Written by Helen Cooke and the CAM-Cancer Consortium.
Updated April 29, 2016


What is it ?


Biofeedback is a process that is used to enable an individual to learn how to change physiological activity for the purposes of improving health and performance1. A variety of different biofeedback techniques are available. The two most commonly used techniques by people with cancer are electromyography (EMG), which measures the electric activity in muscles, and skin temperature (ST) biofeedback. These instruments rapidly and accurately 'feed back' information to the user. The presentation of this information — often in conjunction with changes in thinking, emotions, and behaviour — supports desired physiological changes. Over time, these changes can endure without continued use of an instrument.

Application and dosage

Biofeedback is most commonly taught by health care professionals including clinical psychologists and nurses, as well as hypnotherapists and complementary practitioners. Training is either conducted in groups or one-on-one sessions, lasting twenty to thirty minutes. Patients are informed about the purpose of the training; i.e. to help them become relaxed and comfortable. The therapist then attaches electrodes or skin temperature thermistors and demonstrates how to use the equipment2.

Participants are subsequently given suggestions about how to influence physiological responses and any symptoms they are experiencing. For example EMG-biofeedback users are told they may find it helpful to imagine relaxing and letting go of any muscle tension and see how this alters the biofeedback reading and tone. ST-biofeedback users are told they may find it helpful to imagine that their fingers and hands are warm and comfortable. A small band indicates changes in finger temperature.

Patients are recommended to use the equipment once or twice a day, in order for them to master the skill3.


Scientists began to make the link between electrical responses in nerve and muscle activity in the early 1900s. Edmund Jacobson who worked as a physiologist/physician in the 1930s and John Basmajian, a Canadian academic and scientist were early pioneers in the field of biofeedback4.

Claims of efficacy/mechanism of action/alleged indications

Biofeedback is aimed at allowing people to monitor and influence specific physiological responses the individual would likely to be otherwise unaware of by providing information about moment-to-moment physiological responses such as muscle tension and skin temperature3.

 EMG feedback is most commonly used by people with cancer as a technique to initiate a deep state of muscle relaxation, with the aim of inducing a generalised relaxation response and relief in cancer-related symptoms.

Adverse effects, including gastro-intestinal upsets such as nausea and vomiting that are caused by high levels of anxiety also appear to be reduced through this muscle relaxation mechanism. It is thought that muscular relaxation may directly inhibit the characteristic sequence of muscular activity that generally precedes nausea and vomiting. It has been suggested that the 'relaxation response' may help break the pain-anxiety-muscle-tension cycle5. ST biofeedback aims to help people control peripheral blood flow to their peripheries and has been shown to improve circulatory and vascular disorders such as Raynaud’s disease3. Skin temperature drops just before vomiting, it has therefore been proposed that by teaching patients to adapt their skin temperature biofeedback may also benefit chemotherapy-related nausea and vomiting3.

It has been proposed that learning biofeedback and relaxation skills can contribute to improved feelings of self-efficacy, by helping people with cancer feel more in control of any side-effects including chronic pain5.

Prevalence of use

The exact prevalence of the use of biofeedback for cancer patients is unknown.

Legal issues

The Biofeedback Certification International Alliance10 certifies individuals who meet education and training standards in biofeedback. It is the certification body for the clinical practice of biofeedback by the Biofeedback Foundation of Europe11, the Biofeedback Certification Institute of America1 and the International Society for Feedback Research12.

Costs and expenditures

Biofeedback can be administered or taught fairly easily and is therefore a relatively inexpensive therapy depending on the context within in which it is administered.

Citation Helen Cooke, CAM-Cancer Consortium. Biofeedback [online document]. http://ws.cam-cancer.org/The-Summaries/Mind-body-interventions/Biofeedback. April 29, 2016.


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