Massage and Cancer
Is massage safe for someone in cancer treatment?
The short answer is yes, absolutely! Massage is safe and appropriate for someone with a cancer experience during treatment and post-treatment when performed by a therapist with specialized advanced training in massage and cancer. Tracy Walton and Associates' intensive course “Oncology Massage Therapy: Caring for Clients with Cancer”, is one of those trainings. It is approved by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and recognized by the Society for Oncology Massage, whose mission is to “support the safe delivery of massage therapy to people who are living with cancer, to promote an oncology massage education standard, and to collaborate in research”. I am a graduate of that training and proud to be a Preferred Practitioner with the Society for Oncology Massage.
It used to be believed that massage could spread cancer due to its circulatory effects. It was thought that tumor cells traveling through blood and lymph vessels could metastasize by raising general circulation in the body through massage. That no longer holds true. It is now recognized that exercise and movement increase circulation much more than a massage can and physical activity is usually encouraged in people with cancer.
What is the difference between “regular” massage and oncology massage?
Oncology massage is informed by an understanding of the ways cancer and cancer treatment affect the whole person - physically, emotionally, psychologically, and spiritually. With this knowledge, a therapist can assess and, through critical thinking, provide massage adjustments for anyone who has ever received a cancer diagnosis or undergone cancer treatment to provide a safe and effective experience.
Before the hands-on session begins, the therapist conducts an in-depth health history with the client. Through an understanding of the many effects of cancer and the treatment side effects (current and long-term), the therapist then creates a personalized care plan that adapts to the client’s situation with appropriate adjustments. Factors that determine whether adjustments will be made include tumor status, surgery and radiation side effects, neutropenia, thrombocytopenia, neuropathy, metastasis, lymphedema (or risk of), deep vein thrombosis (or risk of), compromised organ function, medication side effects and risks, and fragile or unstable tissues or bones. Adjustments may include client positioning, area(s) worked, pressure and pace. By adapting techniques and adjustments, the emotional and physical benefits of touch can be experienced by all no matter where they are on the journey.
What are the benefits of receiving massage during or post-treatment for cancer?
Massage is widely offered at a growing number of hospitals and cancer treatment facilities in the US, including the Dana-Farber Cancer Institute, Memorial Sloan Kettering, Massachusetts General, Mayo Clinic, MD Anderson Cancer Center, and many others. Studies have shown that it helps to reduce symptoms and side effects, enhance quality of life, and improve coping. And feedback from clients again and again has confirmed this for me.
A large published report of 1,290 cancer patients treated at the Memorial Sloan–Kettering Cancer Center in New York City evaluated changes in symptoms in patients receiving Swedish, light touch, or foot massage over a period of three years. Independent observers recorded data collected before and after the first massage session. Patient symptom severity of pain, fatigue, stress/anxiety, depresssion and nausea declined by approximately 50%! Outpatients improved about 10% more than inpatients. And the inpatients’ relief endured with reports of no return to symptoms baseline scores throughout a 48 hour follow up. Swedish and light touch massage were found to be more effective than foot massage alone.
A previously published report of 34 cancer patients undergoing autologous bone marrow transplant at Dartmount-Hitchcock Medical Center evaluated the effects of massage therapy on anxiety, depression and mood. Patients in the massage group received 20-minute sessions of upper body Swedish massage (shoulder, neck, head, and face). Patients in the control group received standard treatment with no massage. Patients’ immediate effects were assessed pretreatment, midtreatment and prior to discharge. The massage group’s distress, anxiety, nausea, fatigue, and diastolic blood pressure levels dropped significantly, compared to the control group.
Research has reported multiple benefits to massage, including:
Reduction in Anxiety and Depression:
Clients report being less anxious overall when receiving regular massage, especially before and during procedures and treatments that are uncomfortable. Studies also show that massage helps reduce depression.
Reduction in Pain:
Individuals receiving massage express less pain related to cancer, cancer treatment and muscle tension. They state that massage helps “take the edge off” of acute pain and even relieve it altogether, in some cases.
Reduction of Nausea:
As mentioned earlier, gentle Swedish massage was shown to reduce nausea in patients receiving autologous bone marrow transplants. In another small study, it was suggested that massage helped decrease medical costs of managing nausea and vomiting.
Improvement in Sleep and Reduction in Fatigue:
At least one study shows massage helps to facilitate sleep and reduce fatigue.
Reduction in Chemotherapy-Induced Peripheral Neuropathy (CIPN)
CIPN can cause pain and/or numbness in the hands and/or feet due to chemotherapy drugs that damage the nerves. Research has suggested that massage can help reduce the pain and numbness and other problems associated with CIPN. A 2019 study found that patients receiving three (versus two) 30-minute massages per week had sustained improvement in lower body CIPN up to 6 weeks after session completion, regardless of the massage treatment site (upper body versus lower body) . Another 2019 study found massage successfully prevented CIPN pain and improved the patients’ quality of life.
References for studies:
Overall Reduction in Symptoms
Cassileth BR, Vickers AJ. “Massage therapy for symptom control: outcome study at a major cancer center”. J Pain Symptom Manage. 2004;28:244–9. [PubMed]
Reduction in Anxiety and Depression:
Lawvere, S, “The effect of massage therapy in ovarian cancer patients,” in Rich, GJ, ed. Massage Therapy: The Evidence for Practice. Edinburgh: Mosby, 57-83, 2002.
Ahles, TA et al., “Massage Therapy for Patients Undergoing Autologous Bone Marrow Transplantation,” Journal of Pain and Symptom Management 18:157-63, 1999.
Field, T. et al., “Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients,” Journal of the American Academy of Child and Adolescent Psychiatry 31(1):125-131.
Reduction in Pain:
Ahles et al. (above)
Wilkie, DJ et al., “Effects of Massage on Pain Intensity, Analgesics and Quality of Life in Patients with Cancer Pain: A Pilot Study of a Randomized Clinical Trial Conducted within Hospice Care Delivery,” Hospice Journal 15:31-53, 2000.
Grealish, L et al., “Foot massage: a Nursing Intervention to Modify the Distressing Symptoms of Pain and Nausea in Patients Hospitalized with Cancer,” Cancer Nursing 23:237-43, 2000.
Smith, MC et al., “Outcomes of Therapeutic Massage for Hospitalized Cancer Patients,” Journal of Nursing Scholarship 34(3): 257-262, 2002.
Reduction of Nausea:
Ahles et al, above.
Lively, BT et al., “Massage Therapy for Chemotherapy-Induced Emesis,” in Rich, GJ, ed. Massage Therapy: The Evidence for Practice. Edinburgh: Mosby, 85-104, 2002.
Improvement in Sleep and Reduction in Fatigue:
Smith, MC et al, above
Reduction in Chemotherapy-Induced Peripheral Neuropathy:
Lopez, Gabriel et al., “A pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy (CIPN),” Journal of Clinical Oncology, 37, no. 15_suppl, 2019.
Izgu N, et al., “Prevention of chemotherapy-induced peripheral neuropathy with classical massage in breast cancer patients receiving paclitaxel: An assessor-blinded randomized controlled trial,” Eur J Oncol Nurs. 2019 Jun;40:36-43.
