RAA Conference, Anchorage Alaska USA, 30 April 2016

Cancer and Reflexology – expanding our understanding of a complex disease

By Sharon Stathis R.N.


There was a time when many in the reflexology community considered cancer to be a contraindication to reflexology. Sharon Stathis defied conventional protocol and worked with cancer patients in her private clinical practice. She also took her undergraduate reflexology students to work in a palliative care unit attached to a large, public hospital in Brisbane, Australia.

How times have changed. Reflexology is now routinely accepted and welcomed as a helpful complementary therapy for cancer patients. However, as the incidence of cancer rapidly increases, new challenges emerge for reflexologists working in the complex and ever expanding area of oncology.

In early 2009, Sharon was diagnosed with a rare form of lymphoma stage IV. The cancer was considered medically incurable. Her prognosis was poor. At the time, no medical treatment was offered. Instead, a ‘wait and see’ approach was taken by her oncologist.

Sharon now shares her valuable insights and discoveries about cancer and its management with fellow reflexologists. She draws from her personal journey of LIVING with advanced cancer, also her nursing background, and extensive clinical experience. The following topics are considered in this presentation.

• understanding cancer – a complex and confusing disease
The cancer maze is very large, complex and hard to navigate. The complexity is compounded by the differing opinions amongst the ‘experts’ regarding the causation of cancer, its treatment and its management. These experts belong to main-stream medicine and to the natural therapy industry. The resulting uncertainties can create confusion and anxiety amongst therapists and their cancer patients.

• managing cancer – the needs of the cancer patient
Needs vary due to the very personal nature of the cancer journey. Decisions made by the patient in regard to these needs will impact on their quality of life and possibly the disease outcomes. Making important choices can prove difficult when patients are overwhelmed by fear, confusion, uncertainty, physical fatigue and pain.

• reflexology – an holistic approach to healing
We explore the dynamic of energy healing from the perspective of Ayurvedic philosophy. Ayurveda helps explain why foot reflexology (as compared to hand, ear or face reflexology) is so important in the transformative process from disease to wellness.

• the role of the reflexologist – understanding the challenges
Every day reflexologists are competently applying reflexology to help cancer patients cope better with their disease. However, therapists can experience feelings of anxiety and inadequacy when confronted with an overwhelming amount of information outside their area of expertise. Working from a comprehensive knowledge base will enable relexologists to work more confidently and effectively with their patients.


The word cancer is feared, hated and avoided by many in our society. The media describes cancer in terms of “waging a war”, or “winning the battle” against cancer. It rarely describes a cancer journey in positive terms. Yet, for many, having cancer is a profound experience that provides a unique opportunity to make positive and meaningful life changes. It certainly has for me.

The volume of available information about cancer is large, complex and hard to navigate. This complexity is compounded by differing opinions amongst the ‘experts’ regarding the causation of cancer, its treatment and its management. The resulting uncertainties and contradictions can create confusion and anxiety amongst therapists and their cancer patients.

Reflexologists are naturally caring, empathic and supportive practitioners. These qualities are important when caring for cancer patients who can feel isolated and unsupported. Although empathy and support are important, practitioners need to work from a comprehensive knowledge base if they are to work confidently and effectively with their cancer patients.

Fundamental knowledge includes cancer related terminology, common approaches to cancer treatments, and their possible side effects. Side effects that affect the feet and hands are especially important for reflexologists.

For those experiencing cancer, it is probably one of the most fearful, confusing and disruptive times of their life. It is important that therapists not only understand the challenges they face, but also the many and varied ways of dealing with these challenges.

Well informed, confident reflexologists have a wonderful opportunity to make a valuable and positive contribution to a cancer client’s healing journey.

Topics of this presentation include:
1. A personal history
2. Understanding cancer – a complex and confusing disease
3. Managing cancer – the needs of the cancer patient
4. Reflexology – an holistic approach to healing
5. The role of the reflexologis– understanding the challenges

1. A Personal History
(Please Note – this section is an abbreviated version of the original presentation.)
In April 2009 I was diagnosed with Stage IV Splenic Marginal Zone Lymphoma (SMZL). No conventional medical treatment was offered! Although diagnosed at an advanced stage, my cancer was slow growing. My oncologist suggested that we “wait and see”.

…my cancer progressed, and my quality of life slowly deteriorated. My massive spleen was removed in May 2011, without complications. Due to the major reduction in tumour load, and appropriate lifestyle interventions, …… I feel wonderful.

I am often asked how I have coped so well with life threatening cancer. Apart from addressing obvious physical needs, I believe attending to my mind was the most important.

