Water therapies (hydrotherapy, balneotherapy or aqua therapy) for patients with cancer: a systematic review

Abstract

Background Water therapies as hydrotherapy, balneotherapy or aqua therapy are often used in the relief of disease- and treatment-associated symptoms of cancer patients. Yet, a systematic review for the evidence of water therapy including all cancer entities has not been conducted to date. Purpose Oncological patients often suffer from symptoms which in patients with other diseases are successfully treated with water therapy. We want to gather more information about the benefits and risks of water therapy for cancer patients. Method In May 2020, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of water therapy on cancer patients. Results Of 3165 search results, 10 publications concerning 12 studies with 430 patients were included in this systematic review. The patients treated with water therapy were mainly diagnosed with breast cancer. The therapy concepts included aqua lymphatic therapy, aquatic exercises, foot bathes and whole-body bathes. Outcomes were state of lymphedema, quality of life, fatigue, BMI, vital parameters, anxiety and pain. The quality of the studies was assessed with the AMSTAR2-instrument, the SIGN-checklist and the IHE-Instruments. The studies had moderate quality and reported heterogeneous results. Some studies reported significantly improved quality of life, extent of lymphedema, neck and shoulder pain, fatigue and BMI while other studies did not find any changes concerning these endpoints. Conclusion Due to the very heterogeneous results and methodical limitations of the included studies, a clear statement regarding the effectiveness of water therapy on cancer patients is not possible.

Assessment of Integrative Therapeutic Methods for Improving the Quality of Life and Functioning in Cancer Patients—A Systematic Review

“…Reger et al conducted a systematic review, published in 2022, of 430 cancer patients aged 18–78 composed of 378 women and 52 men. Patients with breast cancer (n = 206, 4 studies) and gynecological cancer (n = 113, 3 studies) predominated; patients with colorectal cancer (n = 40, 1 study) and a mixed group of patients with various cancers (bladder, prostate, lung, liver) (n = 38, 2 studies) were also included [ 68 ]. The most frequently used intervention was represented by aquatic exercises such as aquatic lymphatic therapy, including aerobic exercises, mobilizations and stretching in pools of water, partial foot baths or general baths.…”

“…not for passive mobilizations. Future studies are needed regarding the safety of using mineral waters with high temperatures [ 68 ].…”

“…Active forms of aquatic physiotherapy are indicated in these cases. Before starting the therapy, it is recommended for the oncologist to evaluate the patient and assess the risks and contraindications [ 68 ].…”

An update on rehabilitative treatment of shoulder disease after breast cancer care

“…Odynets et al [ 17 ] found that a 12-week program of water-based exercise was better than pilates for active shoulder ROM and upper limb lymphedema but did not report significant differences in upper limb strength between the two groups. Water therapies have been long studied for the treatment of different pathologies including cancer related symptoms [ 38 ]. The capacity of cold water to induce peripheral vasoconstriction followed by vasodilatation as well as the massaging effect have been used to help alleviate lymphedema.…”

The Practice of Physical Activity on Psychological, Mental, Physical, and Social Wellbeing for Breast-Cancer Survivors: An Umbrella Review

“…Aerobic training, resistance training [ 25 ], interventions based on flexibility, yoga, tai chi, qigong, and Pilates [ 26 ], or exercise in general [ 27 ], have been proposed, with different outcomes and conclusions. Despite the large number of studies on this topic, heterogeneity in the results and methodological limitations have made the findings of the studies limited [ 28 ]. This confusion on the effects of physical-activity interventions on BC symptoms makes it necessary to deeply investigate the topic [ 29 ] to also understand the magnitude of the positive effects of physical activity among BC survivors [ 30 ].…”