Cancer & Massage
Studies of massage for cancer patients suggest massage can decrease stress, anxiety, depression, pain, and fatigue in some. Many health care professionals recognize massage as a useful, non-invasive addition to standard medical treatment. Therapeutic massage is most often given by trained massage therapists. Caregivers can also be trained to provide safe massage techniques.
How is it promoted for use?
Massage is recommended by some health care professionals as a complementary therapy, that is, one that is used in addition to conventional medical care. They believe massage can help people with serious illnesses such as cancer to reduce stress, anxiety, and pain. It is also known to help relax muscles. Many people find that massage brings a temporary feeling of well being and relaxation. Massage is also used to relieve pain and stiffness, increase mobility, rehabilitate injured muscles, and reduce the pain of headaches and backaches.
Some practitioners claim massage raises the body's production of endorphins (chemicals believed to improve overall mood) and flushes lactic acid (a waste product) out of muscles. Proponents also claim massage promotes recovery from fatigue produced by excessive exercise, breaks up scar tissue, loosens mucus in the lungs, promotes sinus drainage, and helps arthritis, colds, and constipation.
Proponents claim myotherapy (a specific type of massage) can reduce 95% of all muscle-related pain, and in some cases can replace the use of pain-relieving drugs. They say the techniques used in myotherapy relax muscles and improve muscle strength, flexibility, and coordination; relieve pain; reduce the need for pain medications; increase blood circulation; improve stamina and sleep patterns; and correct posture imbalances.
What does it involve?
There are many types of massage, including Swedish, sports massage, neuromuscular therapy, myotherapy, and others (see also Acupressure, Shiatsu, and other Asian Bodywork and Myofascial Therapy). Swedish massage is one of the most common types of massage used in the United States today, although most massage therapists combine a number of different styles and techniques.
In all forms of massage, therapists use their hands (and sometimes forearms, elbows, and massage tools) to manipulate the body's soft tissue. Massage strokes can vary from light and shallow to firm and deep, and from slow steady pressure to quick tapping. The choice will depend on the health and needs of the individual and the training and style of the massage therapist. During active treatment for cancer, special considerations may apply (see possible problems or complications).
Swedish massage uses several techniques to apply pressure to muscles in order to relax them and encourage circulation. Deep tissue massage focuses on deep layers of muscle tissue and connective tissue with the goal of releasing chronic tension or tightness. Sports massage is used in different ways depending on the sport, but the overall goals are to reduce fatigue and improve mobility.
Myotherapy and neuromuscular therapy focus on finding “trigger points,” and use different techniques such as deep pressure to reduce them. Trigger points are abnormally sensitive, highly irritable knots of tight muscle tissue that may cause pain or limit range of motion. This type of massage is also called trigger point therapy.
Massage usually takes place on a massage table. The client may wear minimal clothing, and is covered by a sheet, light blanket, or towel. Oils or lotions are often used to keep friction from irritating the skin. Typical massage therapy sessions last from 30 minutes to one hour. Massage therapists often play soothing music and use dim lighting to increase relaxation and comfort.
Some massages take place with the client seated fully clothed on a massage chair with the client fully clothed. Chair massage focuses on the head, neck, shoulders, back, arms, and hands. These massages tend to last 15 to 30 minutes.
Many hospitals and cancer centers now offer massage to cancer patients. When provided to inpatients, massages generally last a shorter time.
What is the history behind it?
Massage has been used in many ancient cultures including those of China, India, Persia, Arabia, Greece, and Egypt. Chinese texts dating back to 2700 BC recommended massage and other types of body movements as treatments for paralysis, chills, and fever. Hippocrates, known as the father of western medicine, recommended massage for sports and war injuries.
Swedish massage, one of the most common forms of massage used today in the United States, is usually attributed to 19th century Swedish physician Per Henrik Ling. A number of writings from the late 1800s discuss techniques that have been incorporated into what we call Swedish massage.
Myotherapy and trigger point massage were developed as a result of the work of Janet Travel, MD and colleagues in the 1940s. She developed a technique called trigger point injections, in which pain-relieving drugs are injected directly into the tender area of painful muscles. Later therapists noted that external pressure could help relieve trigger point pain without injections. Neuromuscular techniques emerged during the last half-century in Europe and North America.
In 1992, massage therapists set up the National Certification Board for Therapeutic Massage and Bodywork so that their qualifications could be standardized and officially recognized. A person who completes the required training and passes the Board's exam can say that he or she is Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). In 2005, the board created a new test which allows a person to call himself or herself Nationally Certified in Therapeutic Massage (NCTM). The newer title requires the same basic knowledge, but the person is tested on fewer types of massage. Both credentials must be renewed every 4 years by continuing education and practice. The massage therapists' certifying board is recognized by the National Commission for Certifying Agencies.
In addition, massage therapists have asked state legislatures to require licensing so that untrained people cannot call themselves massage therapists. According to the American Massage Therapy Association, 38 states now regulate massage therapists. Certification and licensure make it easier to find a professional massage therapist.
What is the evidence?
A growing number of health care professionals recognize massage as a useful addition to conventional medical treatment. Some studies of massage for cancer patients suggest that it can decrease stress, anxiety, depression, pain, and fatigue for many patients. These potential benefits hold great promise for people with cancer, who deal with the stresses of a serious illness and some unpleasant side effects of conventional medical treatment. While some evidence from research studies with cancer patients supports massage for short-term symptom relief, additional research is needed to find out if there are measurable, long-term physical or psychological benefits. While massage appears promising for symptom management and quality of life, available scientific evidence does not support claims that massage slows or reverses the growth or spread of cancer.
In a 2005 review of research, Deng and Cassileth reported that massage therapy has been shown to reduce pain and anxiety in randomized controlled trials. Large, well-controlled studies are still needed to determine the long-term health benefits of massage.
Meanwhile, most patients feel better after massage, which may result in substantial relief. In a 1999 publication, the National Cancer Institute found that about half of their cancer centers offered massage as an adjunctive therapy to cancer treatment.
Are there any possible problems or complications?
People with rheumatoid arthritis, cancer that has spread to the bone, spine injuries, osteoporosis or other bone diseases that could be worsened by physical manipulation should avoid physical manipulation or deep pressure. Manipulation of a bone in an area of cancer metastasis could result in a bone fracture. Also, people who have had radiation may find even light touch on the treatment area to be uncomfortable. People with cancer and chronic conditions such as arthritis and heart disease should consult their physicians before undergoing any type of therapy that involves manipulation of joints and muscles. It is important to have massage given by trained massage therapists, and to be sure they know about your cancer and its treatment. Generally, gentle massage and bodywork can be adapted to meet the needs of cancer patients.
People receiving radiation treatment should not have lotion or oil used on the areas on which radiation was used. Even without radiation treatment, a few people have allergic reactions to oils used during massage.
Another concern for people with cancer is that tissue manipulation in the area of a tumor might increase the risk that cancer cells might travel to other parts of the body. It may be prudent for cancer patients to avoid massage near tumors and lumps that may be cancerous until this question is clearly answered.
It is important for people with cancer to let their medical care provider know they are receiving massage. Massage should be provided by a trained professional with expertise in working safely with people with cancer and with cancer survivors. Family members and other caregivers can be instructed in certain massage techniques as well.
Additional Resources
More Information From Your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be ordered from
our toll-free number (1-800-ACS-2345).
Guidelines for Using Complementary and Alternative Methods
AhlesTA, Tope DM, Pinkson B, Walch S, Hann
D, Whedon M, Dain B, Weiss JE, Mill L, Silberfarb PM. Massage therapy for
patients undergoing autologous bone marrow transplantation. J Pain Symptom
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The effects of post injection massage on the sensitivity of lymphatic mapping
in breast cancer. J Am Coll Surg. 2001 Jan;192(1):9-16. Bureau of Labor
Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07
Edition, Massage Therapists, Available at: http://www.bls.gov/oco/ocos295.htm
Accessed 4/2/07.
Calvert RN. Pages from history: Swedish Massage. Massage Magazine Web site. Available at: http://www.massagemag.com/Magazine/2002/issue100/history100.php Accessed 3/13/07.
Cassileth, B. & Vickers, A.J. Massage Therapy
for Symptom Control: Outcome Study at a Major Cancer Center. J Pain Symptom
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Vol. 28(3), 244-249.
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Deng G, Cassileth BR. Integrative Oncology: Complementary Therapies for pain, anxiety, and mood disturbance. CA Cancer J Clin. 2005; 55:109-116.
Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database Syst Rev. 2004;(2):CD002287.
National Institutes for Health. Manipulative and body-based practices: An overview. NCCAM Backgrounder, 2004. Available at: http://nccam.nih.gov/health/backgrounds/manipulative.htm Accessed 3/13/07.
National Institutes of Health/National Center for Complementary and Alternative Medicine. Massage Therapy as CAM. NCCAM Backgrounder, 2006. Available at: http://nccam.nih.gov/health/massage/ Accessed 12/09/06.
Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I. Breast cancer patients have improved immune and neuroedocrine functions following massage therapy. Journal of Psychosomatic Research 2004;57:45-52.
Post-White J, Kinney ME, Savik KS, Gau JB, Wilcox C, Lerner I. Therapeutic Massage and Healing Touch Improve Symptoms in Cancer. Integrative Cancer Therapies. 2003;2(4):332-344.
Rosser RJ. Sentinel lymph nodes and postinjection massage: It is premature to reject caution. J Am Coll Surg. 2001; 193(3):338.
Smith MC, Kemp J, Hemphill, Vojir. Outcomes of therapeutic massage for hospitalized cancer patients. Journal of Nursing Scholarship. 2002;34(3):257-262.
Weinrich SP, Weinrich MC. The effect of massage on pain in cancer patients. Appl Nurs Res. 1990;3:140-5.
Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.
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