can, to a certain degree, relieve pain and discomfort. I wish “comfort measures” such as woo-less massages were still provided to certain patients. Furthermore, I wish that insurance companies would cover it, especially for patients with certain chronic medical conditions which might benefit from pain and stress relief.

    Do you really believe that a massage would/could not in any (beneficial) manner affect a patient’s pain and discomfort:?

    I can still remember in great detail a hospital nurse I had back in the 80′s. She used to make rounds every evening and give a 10 minute massage to any patient that wanted one. Best darn nurse I ever had. The massages helped relieve a lot of post-op pain and stiffness which seemed worsened by laying in an uncomfortable hospital bed for almost 2 weeks.

  37. #37 Marie
    November 27, 2012

    @eli
    I’m feeling “cured” of my cancer right now; time will tell. Something tells me it was the chemo, radiation, clinical trial drug and bone marrow (stem cell) transplant that cured me – not a foot massage I received during treatment. Perhaps I should be more open- minded (but not so open-minded that my brains fall out!).

  38. #38 Denice Walter
    November 27, 2012

    @ S:

    Some gentlemen I know highly recommend inexpensive tui na massage which is usually easily accessible wherever there are Chinese nationals living. May not be registered as therapists but appear to know what they’re doing. Ten minutes once fixed up my neck that was bothering me for weeks.. may be coincidental.

  39. #39 lilady
    November 28, 2012

    @ S: Have you been in a hospital lately? These are the days when pre-admission labs and “medical clearance” is done before scheduled surgery. These are the days when patients are instructed to go in the early morning to a holding area to await their surgery. Women have mastectomies and are released from the hospital the following day. There is no “down time” for a nurse assigned to a group of patients some of whom are a few days beyond the post-op period. (They are all post-op who require frequent monitoring and post-op pain medication and ambulation…before they are discharged the following day).

    This study was conducted with advanced breast cancer patients who had already been discharged to their home, and who are undergoing chemotherapy. I would have to discard everything I ever learned about human anatomy and the effects of chemotherapy on the gastrointestinal tract…to believe that a foot massage would eliminate the nausea, pain, discomfort and the disease course of a patient who is undergoing breast cancer treatment.

  40. #40 eli
    November 28, 2012

    @Composer99: well maybe people here in their careers/day jobs/employment are seeking solutions, but all the thinking / sharing here is clearly not focused on finding solutions. The blogger believes something about reflexology-based on something he read. Has he researched reflexology? Has he ever experienced it personally? Has he applied his medical scientific training to the reflexology subject?

  41. #41 eli
    November 28, 2012

    @christine: “This reflexology study did both”

    Well, there are two aspects here right? There is reflexology and there is the approach the study used, the methods, how the data was collected etc. Other commenters here seem to have a problem with aspects of the study methods/approach/data -perhaps the study could have been conducted differently or improved. But lets say it was a poorly designed or implemented study, does one automatically then make assumptions about the subject being studied? Crap study, its quackery i tell you!!!

  42. #42 eli
    November 28, 2012

    @Christine: And before we start singing the praises of the Egyptians, we should remember they thought….

    Christine, is this a summary of evidence-based practices? Or is this ‘common knowledge’ about Egyptians peoples’ impressions, from what they have read no doubt, of the result of best efforts of historians and other scholars working with remnants of the past? Isn’t our understanding of ancient history subjective? Oh I get it, maybe you were joking?

  43. #43 Mephistopheles O'Brien
    November 28, 2012

    eli – in order to find a solution, you must look in the right spot. If reflexology is the wrong spot (as current evidence suggests) then it’s appropriate to point that out and encourage work in more productive areas.

  44. #44 JGC
    November 28, 2012

    But lets say it was a poorly designed or implemented study, does one automatically then make assumptions about the subject being studied?

    But one has claimed that reflexology is quackery because this study evaluating was poorly designed. Instead, after noting the design falws they’ve analyzed and drawn conclusions from the results the ‘crap study’ generated.

    Recall what those were–no significant improvement seen in the majority of the primary measures the investigators examined, improved dyspnea was seen in the foot reflexology group and improved chronic fatigue was seen in the control non-reflexology foot massage group. None of which supports a conclusion that reflexology is effective as a complementary cancer treatment.

  45. #45 S
    November 28, 2012

    ….and there wasn’t any nonsense that a massage would in any manner affect a patient’s nausea, pain and discomfort…or the disease course.

    Do you really believe that a massage would/could not in any (beneficial) manner affect a patient’s pain and discomfort:?

    @lilady: I’m not limiting the potential benefits of massage to patients who are in the hospital, but extending the potential for benefit to any patient with chronic medical conditions, in or out-patient, and especially those with chronic pain and stress-related complaints – including those with cancer.

    I have no experience or knowledge so as to offer any opinion either way as to whether massage, foot or otherwise, would offer any relief of cancer or chemo-induced breast-focused pain. I certainly have serious doubts as to the benefits of reflexology and wish that the research monies wasted spent on these studies were spent more wisely.

    Aside from this study, it is my anecdotal experience that woo-less regular massage can indeed offer varying levels of relief to patients with pain and discomfort, especially those with chronic neuromuscular pain and stress-related complaints.

    Additionally, I think that regular massage could in many cases allow patients to reduce their dependency on prescription pain medications, such as opiates, and muscle relaxers and benzodiazepines. In some cases, even a slight reduction in a patients medications could set-off a series of beneficial effects. Less opiates might equate to an alleviation of gastrointestinal problems (less constipation, better motility, etc.), and less opiates might in some cases offer relief of opiate-induced depression and fatigue symptoms. Better motility and lessening depression in a patient with a chronic condition would, in my opinion, indeed offer clinically relevant benefits.

    I will gladly offer myself for a study as to the long-term benefits of woo-less massage, twice a week. :-)

  46. #46 Narad
    November 28, 2012

    Has he applied his medical scientific training to the reflexology subject?

    “Medical scientific training” is not necessary to recognizing warmed-over homuncular prattle.

  47. #47 Interrobang
    November 28, 2012

    “He/she doesn’t know anything about it” is the first refuge of the lazy crank…lazy in part because the crank in question can’t be bothered to, oh, you know, use the search function and see if the writer has actually written anything on the subject before (hint: he has) which would indicate a familiarity with the topic at hand, and who also expects everyone else on the comments to do the crank’s homework for them. Not to mention that the lazy crank can’t be bothered to look up actual statistics on cancer survivorship, and things. (To take one example I was looking at this afternoon, in the 1950s, ~90% of children with leukemia died. Now, ~90% survive. So much for “wah wah wah, medicine doesn’t cure cancer.” On behalf of my cancer-survivor mother and grandmother (thanks to science-based medicine), fuck you and your quackery sideways.

    By the way, I must say (I plead relative youth and foreignness) that I’m gobsmacked by the idea that Nixon’s “C.R.E.E.P.” was a real thing. Honest to squid, I thought that was a Mad Magazine satire right up until five minutes ago. Dayum.

  48. #48 thenewme
    November 29, 2012

    I see that the moderators over at BCO (breast cancer[dot]org) jumped right on board with this reflexology article, with a big “BREAKING NEWS: Reflexology Helps Ease Chemo, Hormonal Therapy Side Effects ” proclamation on the forum’s main page. Ack. I’m so disappointed yet so unsurprised.

  49. #49 Christine (the public servant Christine)
    November 29, 2012

    @eli: I absolutely was not joking about the Egyptians. They had a complete misundersanding of human biology, believing that the heart basically performed the functions we now know the brain handles. If they got that totally wrong, how the Hell can we believe them about relexology? If they didn’t know what the different organs in the body were for, how on earth could they be right about the different organs being healed by specialised foot massages?

    And I didn’t explain my point about the reflexology study very clearly. In most areas, the study showed reflexology didn’t provide any marked difference, especially in areas where they expected it would (pain management and anxiety). Granted, there was one area where there was a difference, but not enough to claim the massive success the study doers were touting. And then a simple foot massage was shown to have potential benefit in relieving fatigue – certainly more than reflexology, and that was another area that reflexology was supposed to help. And this was largely ignored. To me, that would point towards massage being of more benefit than reflexology, and this, let me tell you, is something most SBM practitioners are already aware of – massage is known to provide relief for a great many conditions.

