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CLINICAL REVIEW: Andrew Vickers and Catherine Zollman ABC of complementary medicine: Massage therapies BMJ 1999; 319: 1254-1257 [Full text]

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Complementary therapy for cancer

David Gurwitz   (8 November 1999)

Evidence that reflexology may work

Ole Olsen   (19 November 1999)

Correction "18th century Per Hendrick Ling"

Franz Alfred   (29 July 2000)

Re: Correction "18th century Per Hendrick Ling"

Andrew Vickers   (7 August 2000)

Complementary therapy for cancer 8 November 1999
David Gurwitz, National Laboratory for the Genetics of Israeli Populations Tel-Aviv University Send response to journal: Re: Complementary therapy for cancer	The superb clinical review by Vickers and Zollman [1] highlights the advantages of massage as complementary therapy for diverse human ailments, and the crucial need for refined studies of these benefits in controlled clinical trials. Pain is a major concern in treating cancer. Gentle massage therapy relieved pain in cancer patients [2]. Additional benefits for massage therapy in cancer could include improved immune function. Indeed, increased natural killer (NK) cell number and NK cytotoxicity were measured in blood samples from massage-treated cancer patients [3]. The enhanced NK cytotoxicity could reflect the stress reduction capacity of massage, since stress is associated with inhibition of NK activity [4,5]. More in-depth studies are needed for delineating the immune-enhancing potential of massage therapy in cancer and other immune-compromised patients. References [1] Vickers A, Zollman C. (1999) ABC of complementary medicine. Massage therapies. BMJ 319:1254-1257. [2] Weinrich SP, Weinrich MC (1990). The effect of massage on pain in cancer patients. Appl Nurs Res 3:140-145. [3] Ironson G, Field T, Scafidi F et al. (1996) Massage therapy is associated with enhancement of the immune system's cytotoxic capacity. Int J Neurosci. 84:205-217. [4] Andersen BL, Farrar WB, Golden-Kreutz D et al (1998). Stress and immune responses after surgical treatment for regional breast cancer. J Natl Cancer Inst 90:30-36. [5] Ben-Eliyahu S, Page GG, Yirmiya R, Shakhar G. (1999) Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity. Int J Cancer. 80:880-888.
Evidence that reflexology may work 19 November 1999
Ole Olsen, senior researcher The Nordic Cochrane Centre Send response to journal: Re: Evidence that reflexology may work	Massage therapies - Evidence that reflexology may work Editor - In their ABC on massage therapies (1) Vickers and Zollman state that 'Practitioners of reflexology claim that ... they can bring about more specific changes in health', but also that 'There are very few clinical trials showing that any massage technique can have specific effects'. I therefore wish to bring an unpublished trial (2) to your attention. In 1992 a single-blinded, concealed, randomised trial supported by the Danish Health Insurance Fund was carried out by two Danish midwives and reflexologists. Some 99 pregnant women with diagnosed primary inertia during labour were randomised to receive either reflexology in two sessions each of 30 minutes or to receive general supportive care for the same amount of time. Either type of randomised care was carried out by the research midwife on duty, whereas the assessment of dilatation of the cervix was carried out before and after treatment by a third midwife who were meticulously kept blinded to the actual treatment. If there was still no progress the woman would be entitled to usual care, i.e. augmentation, whereas the randomised care would continue in case of progress. The observed outcomes were tabled in the photocopied research report. A later statistical analysis of the data shows that lack of progress assessed by the blinded midwife (OR=0.27; 95%CI 0.12-0.62) and augmentation with oxytocin (OR=0,42, 95%CI 0,42-0,95) was significantly less common in the group treated with reflexology. The trial shows that a large fraction of women (38%), who would have been offered augmentation under usual care, actually makes progress when they are offered extra supportive midwifery care, and that an even larger fraction (70%) makes progress when they are additionally treated with reflexology. If these findings can be confirmed in a larger, equally well conducted, three armed trial (usual care vs. midwife support vs. reflexology), high rates of unpleasant and painful oxytocin augmentation (3) practiced in many hospitals can be dramatically reduced. 1. Vickers A, Zollman C. ABC of complementary medicine - Massage therapies. BMJ 1999;319:1254-1257. 2. Clausen J, Møller E. En randomiseret undersøgelse af zoneterapi ved inerti og retentio placentae (A randomised trial of reflexology in inertia). Århus Kommunehospital Afd Y8. 3. Enkin M, Keirse MJNC, Renfrew MJ, Neilson JP. A Guide to Effective Care in Pregnancy and Childbirth. Oxford: Oxford University Press 1994.
Correction "18th century Per Hendrick Ling" 29 July 2000
Franz Alfred, Researcher Send response to journal: Re: Correction "18th century Per Hendrick Ling"	I would like to quote your statement "systematised in the early 18th century by Per Hendrik Ling." However, it seems that Per (or Pehr = old Swedish spelling) HENRIK Ling lived from 1776-1839 and worked with massage only after 1800. So it seems appropriate to correct: (a) his name to Per HENRIK Ling and (b) the 18th century to early 19th century Sources: - "Svenskt biografiskt handlexikon," Herman Hofberg, 1906; Volume II, pp. 80-1 - "Encyclopedia Britannica," CD-ROM 1999; Heading: "Major therapeutic techniques, Massage"
Re: Correction "18th century Per Hendrick Ling" 7 August 2000
Andrew Vickers, Author of ABC series Send response to journal: Re: Re: Correction "18th century Per Hendrick Ling"	Mea culpa! You are correct on both counts.