Peter Mackereth

A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture

BACKGROUND Maintenance acupuncture is advocated by clinicians after successful clinic-based acupuncture. We aimed to assess the effectiveness of maintenance acupuncture in the management of cancer-related fatigue (CRF); treatment delivered by therapists or self-acupuncture/self-needling was compared with no maintenance treatment. METHODS Breast cancer patients who participated in a randomized trial of acupuncture for CRF management (reported elsewhere) were re-randomized to receive an additional four acupuncturist-delivered weekly sessions; four self-administered weekly acupuncture sessions (self-needling); or no acupuncture. Primary outcome was general fatigue (Multidimensional Fatigue Inventory). Mood, quality of life and safety were also assessed. RESULTS In total, 197 patients were re-randomized, with 65 to therapist-delivered sessions, 67 to self-acupuncture/self-needling and 65 to no further acupuncture. Primary outcome scores were equivalent between the therapist-delivered acupuncture and self-acupuncture (P > 0.05). A non-significant trend in improving fatigue was observed at the end of 4 weeks in the combined acupuncture arms (P = 0.07). There was no impact on mood or quality of life of the further acupuncture sessions at 18 weeks beyond the improvement observed in initial trial. CONCLUSION Self-acupuncture is an acceptable, feasible and safe maintenance treatment for patients with CRF. However, overall, maintenance acupuncture did not yield important improvements beyond those observed after an initial clinic-based course of acupuncture. TRIAL REGISTRATION NUMBER NCT00957112.

Clinical supervision for 'potent' practice.

The author has received regular supervision since completing his training in biodynamic massage therapy. This is a requirement of the Code of Conduct for the Association of Holistic Biodynamic Massage Therapists. Initially, this proved difficult to arrange as supervisors familiar with this form of bodywork were based either in London or Cambridge, UK and the author has been living and working in the North West of England. One-to-one supervision was tried over the telephone, supported by 3-monthly meetings with a supervisor in London. Four years ago, the author was able to obtain monthly one-to-one supervision locally. He is now a member of a small supervision group who meet for 3 hours per month. More recently, he has taken on the role of supervisor with a focus on working with nurses involved in either complementary therapies and/or in developing clinical supervision. The following article explores the concept of supervision with the intention of sharing these experiences and promoting discussion on an understanding of the process and potential application within therapeutic nursing work.

A minority report: teaching fathers baby massage.

Infant or baby massage has emerged in the recent decade as an activity promoted by health care professionals, popular with parents and the subject of a growing body of research evidence (Complement. Ther. Nurs. Midwifery 2 (1996) 151; 3 & 8 Tough Ther. 2000). This paper reports on the experience of establishing and facilitating baby massage training. There is a focus in the discussion on teaching fathers, as only one male parent attended the classes over a 6-month period. Recommendations are made in the conclusion, identifying possible ways of promoting fathers involvement in babies massage. The paper, with its images of a father engaged in baby massage, is intended to add to the current limited amount of literature available on this subject.

Chair massage for patients and carers: a pilot service in an outpatient setting of a cancer care hospital

PURPOSE To gather patient and carer evaluations of a 20 min chair massage treatment provided one afternoon a week in an outpatient waiting area. METHOD Information gathered over a year included documented evaluation of chair massage, pre- and post-treatment well-being scores (visual analogue scale). RESULTS Both patients (n=224) and carers (n=185) positively evaluated the treatment. Key benefits reported included: relaxation, comfort, time out/treat, distraction, and relief of anxiety. There were significant changes in self-reported well-being score (p=<0.001), but no significant changes between scores for males and females. The changes in well-being scores on occasions (n=3) did not match the positive feedback. CONCLUSIONS The findings suggest that the service was appreciated by patients and carers. The project was continued for a further year with internal funding. Further research is warranted to ascertain the added and longer-term value of this intervention.