I took responsibility for my situation and steadfastly refused to become a victim. I acknowledged my fear but refused to become paralysed by it. I stood guard over negative thinking, and remained positive by using daily affirmations, creative visualisation and Emotional Freedom Technique (EFT).

I had regular psychology sessions with my major support person and best friend, my husband Richard. This helped me make sense of my emotions, thoughts and attitudes. Throughout, I held close to my spiritual faith and retained true hope.

The journey has been an amazing and worthwhile experience, as it is for many who tread a similar path. Cancer can open the door of opportunity for those with the courage to enter. Every day becomes a precious gift that deserves to be enthusiastically embraced. And the greatest lesson of all, for each of us, despite the circumstances, is to see the unique beauty of our being, and to celebrate it.

It is important we do not automatically visualise cancer in a negative light. For many cancer patients it is the road to a new and wonderful life. For those who do succumb to their illness, many choose to pass from this life with peace, grace and dignity – an inspiration to us all.

2. Understanding cancer – a complex and confusing disease
What is cancer? My oncologist has a simple definition “Cancer is a mistake”. We can all agree that cancer is a corruption of purpose for those cells that are affected. Cancer is not one disease. It is the name given to a collection of diseases that are currently known to exceed two hundred.

Cancer is indiscriminate. All ages can be affected. It can affect the wealthy and the poor, vegans and meat eaters, those that meditate and those that do not. Some cancers are aggressive, others slow growing, and some in between. Some patients respond to treatment and others do not. Some patients embrace self-advocacy and others become inactive and disempowered.

It seems almost everyone has an opinion regarding the causation of cancer. Most are familiar. They include ageing, poor lifestyle choices, nutritional deficiency, excessive internal acidity, invasion by pathogens, environmental toxins, depressed immune function, stress – and the list goes on.

I have no doubt many of these do contribute to the development of cancer. But the truth is there is still so much we don’t understand about what initiates and nurtures the development of these diseased cells that can grow to threaten life itself.

Adding to the confusion, many claim to have a magic cancer ‘cure’, and they prey on the vulnerable and desperate. There is an overwhelming amount of misinformation out there. It can cause confusion, overload and the loss of a sense of control. Successfully negotiating the cancer maze is a major challenge for therapists, cancer patients and their loved ones.

main-stream cancer therapy
The conventional approach to cancer management commonly involves the modalities of medicine, nutrition, physiotherapy, counselling and social work. Commonly used main-stream cancer treatments include surgery, radiation, chemotherapy, biotherapies and hormone therapy. First, second and third line treatments may incorporate any of these.

Although these therapies do cure some cancers, many offer only short term relief instead of long term solution. However, even short term relief can give patients extra time to make appropriate lifestyle changes, and implement other strategies that may eventually lead to long term remission or even cure.

The most common form of pharmacological treatment given for many types of cancer is still chemotherapy. It includes a vast collection of cytotoxic drugs that are used in isolation or in combination. The chemotherapeutic agents are often combined with other drugs such as steroids to enhance effectiveness and minimise unwanted side effects.

The side effects of chemotherapy are well documented and can vary considerably. This is due to the types, dosage and frequency of drugs used, and of course, the unique response of individuals. Some side effects are short lived, while others are permanent. For many cancer patients, chemotherapy is an almost unbearable ordeal. For others, it is less burdensome. However, overall, it is considered that the cure rate with chemotherapy is abysmal.

Many patients remain unaware of potentially serious side effects of some diagnostic procedures and cancer treatments. If cancer patients are to make wise choices regarding their treatment and subsequent welfare, it is imperative their decisions are based on factual information.

Scientific research is constantly evolving. Current cancer research is involved in the formulation of new and more personalised approaches to cancer treatments. New research fields include epigenetics, targeted therapies and circulating tumour cells.

We seem to be in the process of changing the ‘one size fits all’ approach to cancer treatment, to more precise, individualised treatment options. Hopefully, this will result in the significant reduction of burdensome and unpleasant side effects experienced by cancer patients.

3. Managing cancer – the needs of the cancer patient
True healing involves mind, body and spirit. Successful outcomes for cancer patients are reliant on attention to emotional, mental, physical and spiritual health. It is important that cancer patients (age permitting) take control, and make the BIG decisions that will affect their personal cancer journey.

emotional health
Emotional well-being is an important part of achieving and maintaining physical health. The list of emotions that might be experienced by cancer patients is impressive. Shock, fear and grief are some of the initial emotions associated with cancer diagnosis. Other emotions can include anxiety, anger, rage, depression, despair, guilt, humiliation and panic. If these emotions are not appropriately dealt with, they may wash over a cancer patient like an overwhelming tsunami, resulting in inaction and loss of control.

