Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage

Abstract

The diagnosis and treatment of breast cancer can adversely affect quality of life. Here the aim was to determine the effects of reflexology on host defences and endocrine function in women with early breast cancer. Six weeks after surgery for early breast cancer, 183 women were randomly assigned to self-initiated support (SIS), SIS plus foot reflexology, or SIS plus scalp massage. Peripheral blood mononuclear cells and serum were isolated at T1 (6 weeks post surgery; baseline), T2 and T3 (4 and 10 weeks post completion of intervention, respectively). Lymphocyte phenotyping found that CD25(+) cells were significantly higher in the massage group compared with the SIS group at T3. The percentage of T cells, and more specifically the T helper subset expressing IL4, decreased significantly in the massage group compared with the SIS group at T3. This change was accompanied by an increase in the percentage of CD8(+) T cytotoxic cells expressing IFNγ in the massage group. Natural killer and lymphokine activated killer cell cytotoxicity measurements, serum levels of cortisol, prolactin and growth hormone, and flow cytometric assessment of their corresponding receptors all revealed no significant differences between the three groups of patients. This study provides evidence that the immunological balance of patients can be altered in a potentially beneficial manner by massage. The original trial was registered with the International Standard Randomised Controlled Trial Registry (ISRCTN87652313).

Figure 1.

Timeline of complementary therapy (reflexology or scalp massage), chemotherapy and/or radiotherapy with respect to surgery and randomisation. T1 (week 6), T2 (week 18) and T3 (week 24) are the sample time points.

Figure 2.

Flow cytometry analysis gating strategies. (A) Forward scatter (FSC-H) and side scatter (SSC-H) characteristics of a PBMC population with the lymphocytes isolated in the quadrilateral gate. Gated-PBMCs labelled with both CD3-FITC and IL2-RPE, with (B) and without (C) prior stimulation with PMA, ionomycin and brefeldin.

Figure 3.

Consort flow chart depicting the recruitment of patients into the three treatment groups and the use of samples in each of the biological assays employed.

Figure 4.

Percentage of PBMCs from patients with early breast cancer positive for (A) CD3/IL4 (B) CD4/IL4 and (C) CD8/IFNγ, at T1, T2 and T3. *Significant differences between groups (p<0.05).