  50. #50 Christine (the public servant Christine)
    November 29, 2012

    And also, @eli, my mother is “cured” of endometrial cancer, and my sister-in-law’s parents are cured of breast cancer (mother) and cancer of the liver (father). In all three cases, there was different combinations of radiation and chemo. And in a month’s time, a very good friend of mine will be getting his PhD. If your comment about children dying were true, he would not be getting his PhD, because 20 years ago he had leukaemia – cured by chemo.

  51. #51 herr doktor bimler
    November 29, 2012

    Eli: Or is this ‘common knowledge’ about Egyptians peoples’ impressions, from what they have read no doubt, of the result of best efforts of historians and other scholars working with remnants of the past?

    [Waves hand] Oh I know! Ask me!
    Here’s Flinders Petrie, in “The Religion of Ancient Egypt”:

    The ab is the will and intentions, symbolised by the heart; often used in phrases, such as a man being ‘in the heart of his lord,’ ‘wideness of {10} heart’ for satisfaction, ‘washing of the heart’ for giving vent to temper.

  52. #52 Krebiozen
    November 29, 2012

    The blogger believes something about reflexology-based on something he read. Has he researched reflexology? Has he ever experienced it personally? Has he applied his medical scientific training to the reflexology subject?

    What a lot of twaddle. Reflexology was clearly invented a few decades ago and then promoted as an ancient healing modality, based on highly ambiguous “evidence”. It’s the alternative medical equivalent of the Ploughman’s Lunch. There is absolutely no reason to think that it has any basis in fact at all. There are no known physiological connections between the parts of the foot that are supposed to relate to parts of the body and those parts of the body themselves, and not even any connections in the imaginary channels in TCM. It isn’t at all surprising that clinical trials of reflexology offer it no convincing support.

    BTW I have had reflexology massages, and experimented with it myself years ago when I was young and gullible; I discovered it is a useful skill for a young single man to acquire. It was when I massaged the feet of people with known medical conditions and found no knots or tender spots in the right places, and others who had tender spots and no corresponding ailments that I lost any little confidence I had in it, except as a pleasant and relaxing experience.

  53. #53 Christine (the public servant Christine)
    November 29, 2012

    Thankyou, Herr Doktor. I was hunting up my copy of The Book of The Dead to answer Eli with quotes. Yours does the job nicely.

    And again to Eli: my knowledge of Egyptian funerary customs and medical practice is based on the work of quite a few eminent historians. History’s my thing, see. The Egyptians wrote a lot of stuff down, and clever men and women have translated those texts. OK, so we have to take their word for it that they got it right, and indeed there are arguments about certain translations. But there is a significant body of agreed upon work.

    Here’s some homework, eli: track down a translation of the text I mentioned above, The Book of the Dead. The Wallis Budge translation is quite reasonable and widely available. The Book of the Dead is a collection of spells and prayers designed to help the dead gain the afterlife. There are a number of spells and prayers for the protection of the heart because of its function as the seat of reason and thought, and home of the spirit. Granted it’s been a while since I read it, but there were none for the protection of the brain, and indeed the brain was discarded during the mummification process because it wasn’t considered important (the embalmers wrote down their practices, that’s how I know).

    Come to think of it, I can’t think of any prayers or spells asking the goddess for a nice foot rub to fix up the ailments. So where is the reflexologists’ evidence that the Egyptians practiced it?

  54. #54 JGC
    November 29, 2012

    Forget foot rubs—it’s the Eater of the Ass I’m worried about.

  55. #55 flip
    November 30, 2012

    I’d like to know more about this ‘royal herbs’ terminology – anyone have a useful link they can post?

    @eli

    Has he researched reflexology? Has he ever experienced it personally? Has he applied his medical scientific training to the reflexology subject?

    Ech, I wish there was a way to force new cranks to read the entire history of this blog and its comments, if only so they’d learn that all of their questions have been dealt with already.

    But lets say it was a poorly designed or implemented study, does one automatically then make assumptions about the subject being studied?

    Yes. Duh! If it’s poorly designed or implemented, then it’s proven nothing. Then you continue to take the null hypothesis as true in regards to reflexology. You seem to have things back to front.

  56. #56 S
    December 11, 2012

    This is a test of the trademark symbol code.

  57. #57 JGC
    December 12, 2012

    cookie, please

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