Amongst the plethora of emotions, I believe fear is potentially the most damaging. Fear can be crippling. It is usually self generating, and can be unintentionally fed by loved ones and well meaning friends. Even professional health workers can unwittingly contribute. On the flip side, fear can be a great motivator, spurring the patient on to take positive action such as researching their cancer and making positive lifestyle changes.

mental health
Conscious and sub-conscious thoughts and attitudes have a major influence on the way we live. Confusion, disbelief, disappointment, denial and worry are commonly experienced by those with cancer. These thoughts need to be acknowledged and successfully managed.

Developing healthy attitudes includes positive thinking. This is especially important with regard to treatment options, be it radiation, chemotherapy, immunotherapy, surgery or others. Directing enthusiasm and a positive approach towards treatment will assist healing.

Hope can assist the cancer patient to heal. True hope must not be confused with false hope. True hope is based on sound knowledge of the type of cancer, its treatment options and prognosis. False hope is the belief that one will survive the cancer despite having the bleakest prognosis. This is called denial.

Standing guard over negative thoughts is an important and ongoing, daily necessity. Positive affirmations can be enormously helpful for retraining the subconscious mind. Emotional Freedom Technique (EFT) and creative visualisation are effective tools that can help patients make those changes. Activities such as meditation, yoga, tai chi and qi gong can help to still worrying thoughts.

The key to successful cancer management involves taking responsibility, looking at things that need to be changed, then having the desire, determination and motivation to make those changes. It is important that cancer patients seek help from appropriately trained professionals if they are unable to adequately deal with mental health issues.

physical health
The majority of patients with cancer will require some form of main-stream intervention to help eradicate, reduce or prevent their cancer from spreading. However, input from complementary therapists can play an important role in regulating and improving the health status of these patients.

Although optimal nutrition is vital, it is unwise for cancer patients to self-medicate with nutritional supplements. Many patients and therapists remain unaware that certain supplements can cause premature excretion of antineoplastic agents. This may result in an ineffective response to the drugs, and necessitate an unwarranted, higher dosage to be administered. The supplements in question are particularly those that have a diuretic action or support liver function.

When considering nutritional deficiencies, it can be advantageous for the cancer patient to consult with a naturopath or nutritionist who specialises in cancer management. It might also be necessary to enlist the help of a doctor of integrative medicine who can order appropriate pathology tests to help establish nutritional status.

Fatigue is a symptom experienced by many cancer patients. Fatigue is also a side effect of some cancer treatments. Adequate quantity and quality of relaxation, rest and sleep are important for healing and health maintenance. Taking time out to replenish diminished energy is mandatory.

Physical exercise is an important contributor to mental, emotional and physical health. This can be a problem for some cancer patients due to fatigue and/or physical impairment. Appropriate, flexible exercise regimes must be chosen according to the patient’s individual needs at any given time. There are now physiotherapists who specialise in cancer management and can give appropriate guidance.

Optimal Vitamin D levels (preferably from sunshine) are required to aid healing and maintain health. It has been suggested that Vitamin D deficiency could be implicated in the formation of cancer. It is also thought that optimal Vitamin D levels might aid cancer recovery.

[Footnote –
An intervention that is not documented in main stream literature is ‘Earthing’. This involves making an electrical connection with the earth. Skin contact with the earth, or an ‘earthing’ device, allows negatively-charged free electrons to enter the body. This action can help reduce inflammation and promote healing. I personally found earthing to be one of the most important inclusions in my personal journey to recovery. For more information go to www.earthinginstitute.net ]

spiritual health
For many, true healing is not complete without harmony in body, mind AND spirit. Attention to spiritual values and religious practices is very important to many cancer patients. To others it is not.

Some cancer patients derive much comfort from their particular belief system, especially if they have no fear of death. It helps them create a positive mental attitude, engenders hope and optimism, and overall, helps them cope better with the challenges of cancer and its treatment (or absence of available treatment).

Others may experience what is termed spiritual distress. They might believe their cancer is a form of ‘Divine punishment’, or they may feel God has abandoned them. If not resolved, this can negatively affect their health and ability to cope.

