Reflexology for Cancer Patients

One large RCT showed significant differences in quality of life and mood when reflexology was compared with self-initiated support. This study suggested favorable effects of reflexology on pain, nausea, and vomiting. (5) In a recent randomized controlled trial (RCT), researchers evaluated the effects of reflexology on quality of life (QofL) in women with early breast cancer. One hundred and eighty-three women were randomized 6 weeks post-breast surgery to a reflexology intervention group or control group. Reflexology and massage comprised eight sessions at weekly intervals. The primary end-point was 18 weeks post surgery and the secondary end-point was 24 weeks post surgery.  Researchers concluded that reflexology and massage have statistically significant and clinically worthwhile effects on Quality of Life following surgery for early breast carcinoma. (15)

Massage for Children with Cancer

Research has shown positive effects from massage therapy for premature infants and for children with asthma, arthritis, and other illnesses.  Although these effects have been demonstrated, massage therapy research on children with cancer and blood disease has been lacking. One recent study, conducted at the Cancer Center at the University of Florida, Gainesville, measured the physical and psychological effects of massage therapy on pediatric oncology and hematology patients. The participants were 30 children with cancer or blood disease, ages 6 months to 17 years.  The treatment group received 20-minute sessions of Swedish Massage once daily for approximately 4 days (inpatients), or once weekly for approximately 4 weeks (outpatients); the control group received no massage therapy.  Results of the study indicated significant psychological improvements for the massage therapy group on anxiety and emotional state. Additional finding of the study indicated significant physical improvements for the massage therapy group on muscle soreness , discomfort, respiratory rate, and overall progress. The study concluded that in children with cancer and blood diseases, massage therapy can reduce psychological and physical distress and can have a positive effect on quality of life. (21)  In another study, researchers studied changes in relaxation (heart and respiratory rates, blood pressure, and salivary cortisol level) and symptoms (pain, nausea, anxiety, and fatigue) in children. Massage was more effective than quiet time at reducing heart rate in children, anxiety and parent anxiety. Children reported that massage helped them feel better, lessened their anxiety and worries, and had longer lasting effects than quiet time. Massage in children with cancer is feasible and appears to decrease anxiety in parents and younger children. (22)

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Massage for the Bereaved

One research study explored how bereaved relatives experienced soft tissue massage during the first four months after the death of a family member who was in palliative cancer care. Death of a close family member or friend is recognized as being an emotional and existential turning point in life. Previous studies emphasize need for various support strategies to assist relatives while they are grieving. Eighteen bereaved relatives (11 women and seven men) received soft tissue massage (25 minutes, hand or foot) once a week for eight weeks. In-depth interviews were conducted after the end of the eight-week periods. Interviews were analyzed using a qualitative descriptive content analysis method. Soft tissue massage proved to be helpful and to generate feelings of consolation in the first four months of grieving. The main findings were organized into four categories: 1) a helping hand at the right time, 2) something to rely on, 3) moments of rest and 4) moments of retaining energy. Soft tissue massage was experienced as a commendable source of consolation and support during the grieving process. An assumption is that massage facilitates a transition toward rebuilding identity, but more studies in this area are needed. Soft tissue massage appears to be a worthy, early, grieving-process support option for bereaved family members whose relatives are in palliative care. (10)

Future Massage and Cancer Research

There is much preliminary evidence that therapeutic massage is a useful modality for the relief of a variety of symptoms and symptom-related distress affecting cancer patients. Mechanistic studies are necessary to delineate underlying biologic and psychological effects of massage and their relationship to outcomes. Future research may incorporate a model using nuclear magnetic resonance techniques to capture dynamic in vivo responses to biomechanical changes induced in the soft tissues by massage. This model enables study of the communication of soft tissue changes to activity in the sub-cortical central nervous system. The hypothesis is that the therapeutic components of massage are twofold: (1) a rapid direct effect on local fascia, muscle, and nerves and (2) a slower delayed effect on the sub-cortical central nervous system that ultimately incorporates remodeling of plastic neuronal connections.

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This testable model has important implications for mechanistic research on massage for symptom control of cancer patients since it opens up new research avenues that link objective physiologic responses with the effects of massage on the subjective experience of pain and other symptoms.

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