Massage Therapy for People With Cancer

Benefits and Risks

Woman with cancer receiving massage therapy
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Many cancer centers are now offering massage therapy as a complementary treatment for cancer. In this sense, massage is not used as a treatment for cancer, per se—such as chemotherapy or surgery would be—but as a method of helping with the symptoms of cancer and the side effects of treatment. The research is young, but massage therapy may help with pain, nausea, anxiety, and meets evidence based guidelines for aiding in the relief of depression and mood disorders in women with breast cancer. There are potential risks, such as infection, bruising, and skin breakdown, as well as reason it should not be performed, such as if blood clots are present, or the platelet count is very low. Let's take a look at how massage may benefit people with cancer, and how to find an oncology massage therapy.

Integrative Oncology

The term "integrative treatment" refers to the practice of combining traditional cancer treatments to address the tumor with "alternative" treatments to ease symptoms, and is an approach many cancer centers are now adopting.

Massage Therapy Basics

Massage is defined as the rubbing of skin and muscles in the body to give someone a sense of well-being. Many of us are familiar with traditional back rubs, and massage therapy isn’t that much different—in the sense that it simply feels good to many people.

Massage Techniques

But when it comes to massage therapy techniques, there are many different forms. Some forms of massage therapy include Swedish massage, aromatherapy massage, and deep tissue massage. (Deep tissue massage is not usually used during active cancer treatment, but may be used to help with chronic pain and limited motion due to scar tissue after treatment is done).

best type of massage can vary...

Uses of Different Techniques

The best type of massage can vary depending on your symptoms and how your cancer and cancer treatments have affected your body. Gentle massage is tolerated by most people with cancer, and is sufficient to release "endorphins," the "feel good" chemicals released by the brain that can reduce pain. For those who have muscle tightness and stiffness, stronger methods of massage, such as Swedish massage, may be needed.

Health Benefits

General Health Benefits

Researchers believe massage may be helpful for both its physical and psychological benefits.

Physically, massage may:

  • Decrease inflammation and swelling
  • Improve circulation
  • Help sore muscles
  • Lower the level of stress hormones in your blood

Emotionally, massage may help people relax, provide a distracting experience that takes the mind off of pain and fear, and reduce anxiety and sometimes, depression.

Benefits for People With Cancer

Intuitively, it seems that massage should benefit those living with cancer. Unlike the often intense (and sometimes cold) nature of treatments such as chemotherapy and radiation, massage can lead to a sense of calm and serenity. In addition, since much of cancer treatment is aimed at treating a tumor, massage can help people feel pampered as the therapy involves a therapist being devoted to your personal and non-clinical well-being.

Some studies evaluating the potential benefits of massage therapy in oncology have focused on specific treatments. For example, a 2016 study looked at the benefits of massage in people going through chemotherapy, finding that it led to improvements in pain, fatigue, nausea, and anxiety.

Other studies have looked at the benefits of massage for specific symptoms related to cancer, including:

Chemotherapy-Related Nausea

A few studies have suggested that massage therapy, when combined with other treatments, may reduce chemotherapy-induced nausea and vomiting. A 2015 study looking at combining conventional and alternative therapies for cancer found that the combination of dexamethasone, massage therapy, and ginger for chemotherapy-induced nausea worked better than some other combinations of conventional and alternative treatments.

It's important to note that when massage therapy is used to help with nausea, it does not mean foregoing medications that are used to both prevent and treat nausea, only that massage may be a useful adjunct to more traditional therapies. This is true when it comes to many cancer-related symptoms, in which a combination of therapies is usually most effective.

Anxiety and Stress

Several studies have found that massage therapy can reduce anxiety and stress for people living with cancer. On a more objective level, massage also appears to lower cortisol levels, with this reduction in stress hormones possibly having other physical benefits as well.Decreased stress and anxiety

Depression/Mood Disorders

Of all of the symptoms that massage may help with, depression and mood disorders have the strongest evidence. As of 2017, the Society of Integrative Oncology states that massage therapy meets evidence-based clinical practice guidelines. This was endorsed by the Amercian Society of Clinical Oncology in 2018. Depression and mood disorders are not only common in women with breast cancer but can be challenging to treat, as many antidepressant drugs reduce the effectiveness of some breast cancer medications (such as Tamoxifen). In addition, a few studies have found that depression is associated with lower survival rates in women with breast cancer.

Cancer Fatigue

Massage has been found to reduce cancer fatigue in some people. While not a life-threatening symptom, fatigue is one of the more annoying and frustrating symptoms for people with cancer, and often persists for years after treatment has been completed in those with early stage disease.