[Footnote –
My spiritual faith has been a very important part of my healing journey. It gave me great comfort during my darkest and most challenging times with progressive cancer. I had many productive conversations with my ‘Inner Doctor’ (Higher Self). Members of my support team were aware of my belief systems and supportive of them. My oncologist (a geneticist) was bemused when I told him that I had conversed on many occasions with my cancer cells! It was Einstein who said “For an idea that does not first seem insane, there is no hope”.]

4. Reflexology – an holistic approach to healing
Reflexologists promote reflexology as an holistic therapy, catering to the needs of body, mind and spirit. Although approaches to reflexology vary considerably, the positive effects experienced by so many, are a testimony to its effectiveness. No matter what type of reflexology is used, the most important consideration for cancer clients, is that they are nurtured and supported on their journey.

Anatomically related reflex areas are the focus for all forms of reflexology. But let me introduce you to a type of reflexology that also focuses on another dynamic – the subtle energy systems. Ayurvedic Reflexology combines the philosophy of India’s ancient medical system, Ayurveda, with contemporary, Western reflexology. Varying techniques are used in the application of Ayurvedic Reflexology to positively influence both physical and subtle energy systems.

According to Ayurvedic medicine, the health of the mind/body/spirit organism is dependant on receiving an adequate supply of nurturing subtle energy (prana). Prana is the equivalent of chi (or qi) within the Traditional Chinese Medicine (TCM) system. Prana is distributed to all parts of the mind/body system via energy pathways called nadis (the equivalent of the Chinese meridians).

Vital energy points (marmas) are located along the nadis. Marmas are the equivalent of the Chinese acupuncture points. Marma points can be worked to help regulate the flow of prana. Specific marma points are traditionally worked to affect the health of related tissues and body systems. Five of these important points are situated on each hand and foot.

Two of the five marma points (Talahridaya and Kshipra), have a positive and significant influence on marma points elsewhere in the body. Kshipra is especially helpful for those with compromised immune function. It is prudent to include work on both points in a reflexology session for cancer clients.

Metals are commonly used in Ayurvedic treatments. Ayurvedic Reflexology incorporates the use of a traditional kasa (or kansa) bowl. The kasa bowl is made of bronze. It is lubricated and lightly rubbed over the soles of the feet or palms of the hands to help harmonise and balance the subtle energy system.

According to Ayurvedic philosophy, all life processes are regulated by three bioenergetic principles (doshas) – VataPitta and Kapha. Individuality exists due to the unique combination of these three doshas. Good health relies on maintaining each individual’s unique balance of Vata, Pitta and Kapha.

Ayurvedic doctors estimate that an imbalance of Vata is responsible for at least 70% of all mind/body disease. This can, in part, be attributed to ongoing, uninterrupted stress. Many Ayurvedic treatments focus on rebalancing (calming) Vata to help re-establish health.

It is not well known in the reflexology community, that according to Ayurveda, Vata has a special affinity with the feet. Due to this relationship, foot reflexology (as compared to hand, face or ear reflexology) offers reflexologists significant opportunities to positively influence the health of their clients. Cancer clients, especially, can benefit from the Ayurvedic Reflexology approach.

[Footnote –
As an important part of my own cancer care. I applied Ayurvedic Reflexology daily to my hands and feet. As my cancer progressed, I completely handed over my foot reflexology to a professional Ayurvedic reflexologist. A major goal was to help calm and rebalance my Vata dosha through the footwork.]

5. The role of the reflexologist – understanding the challenges
The role of a skilled and compassionate reflexologist is to provide a safe, loving and relaxing environment where cancer patients can freely express emotions and share their deepest thoughts, without fear of judgment or bias.

The role of the reflexologist is to support, encourage and guide their clients, not dictate personal wishes.

Reflexology promotes relaxation, encourages sound sleep and can offer pain relief. These effects are well documented. However, it is important to have realistic expectations when dealing with cancer patients. Some will experience improvement in health, yet others will become progressively worse. It is important to remember that reflexology is given to assist the patient, not cure the cancer!

When someone is confronted with a diagnosis of serious cancer, they can immediately experience shock, disbelief, confusion and fear. It is often at this time that cancer patients are placed under enormous pressure to pursue a particular course of action. This may involve chemotherapy, surgery, radiation or other invasive therapies. This pressure can come from health professionals, loved ones, friends and well meaning acquaintances.

Many cancer patients become paralysed by fear. They languish in victim mode and allow others to make important decisions for them. Cancer patients can easily become disempowered. By encouraging self-advocacy, reflexologists can make a meaningful contribution to the positive and productive way in which cancer patients manage their serious health challenges.

