Most treatments at U.S. cancer centers are evidence-based and cutting-edge. In recent years, however, some of our great temples of healing have begun to dabble in the unscientific and the prescientific. Integrative care centers at Memorial Sloan Kettering, the University of Arizona, and the University of California–San Francisco, to name just a few, offer a panel of unproven therapies, such as reiki, reflexology, and qigong. That’s right—the same institutions that can genetically modify your immune cells to fight leukemia also offer to replenish your life force energy through the laying on of hands.
I’m sympathetic to the challenges that cancer centers face. Oncologists are often accused of insensitivity to their patients’ psychological and spiritual needs, and integrative care is a response to that criticism. Most integrative care centers also offer evidence-based programs, such as exercise classes, that aren’t strictly medicinal. Nevertheless, reiki, reflexology, and their ilk are unproven to treat any disease or ameliorate symptoms. They are far beneath the dignity of a great cancer center.
Reiki is a form of energy healing developed in Japan the late 19th or early 20th centuries. The reiki master waves his hands over the patient, scanning for problems. He then places his hands on areas to be healed, transferring his life-force energy to the patient, which supposedly promotes recovery. If you’re having trouble formulating a mental picture, YouTube is littered with reiki masters working their clients’ auras and chakras. (David Gorski, an oncologist and vocal opponent of integrative care, has also detailed some of the fantastic claims of reiki masters on his blog Science-Based Medicine.)
Does reiki work? It’s unfortunate that this even needs to be asked. We’re talking about energy healing. Still, medical research has answered the question with an unsurprising and unambiguous “no.” The laying on of hands is not an effective medical treatment.
Examine the data. Don’t just pick up any study in PubMed, though. Too many peer-reviewed studies are badly constructed and poorly analyzed. Even a well-designed study is weak in isolation, since normal statistical techniques concede a 1 in 20 chance that the results are inaccurate. It’s much better, especially for a layperson, to look to review articles, which compile, rate, and analyze groups of studies that have investigated the same issue. A good review article represents the state of the evidence.
Here is a smattering of conclusions from review articles on reiki: “The existing research does not allow conclusions regarding the efficacy or effectiveness of energy healing.” “The serious methodological and reporting limitations of limited existing reiki studies preclude a definitive conclusion on its effectiveness.” “The evidence is insufficient to suggest that reiki is an effective treatment for any condition.”
Most reiki studies either don’t include control groups or don’t randomize the distribution of patients between the test and control groups. In most cases the patients and the evaluators are aware of which subjects are in the test group, opening the door to bias. The studies are usually pitifully small, involving no more than a couple of dozen patients.
Other alternative therapies produce similar results to reiki—that is to say, no results. Reflexology is the practice of applying pressure to specific locations on the hands, feet, and ears to ease stress and pain elsewhere in the body. A 2011 review of reflexology studies found it conferred no benefit. The authors concluded, “the notion that reflexology is an effective treatment option is currently not based on the evidence from independently replicated, high-quality, clinical trials.” Review articles in 2010 and 2008 reached similar conclusions. Any perceived benefits are simply the result of the placebo effect.
Integrative care isn’t simply a collection of unproven strategies from the Eastern Hemisphere—there are also unproven Western therapies. Cancer patients suffering from lymphedema, an extremely uncomfortable swelling caused by poor drainage from the lymphatic system, can turn to integrative care centers for manual lymphatic drainage. It’s a form of massage that’s supposed to squeeze fluid from the swollen tissue, like wringing water out of a sponge. Unlike reiki and reflexology, which are preposterous on their face, manual lymphatic drainage has an intuitive appeal. Unfortunately, a 2013 review article was unable to find adequate evidence to support the practice.
Barrie Cassileth, chief of the integrative medicine service at Memorial Sloan Kettering and author of Survivorship: Living Well During and After Cancer, makes a couple of arguments in defense of integrative care centers. (To her credit, she was willing to discuss this issue with a skeptical member of the media.) First, she points out that the forms of reiki and reflexology practiced at Memorial Sloan Kettering aren’t aimed at mystical energy transfer. They are based simply on the healing power of human touch. She uses the terms reiki and reflexology to satisfy patients’ yearning for the wisdom of the ancients. “People are reassured by something that has a historic base,” she explains. Cassileth further argues that the ability of human touch to ease a patient’s discomfort is self-evident. “It’s not worthy of study,” she says. “What we know is that patients like it, they feel comforted, and they feel good.”
Many cancer patients undoubtedly yearn for human contact, especially those who travel to world-renowned centers like Memorial Sloan Kettering, leaving their families and friends behind. You’d have to be uncommonly cold to deny them that comfort. It’s a sad indictment of our medical system that we need special institutes to ensure that sick people experience a few minutes of human contact. When it comes to medical treatments, however, nothing should be treated as self-evident, not even the healing power of human touch. If simple touch were so transformative, the studies probing the efficacy of reiki, reflexology, and the like—many of which measured levels of pain and stress—should have proven it.
Besides, if this is only about human contact, why do these hospitals employ people trained in the debunked arts of reflexology and reiki? If this is about nothing more than the warmth of touch, why does their own literature play into the mythology behind the practices? They could just as easily call all of these services “massage” or simply “companionship.”
You might ask whether integrative care should be subjected to the same rigorous standards applied to cancer drugs. That’s a fair point. Reiki and reflexology carry very little in the way of risk. Like hospital therapy dogs, they may brighten the day of a very sick person. But volunteers who parade dogs through pediatric wards don’t brag about their deep wisdom or ancient roots. It’s just fun to pet a dog.