Effect of Ear Acupressure on Anxiety and Cortisol Levels in Women Receiving Premastectomy Radiotherapy: A Randomized Clinical Trial

Introduction: Radiation therapy before mastectomy increases the severity of stress and cortisol hormone. Because of the preference of patients and physicians for nonpharmacologic stress management methods, we conducted the present study with the aim of evaluating the effect of ear acupressure on anxiety and cortisol hormone levels in women receiving premastectomy radiotherapy. Methods: This randomized clinical trial was carried out on 66 patients (based on sample size formula) at Imam Reza Hospital in Tabriz during the years 2018-19. The intervention group was given acupressure, twice a day (8 minutes on each ear), for three days before surgery. Serum cortisol level and latent and manifest anxiety (the Spielberger State-Trait Anxiety Inventory) were measured before and after the intervention. Data were analyzed using SPSS 20 software. A P value less than 0.05 were considered significant. Results: There was no significant difference in latent anxiety, manifest anxiety, or cortisol levels between the groups at baseline. Ear acupressure caused a significant decrease in latent anxiety (from 43.22 ± 6.41 to 33.09 ± 4.91), explicit anxiety (from 49.50 ± 5.52 to 32.18 ± 5.01), and plasma cortisol levels (from 156.15 ± 18.95 to 115.59 ± 17.80) (P < 0.005), while no significant changes were observed in the control group (P > 0.05). Conclusion: Ear acupressure can reduce anxiety and stress (cortisol) levels in breast cancer patients undergoing radiotherapy before mastectomy.