Cancer is one of the critical health problems today and is the reason for 22% of deaths worldwide. Gynecological cancers are malign diseases of the female genital organs. They are among the first ten cancers most common among women. The symptoms of gynecological cancers differ depending on the involved organ, and this group includes primarily endometrial, cervix, and ovarian cancers1,2. Chemotherapy, radiotherapy, and surgery are used to treat gynecological cancers. Radiotherapy is applied as intracavitary (brachytherapy) or externally, depending on the general health of the patient and the type and severity of the cancer3. In brachytherapy, an applicator is placed in the vagina of the patient, and the radiation dose is given directly. The most crucial advantage of brachytherapy is quickly applying a high radiation dose on a localized area. This way, an increased amount can be applied to the tumor without harming other organs. However, the radiation dose can cause erythema, inflammation, mucosal atrophy, loss of elasticity in the vaginal epithelium, and ulceration of the vaginal tissue4,5. These problems cause pain, vaginal dryness, difficulty in sexual intercourse, and stress in patients.

Pain is a common symptom seen in those having cancer treatment. Cancer pain affects nearly 50-53% of patients at all disease levels and about 62-88% of patients with advanced disease levels6. The procedures during the brachytherapy cause patients to have acute pain and anxiety. It is determined in the studies in the literature that patients have back pain and abdominal pain during the procedure and pain and discomfort during the placing and displacing of the applicator in addition to cancer pain7, 8, 9. In addition, it is stated in the related studies that women having brachytherapy treatment experience emotions such as fear, pain, and humiliation8,9. Warnock (2005) reports that 22 out of 32 women experience back pain, abdominal pain, pain due to lying still during the intracavitary brachytherapy for gynecological cancer or pain/discomfort during the displacing of the applicator7. When women compare brachytherapy with delivery, they report that brachytherapy is the “worst” pain experience. In the same study, the researchers recommend nonpharmacological options for better pain management strategies to complete the pharmacological approaches3.

Health professionals must attach importance to pain management to increase the quality of life and the comfort of the patients and to decrease the use of opioids. Many pharmacological and nonpharmacological approaches are recommended for acute pain and state anxiety arising from cancer-specific treatment. Complementary and integrated treatments (CIT) are essential for pain management and reducing anxiety. It is stated in the guide of evidence-based interventions in pain management and treatment that the use of CIT approaches on their own is appropriate. One of these applications is massage10,11.

Massage is a cheap and easy method without side effects, and it reduces pain by increasing endorphin release and anxiety by providing muscle relaxation12, 13, 14. Hand massage, performed with classical massage techniques, includes slow, gentle, and rhythmic applications applied to the hand with equal speed and light pressure. In addition, hand massage can provide the patient relaxation by increasing parasympathetic activity and decreasing sympathetic activity15, 16, 17. When the studies related to CIT in the literature are reviewed, it is determined that music therapy reduces anxiety and pain significantly in the study Chu-Hui-Lin Chi conducted with patients having brachytherapy6. A study by Blackburn et al. determined that the reflexology and aromatherapy applications practiced on 41 women having brachytherapy reduce pain and anxiety18. There is no randomized controlled study in the literature evaluating the effect of hand massage on acute pain and state anxiety in women with gynecologic cancer having brachytherapy. Therefore, the impact of hand massage applied with lavender baby oil on women with gynecologic cancer having brachytherapy for three sessions on the pain and state anxiety experienced during the intervention was evaluated in this study.