The following article features coverage from the 2018 Oncology Nursing Society’s Annual Conference in Washington, DC. Click here to read more of Oncology Nurse Advisor‘s conference coverage. 

WASHINGTON, DC — Aromatherapy and reflexology may improve pain and anxiety among patients with cervical cancer who undergo brachytherapy, according to findings presented at the 2018 Oncology Nursing Society (ONS) Annual Congress.

Transvaginal and uterine brachytherapy has been associated with cramping and visceral and nerve pain, which leads to increased anxiety and pharmacologic management among this patient population. “Some studies have demonstrated that over 40% of these women develop PTSD from these treatments. The transvaginal applicator placement is an invasive procedure and very intimate in a vulnerable body part,” said Catherine Hill, BSN, RN. “Our team wanted to see if the addition of aromatherapy and reflexology would improve pain and anxiety in this patient population.”

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For this study, the team of investigators led by Hill at the Arthur G. James Cancer Hospital and the Richard L. Solove Research Institute randomly assigned 40 patients to receive aromatherapy continuously throughout treatment and foot reflexology therapy 30 minutes before brachytherapy plus standard of care or standard of care alone. The Numeric Rating scale was utilized to assess patient pain, and the State-Trait Anxiety Inventory for Adults was used during 5 varying times during patient visits in order to evaluate anxiety. 

Results showed that patients assigned to the aroma and reflexology arm had an average pain score reduction of nearly 50% (2.2 vs 5.2) — a reduction of 2 or more points is considered to be clinically significant — and decreased average anxiety by more than 20% compared with standard care. 

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Patients receiving these alternative interventions also had a large reduction of oral morphine equivalents (OME) treatment; reported OME use was 55 and 89 among patients in the treatment arm vs the control arm, respectively.  

“Addition of aromatherapy and reflexology does reduce pain and anxiety in patients receiving brachytherapy for treatment of cervical cancer,” said Hill, and concluded that “addition of nonpharmacological interventions should be considered for other treatment modalities due to the potential reduction of administration of narcotics and benzodiazepines.”


Hill C, Blackburn L, Gottke M, Lindsey A, Thompson K. The effect of aromatherapy and foot reflexology on pain and anxiety during brachytherapy for cervical cancer. Oral presentation at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC.