Reiki, Massage, and Mind-Body Therapies in Cancer Care

NCCIH is the National Center for Complementary and Integrative Health, part of NIH. It states the position plainly. No complementary health approach has been shown to prevent or cure cancer. Some, it adds, may help manage cancer symptoms and treatment side effects.

That is the whole frame. These practices are candidates for symptom relief. They are not treatments for the disease. The Society for Integrative Oncology draws the same line in its clinical practice guidelines. It adds the warning that matters most. Unproven methods should not replace conventional treatment. Delaying cancer treatment reduces the chance of remission or cure.

NCCIH grades these approaches individually, with study counts. The differences between them are large.

Acupuncture. Several reviews concluded that acupuncture can help manage treatment-related nausea and vomiting. A 2020 combined analysis covered 14 studies with 920 participants. It found significant reductions in cancer pain. That held both against sham acupuncture and against no treatment. In two studies, adding acupuncture or acupressure to pain medicine helped people cut their dose. A 2018 review of 10 studies with 1,327 participants found acupuncture may relieve cancer-related fatigue. It compared better than sham acupuncture or usual care. Research on hot flashes is limited.

Mindfulness-based stress reduction. A 2020 review covered 26 studies with 3,476 participants across cancer types. People in mindfulness-based programs had less anxiety, depression, fatigue, and stress. They also had better quality of life than those who did not take part.

Yoga. A 2020 evaluation covered 24 studies in women with breast cancer, more than 1,600 participants in all. It concluded that yoga gives small-to-moderate improvements in cancer-related fatigue and quality of life. The comparison was with programs not involving physical activity. A 2021 review looked at 26 studies of depressive symptoms, with 1,486 participants. It also looked at 16 studies of anxiety symptoms, with 977 participants. Yoga-based programs helped with both. Most of those studies involved women with breast cancer.

Hypnosis. NCCIH describes it as possibly helpful in four settings. Pain from cancer, or from procedures. Nausea and vomiting in people with breast cancer. Anxiety and distress around surgical and medical procedures, in adults and children. And hot flashes in women with breast cancer.

Tai chi and qigong. A 2020 review covered 16 studies in women with breast cancer, with 1,268 participants. Tai chi improved fatigue when added to conventional care. It did not when used instead of it. It improved overall quality of life either way. A 2019 review of 12 studies with 915 participants found effects on fatigue and sleep quality large enough to matter to patients.

Note the pattern in the tai chi result. Added to standard care, it helped. Substituted for standard care, it did not. That is the single most useful finding in this entire area.

Massage therapy, with or without aromatherapy, has been used to relieve pain, anxiety, and other symptoms. NCCIH says there is only limited evidence on whether it helps. Then it gives the detail.

A 2021 review covered 13 studies with 1,100 participants. It took in various manual therapies, including but not limited to massage. It found benefit for pain, physical function, and global well-being. It found no benefit for fatigue, nausea, anxiety, or depression. NCCIH cautions that these results should be read carefully. Different manual therapies and measurement methods were pooled together. Some studies were small or of low quality.

A 2016 evaluation of 19 studies with more than 1,200 participants found some evidence that massage might help with pain and anxiety. The quality of that evidence was very low, and findings were not consistent.

The safety point is concrete rather than general. NCCIH notes that massage therapists may need to change their usual techniques for people with cancer. One example given is using less pressure than usual, in areas made sensitive by cancer or its treatment.

That is worth turning into questions before a first session. Where is the port or central line? Which areas have had radiation, and how recently? Is there bone involvement that changes what pressure is safe? Has the surgical site healed? Is there lymphedema, or a risk of it, in a limb?

In Reiki, practitioners place their hands lightly on a person, or just above them. The aim is to direct energy to support that person's own healing response. It rests on an Eastern belief in an energy that supports the body's natural healing abilities.

NCCIH's bottom line is unusually direct, and it has two parts.

On effectiveness: Reiki has not been clearly shown to work for any health-related purpose. It has been studied for pain, anxiety, and depression, among other conditions. Most of that research has not been of high quality. The results have been inconsistent. NCCIH adds one more point. There is no scientific evidence supporting the existence of the energy field thought to play a role in Reiki.

On safety: Reiki has not been shown to have any harmful effects.

Both halves matter. Here is something with no shown specific effect, and no shown harm. That is a different proposition from something with either. It is not a treatment. It is also not a danger, so long as it does not replace one.

NCCIH separates its cautions by category, and they are not evenly distributed.

Take the psychological and physical practices first. Hypnosis, massage therapy, and yoga are usually safe when used properly. Special precautions may still be needed for people with cancer. Yoga is generally safe under a qualified instructor. Sprains and strains are the most common injuries, and serious injuries are rare. In studies of yoga in people with cancer, adverse events have mostly been minor. Mindfulness and other meditation are generally considered safe. A practice may still need adapting. An instructor can change it for someone who cannot sit still comfortably for long stretches.

Acupuncture has one cancer-specific risk worth naming. Complications are rare when sterile needles and proper procedures are used. But chemotherapy and radiation therapy weaken the immune system. So strict clean-needle procedure matters more here, to reduce infection risk.

The larger risks sit with products rather than practices. Some herbs may make chemotherapy drugs less effective. NCCIH also warns about fraudulent cancer "cures" sold online. Some are dangerous in themselves. Others cause harm because people use them instead of effective treatment.

• Is there any reason this specific practice is unsafe given my treatment, my surgery, or my blood counts?
• For massage: what areas should be avoided, and what pressure is safe?
• For acupuncture: what infection precautions apply during chemotherapy?
• For yoga or tai chi: are there positions to skip because of a port, a stoma, bone involvement, or balance problems?
• Is this being added to standard treatment, or is anyone suggesting it replace part of it?
• Does the hospital have an integrative oncology service, and are these practitioners credentialed there?

Related reading: complementary and integrative medicine covers the wider field. Acupuncture for cancer symptoms goes deeper on the approach with the strongest symptom evidence. And anxiety and distress during cancer covers the symptom most of these practices are reached for.

• Ring your chemotherapy team at once, day or night, if a temperature of 100.4°F (38°C) or higher turns up while you are on treatment. CDC treats fever during chemotherapy as a medical emergency, because your infection-fighting cells may be low and an infection can spread fast. That is true whether or not a session preceded it. If you cannot reach the team, go to an emergency department.
• Call 911 or go to an emergency department if breathing becomes difficult, your face or throat swells, or a rash spreads quickly after aromatherapy oils or a herbal product. Those are signs of a severe allergic reaction.
• Call your care team the same day if chills, or fresh redness, warmth and swelling, follow a session and you are not on chemotherapy. This matters most after acupuncture, or after hands-on work near a port or catheter.
• Call your care team within a day or two if a session leaves new bruising, soreness that does not fade, or swelling in an arm or a leg. Say so too if pressure over a bone area left it hurting.

Source for the infection signs: NCI on infection during cancer treatment, and CDC on fever during cancer treatment.

• NCCIH — Cancer and Complementary Health Approaches: What You Need To Know
• NCCIH — Reiki
• NCCIH — Massage Therapy: What You Need To Know