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Research-Based Massage for Cancer Patients (2 CE Hours)

This course is approved by the Texas Department of State Health Services DSHS for Continuing Education for Massage Therapists CE0009 and by the NCBTMB for Nationally Certified Massage Therapists for 2 CE Hours.

This article reviews the latest clinical research that has reported the effectiveness of massage therapy for the treatment of cancer patients and their symptoms. 

Learning Objectives: After reading this course, you will...

  1. be able to identify the types of symptoms associated with cancer patients that can be influenced positively by massage therapy.
  2. be able to list specific massage therapies that have evidence to support their use with cancer patients.
  3. be able to explain the efficacy of massage therapy in the treatment of symptoms of cancer.
  4. be able to describe what type of massage is best in the treatment of cancer-related symptoms.


Introduction to Massage for Cancer Patients

Complementary and alternative medicine (CAM) for treatment of cancer and for supportive care of cancer patients is quickly becoming a mainstream phenomenon.  Integrative alternative therapies, also known as holistic therapies, have many applications in hospitals and health centers. These may include relaxation therapies, meditation, massage, reflexology, and Reiki or healing touch. Patients today are looking for these services, and institutions continue to explore ways to provide them. There is encouraging evidence for CAM in the treatment of cancer-related symptoms, such as acupuncture and progressive muscle relaxation for chemotherapy-related nausea and vomiting and aromatherapy massage for decreasing anxiety and increasing quality of life. (2, 6) With increasing frequency, patients with cancer and their family members are turning to complementary and alternative medicine and supportive care. Of 41 national cancer centers, 54% had information supporting the effectiveness of massage in the treatment of cancer patients. (11) Even in palliative care, terminal cancer patients find massage an integral part of their process.  Massage has been demonstrated to be very beneficial for decreasing symptoms of pain, nausea, fatigue, anxiety and insomnia in clinical trials. (16, 17) Massage techniques range from light touch to deeper tissue pressure and include reflexology treatments, involving only foot massage. The choice of technique is dependent on the patient’s clinical condition. Those who are frailer and who are near the end of life may tolerate the reflexology treatment rather than full body massage, whereas patients who are early in their symptoms may tolerate deeper massage work. Symptom management is achieved equally through the reflexology and the full body massage, with an average decrease in symptom intensity of 50% for all presenting complaints, and often the relief lasted at least 48 hours post massage or reflexology treatment. (16) The massage treatments have a very favorable risk to benefit ratio and very low risk of adverse side effects. People with incurable cancer often experience soft massage in a palliative care setting in which massage is used as an established and integrated part of the nursing care.  For some cancer patients, soft massage was experienced as a way to find inner peace. During the massage the patients felt dignified, while memories from past sessions were about becoming free. These experiences of dignity and freedom brought hopes for the future. The conclusion is that soft massage ought to be offered in the ordinary palliative care of cancer patients. (13)

Massage Reduces Anxiety and Depression in Caner Patients

Distress associated with cancer often presents with symptoms of depression and/or anxiety. Complementary therapies, especially aromatherapy massage (AM), are often employed to alleviate anxiety. Aromatherapy massage treatment was considered an acceptable treatment and patient’s engagement with treatment was high. Significant improvements in decreased symptoms of depression and anxiety were observed with aromatherapy massage. (2)  Patients with brain tumors report experiencing elevated levels of stress across the disease continuum. Massage therapy is a commonly used complementary therapy and is employed in cancer care to reduce psychological stress and to improve quality of life (QoL). The purpose of this pilot study was to obtain a preliminary assessment of the efficacy of massage therapy on patient reported psychological outcomes and quality of life. Participants were newly diagnosed primary brain tumor patients who reported experiencing stress and who received a total of eight massages over a period of 4 weeks. Participants completed the Perceived Stress Scale and the Functional Assessment of Cancer Therapy-Brain to assess their stress level and quality of life. As a group, levels of stress dropped significantly between weeks 2 and 3. A trend for the reduction in stress continued through week 4 and at the end of week 4, scores of all participants were below the threshold for being considered stressed. By the end of the intervention, participants reported significant improvements in three test domains, emotional well-being, additional brain tumor concerns, and social/family well-being.  This study indicates that massage therapy is both feasible and acceptable to newly diagnosed brain tumor patients experiencing stress. Furthermore, participants in this study reported improvements in stress and their quality of life while receiving massage therapy.(6)  Cancer patients frequently suffer from psychological co-morbidities such as depression and elevated stress. Previous studies have demonstrated that cancer patients benefit from massage therapy on the physical and psychological level. This study investigated the effects of massage on depression, mood, and perceived stress in breast cancer patients. Thirty-four breast cancer patients were randomly assigned to a massage group (n=17) and a control group (n=17). Patients of the massage group received two 30-min classical massages per week for 5 weeks. At baseline, at the end of the intervention period, and 6 weeks after the end of intervention, patients of both groups completed the Perceived Stress Questionnaire (PSQ) and the Berlin Mood Questionnaire (BFS). Depression (PHQ) and anxious depression (BSF) were significantly reduced immediately after massage compared to the control group. This study concluded that Massage Therapy is an efficient treatment for reducing depression in breast cancer patients (8)

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