Legitimising fatigue after breast-cancer treatment

This study aimed to explore the experience of women living with fatigue following chemotherapy for breast cancer. Six focus groups were conducted (n=40); all participants had taken part in a multi-site acupuncture trial. There were three to seven people per focus group. Additionally, two people attended one-to-one interviews and four people provided written responses to the trigger questions. The audiotapes from these sessions were transcribed and analysed using a thematic approach. Participants raised concerns about fatigue possibly being a symptom of the cancer coming back or a sign of senility. Respondents described the effects of fatigue on relationships, sexuality, social life, home life and returning to work. The Coping with Fatigue booklet ( Macmillan Cancer Support, 2011 ) was discussed in terms of legitimising the experience of cancer-related fatigue and explaining symptoms to family and work colleagues. More research work is required to evaluate non-pharmaceutical interventions and advice to support women living with fatigue after chemotherapy for breast cancer.

Calming panic states in the Mould Room and beyond: A pilot complementary therapy head and neck cancer service

Purpose: The service was piloted in response to requests for assistance with patients experiencing severe anxiety undergoing head and neck radiotherapy. This paper describes the aims of the service, interventions provided and the recorded responses of patients to the support given. Data: Information about who referred, patient demographics, the interventions provided and patient feedback ( n = 112) was extracted from treatment records over a 15-month period. Findings: All referred patients successfully completed procedures and treatment. About 43 patients voluntarily disclosed past trauma, for example, sexual abuse, assault, childhood trauma, which they judged to have been linked to their claustrophobic responses. Advice and support was given to 40 patients also referred for smoking cessation; an additional three patients requested support when cravings returned. Conclusion: There is a paucity of information about the extent of the distress triggered by radiotherapy procedures and what interventions could be offered in practice. Further work is required to include an economic assessment and longer term effects on patient compliance with treatment and smoking cessation. Training needs for complementary therapists and radiotherapy staff at this centre were also identified; these are being addressed.

Providing therapies to the opposite sex: views of complementary therapists working in clinical and private practice settings.

AIM The study explored the experiences of working with the opposite sex as a therapists in a cancer care centre (CCC). METHODOLOGY Therapists (n = 17) participated in three focus groups. Audiotapes were transcribed verbatim and analysed. RESULTS Themes and sub-themes were identified; these related to maintaining safety, the relevance of location to how safe therapists felt when working with men, the therapeutic relationship, safety precautions and being vigilant. LIMITATIONS The participants were from one cancer care centre in the North West of England. Only two males participated. CONCLUSION This exploratory study identified that the majority of the participants in this study had concerns about safety related to the gender or sex of their patient or client. This was more of an issue in private practice with concerns centred on inappropriate sexual responses from male clients. This has implications for training and safety in establishing and maintaining a practice.

Return to TRI: Winston Churchill Fellow and Salford University Scholar travel to Miami and the Keys

During May and June 2003, the 2 authors visited the internationally renowned Touch Research Institute based at the University of Miami and Jackson Memorial Hospital. For one of the authors, Peter Mackereth, this was a return visit. Both authors are Ph.D. students who have successfully obtained travel scholarships to participate in seminars and laboratory work. The paper will report on the experience of their visit, the current and future work of the TRI and its collaborators. Jacqui took the opportunity to spend time at the Dolphin Research Centre, this provided insight into the therapeutic value of interacting with these amazing mammals. Peter also took the opportunity to visit a group of massage therapists working in Key West.

Body, relationship and sacred space

This article first appeared in Cahoots and is reproduced with kind permission of the publishers.

Prostate cancer awareness survey to proud postcards

ABSTRACT This paper describes the production and analysis of an informal prostate cancer awareness survey (n = 217), which was conducted in Manchester, UK, in August 2014 by the LGBT (Lesbian, Gay, Bisexual, Transgender) Cancer Support Alliance. Data collected from the survey along with anecdotal evidence collected by the researchers was used to produce a series of four “Prostate Cancer Awareness” postcards targeted at gay and bisexual men and trans women, and which could be displayed in public spaces likely to be accessed by these groups. The aim was to raise awareness of key issues picked up by the survey amongst the local population and highlight particular issues which may encourage men or transsexual women to think about the risk of developing prostate cancer, and what their relationship with sexual partners, carers and health care professionals might be following diagnosis and treatment. The postcards were titled: (1) We are struggling to have sex after treatment (2) Are gay men more likely to develop prostate cancer than straight men? (3) Tips for the guys…looking after your G-spot (4) My doctor always asks me about my wife.