It is important that therapists accept the choices made by their patients. Cancer patients will make the decisions that are right for them. Hopefully, these decisions will be based on sound evidence, and will reinforce the goals and aspirations they have for their journey.

“The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease.” Thomas Edison 1902

The role of the doctor as described by Edison has largely become the domain of the natural health practitioner. The natural therapist can often become the primary health carer. This role brings with it an enormous responsibility to be well informed regarding pathophysiology and health maintenance. Additionally, practitioners caring for cancer patients require knowledge of the specific issues associated with cancer care.

When therapists are confronted with an overwhelming amount of information outside their personal area of expertise, feelings of anxiety and inadequacy can arise. Some therapists do not feel comfortable, or do not have the desire to work with cancer patients. In these situations it would be wise to refer the patient on to an appropriate practitioner.

Before commencing an initial reflexology session with a cancer patient, it is important to seek permission from both the client and the treating medical professional. The health status of the patient needs to be evaluated at each visit. The focus and length of time of each reflexology session will vary accordingly. Reflexologists are aware that a very ill patient will often require a shorter, more gentle application of reflexology.

Family members are often delighted to be included in the reflexology care of their loved ones. As part of self-advocacy, many patients can be encouraged to apply self-help reflexology outside of professional sessions. For various reasons, many patients may not be able to access their feet for self-help work. This is where hand reflexology becomes a helpful alternative.

[Footnote –
For several years my abdomen was swollen with cancer. I could barely touch my feet. Prior to cancer, my personal routine had always included daily foot reflexology and a little hand work. As my cancer progressed, hand reflexology gained greater significance. My daily hand work was rarely missed. Regular foot sessions with my professional Ayurvedic reflexologist continued and were highly valued.]

support network
Successful management of cancer usually requires a multi-disciplinary approach. Building a network of caring, trustworthy and well informed professional therapists to support, guide and treat the cancer patient is imperative if best possible outcomes are to be achieved. Ideally, practitioners will include main-stream health professionals and complementary therapists. It can be very rewarding for reflexologists to be part of a comprehensive support team.

Recording accurate clinical notes at each session is important. On occasion, reflexologists may be required to share (with patient permission) confidential information with associated health care workers. Working with cancer patients within health institutions will have special requirements.

[Footnote –
After my cancer diagnosis, one of the first areas to receive my attention was the building of my support team. It included my oncologist and GP, plus experts in the fields of psychology (my husband), nutrition, acupuncture, reflexology, reiki, pranic healing, Ayurvedic medicine and NeuroLink. These people cared deeply about my welfare. Their loving attitude and professional expertise were a major contribution to the successful management of my cancer journey. I will forever be grateful to them.]

special considerations
Safety for the reflexologist as well as the client is an essential consideration. It is important that reflexologists recognise their limitations and refer on to another professional when required.

Reflexologists need to be aware of the cancer treatments their patients are receiving. Bodily fluids, including sweat, may carry residual radiation and toxic chemotherapy drugs. To avoid risk of contamination, reflexologists need to be familiar with safe excretion times.

Side effects of cancer and their treatments may necessitate attention to specific patient needs. A recliner chair might be more appropriate for very ill patients who are unable to lie comfortably on a massage table. Modification of reflexology techniques may be required when patients bruise easily due to a low platelet count or steroid use. Adaptation of pressure and reflexology techniques might be required for patients with osteoporosis, hand-foot syndrome (HFS) and chemotherapy induced peripheral neuropathy (CIPN). Thermoregulation can be a problem for many, especially if anaemic.

It needs to be remembered that immunosuppressed patients may be put at risk by an unwell therapist. Despite disappointment, it is best to reschedule a session if a reflexologist is not well.

LIVING with cancer (as opposed to dying from it) offers many challenges. Yet the journey, if travelled with desire, determination and discipline to make positive change, can open doorways to a more meaningful and satisfying life. Many cancer survivors say it is the best thing that has ever happened to them.

If the cancer is not cured and physical death is the outcome, does that mean the journey was in vain? Some might consider it a failure. Others will derive satisfaction from their encounter, knowing they have faced the challenge of cancer well.

What ever the outcome, reflexologists are privileged to be part of the healing process. Together, we face the challenges of cancer with our patients, as we tend to their needs with the professionalism, confidence and caring that is appreciated and so well deserved.

©Sharon Stathis 30 April 2016

The author’s new book “To Cancer with Love” is due for release in 2017.

Links to associated articles on this website –
• an extensive glossary of Cancer Related Terminology
• a handout for those with cancer Five Essentials for LIVING with Cancer