Cancer Treatment Side Effects & Supportive and Palliative Care
The use of touch to calm and reassure a patient is universally present through all healing traditions around the world. In Western medicine, the use of massage therapy to increase relaxation and well-being has been studied and shown to be effective for a variety of conditions and populations, including oncology. Evidence for the benefits of massage exists for stress, anxiety, and pain.
For example, in a crossover randomized control trial of massage for symptom reduction in cancer patients published in 2003, 230 cancer outpatients who were assigned to receive either massage, healing touch (an intervention whereby the practitioner is believed to modify a patient's energy fields by motion of his or her hands near or gently on the patient), or the presence of a staff member in the room. Each intervention was given weekly for 45 minutes for 4 weeks. the group receiving massage therapy showed decreased pain and anxiety. Another RCT assessed the effect of massage and acupuncture added to usual care vs. usual care alone in postoperative cancer patients. Providing massage and acupuncture in addition to usual care resulted in decreased pain and depressive mood among postoperative cancer patients when compared with usual care alone. An RCT involving 86 dyads of patients with metastatic cancer and their partners studied the effect of reflexology intervention delivered by the partner. Partners were trained by a certified reflexologist, and were instructed to deliver a 30-minute foot reflexology intervention to the patient. The control group received a 30-minute reading session from their partners. Following the partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety.
In addition, large, retrospective, observational study of pre- and post-massage symptom scores of 1,290 in- and outpatients seen over a 3-year period at Memorial Sloan-Kettering Cancer Center Showed an average 50% reduction in symptoms, including pain as well as fatigue, anxiety, nausea, and depression. Follow-up surveys showed persistence of the benefit at 48 hours. Although the study did not have a randomized design, results support the use of massage for co-management of pain in patients with cancer.
A recent review of the use of massage in oncology care stated that oncologists should feel comfortable referring patients to qualified massage therapists as appropriate. When practiced by licensed massage therapists who have been trained to work with oncology patients, massage is a safe and appropriate therapy for the co-management of cancer-related symptoms.
There are a few case reports in the literature that have reported or theorized serious adverse events induced by massage, including fractures and dislocations, internal hemorrhage, and hepatic hematoma. However, a recently published review of cases reported in the literature found that actually there are few reported adverse events produced by massage sessions. Although cancer patients may be at higher risk for these problems, the fact is that these adverse events are easily avoidable if massage therapists are properly trained to work with oncology populations.
One of the most feared adverse events when referring cancer patients is the possibility of spreading cancer cells by direct pressure over tumors. However, there is no evidence that massage therapy can spread cancer. In addition, massage therapists are trained to avoid direct pressure over a tumor or procedural areas such as areas surrounding catheters, wounds, lesions, etc.
When provided by licensed practitioners who have been trained to work with oncology patients, massage is highly recommended for the co-management of pain and may enable patients to avoid side effects of allopathic medications used for these purposes.
References - Hide References
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