The power of touch: external applications from whole medical systems in the care of cancer patients (literature review)

  • Inga MühlenpfordtEmail author
  • Wiebke Stritter
  • Mathias Bertram
  • Eran Ben-Arye
  • Georg Seifert
Review Article



In the context of whole medical systems (WMSs), external applications are manual treatments that stem from complementary medicine and are performed by practitioners, nurses and caregivers through the application of interpersonal touch. These applications work via physiological, psychological and social processes and are intended for holistic healing. In integrative oncology, these applications are used to improve patients’ wellbeing. The purpose of the review is to collect and compare research results concerning external applications from WMSs applied to patients with cancer.


We conducted a literature review to explore the effects of external applications on patients undergoing cancer treatment. Inclusion criteria were external applications from Anthroposophic Medicine, Traditional Chinese Medicine (TCM) and Ayurvedic Medicine, examined detached from the effect interdependencies of their respective WMSs.


Searches identified 111 publications. Final inclusions were four Shiatsu studies (from TCM), supplemented by two case reports exploring anthroposophic external applications. The literature review suggests that external applications may improve patients’ wellbeing during cancer treatment and are associated with physical and psychological effects that potentially enhance supportive cancer care. The number and quality of published studies in the field is limited.


Future empirical investigations should assess the effectiveness and underlying effects in patients with cancer, adhere to a patient-tailored approach, and investigate the systemic complexity of touch-based applications from WMSs.


External application Touch Cancer Integrative oncology Complementary medicine Whole medical systems 



Christophorus foundation funded this review by a grant. The experts Gisela Blaser (nurse, expert for naturopathic nursing), Dr. med. Christian Kessler (natural medicine and Traditional Indian Medicine specialist), Monika Layer (nurse scientist, expert for integrative care), Doris Rapp, Gabriele Weber and Britta Wilde (nurses, experts for Anthroposophic care) contributed by naming possible sources from grey literature. This permitted a more comprehensive presentation of the procedures of EAs. We thank Christophorus Foundation and the professional experts very much.

Contributions of the authors

Inga Mühlenpfordt: Manuscript writing, organisation, planning, coordination

Wiebke Stritter: Manuscript writing, organisation

Mathias Bertram: Provision of contacts and literature sources

Eran Ben-Arye: Manuscript editing

Georg Seifert: Initiation, organisation, manuscript editing

Funding information

Christophorus Foundation supported this review with a grant (grant number 329CST).

Christophorus Stiftung, GLS Treuhand, Kernerplatz 2, 70182 Stuttgart

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatrics, Division of Oncology and HematologyCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Doerthe-Krause-Institute for Nursing Science and EducationGemeinschaftskrankenhaus Herdecke gGmbHHerdeckeGermany
  3. 3.Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Lin and Carmel Medical CentersClalit Health ServicesTel Aviv-YafoIsrael
  4. 4.The Bruce Rappaport Faculty of Medicine, The TechnionIsrael Institute of TechnologyHaifaIsrael

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