Pain Control

As with nausea and vomiting, massage therapy should not be used instead of conventional treatments for pain, but may help to reduce pain or reduce the amount of pain medication people may need. It may be especially helpful with pain due to surgery. The mechanism isn't well understood, but massage has been found to increase the release of endorphins, and increased levels of endorphins, in turn, are associated with a reduction in pain.

A 2018 study found that massage is helpful in providing immediate help for pain, though it's not certain how long this last. In contrast to many of the current methods available for treating pain, massage also appears to be relatively safe.

Other Benefits

Other benefits that have been found in some studies include improved sleep patterns, and an overall improved quality of life.

Cautions and Risks

It’s important to talk with your oncologist before beginning massage therapy, especially if you have had recent surgery, or are being treated with chemotherapy or radiation therapy. As with an type of treatment massage therapy carries potential risks, as well as contraindications (reasons the therapy should not be performed).

Possible Risks

Some potential risks include:

  • Infection: The risk of infection is greater if your white blood cell count is low due to chemotherapy (chemotherapy-induced neutropenia), if you have had recent surgery, or have open sores from radiation therapy or other conditions.
  • Bruising: If your platelet count is low due to chemotherapy (chemotherapy-induced thrombocytopenia) you will be more likely to develop bruises.
  • Risk of fracture: If you have bone metastases (spread of cancer to bones), or are on medications that can weaken your bones (such as aromatase inhibitors for breast cancer) you may be at an increased risk of fractures. While bone metastases are sometimes mentioned as a contraindication for massage, one study found that massage reduced pain in people with bone metastases.
  • Skin breakdown: Rubbing, especially deep tissue massage, may result in skin breakdown especially during radiation therapy.
  • Reactions to the lotions or oils used (make sure to let the therapist know if you have any allergies or sensitivities)
  • Dislodging a blood clot: There is a potential risk of disrupting an undiagnosed blood clot in the leg, which could be dislodged and travel to the lungs. Of note is that blood clots are common among people with cancer, especially after surgery or during chemotherapy. This is one reason why anyone who is considering massage therapy should talk to their oncologist first.

    Contraindications

    Light massage is safe for most people with cancer, but there are some settings in which massage therapy should be avoided altogether among people with cancer. Some of these include:

    • Known blood clots: Massage should not be done for anyone who has been diagnosed with a deep vein thrombosis or pulmonary emboli.
    • Infection: If someone is currently fighting an infection, especially if a fever is present, massage therapy should not be used.
    • Severely low white blood cell count: If severe leukopenia is present, massage therapy should be deferred until an oncologist gives the clear
    • Severe thrombocytopenia: For people who have very low platelet counts, massage therapy should not be performed.
    • Lymphedema: Swelling of a part of the body due to damage to the lymphatics can occur with several types of cancer (especially melanoma), but is most well known as the arm swelling that occurs in some women with breast cancer. Massage should not be done around the nodes under the arm or on the arm on the same side of the body as the breast cancer. If lymphedema is present, a type of massage called manual lymphatic drainage may be needed, but this is usually performed by a different type of therapist who specializes in rhe treatment of lymphedema.

      Therapy should also avoid sites of active tumor growth, areas around a recent incision, and any areas where an open wound or sore is present. During chemotherapy, deep tissue massage should be avoided even if blood counts are all normal.

      Rlsk of Spreading Cancer

      While there is a theoretical risk that if a cancerous tumor is massaged it could promote spreading, this has not been found to occur in any trials to date.

      What to Expect with an Oncology Massage

      Before you pursue massage therapy, talk to your oncologist about any precautions or concerns she has. Before your massage, discuss any of this with your massage therapist, as well as any concerns you have about lotions, oils, or aromatherapy (chemotherapy can affect your sense of smell and taste, and you may be more sensitive than usual). Some therapists use aromatherapy with massage, and many play soothing music.

      You will usually be asked to remove your clothing except for your underwear, but this can vary. You should never feel uncomfortable, and a massage can be performed through clothing if you wish.

      You will usually be asked to lie on a cushioned table, with a special hole for your face for when you lie on your stomach. Positioning may be limited or need to be altered. For example, if you've had recent breast cancer surgery, you may not be able to lie on your abdomen or one side.

      When you are receiving your massage, make sure to let the therapist know if anything is painful, or if you need a more gentle touch. Being uncomfortable or experiencing pain is not necessary for the massage to be effective and could instead be harmful. Most sessions last 30 minutes to 90 minutes, but you can ask the therapist to stop at any time.

      When you get up after your massage, be careful standing. Some people become very relaxed and feel lightheaded when standing. Give yourself time to get up and get dressed.

      How to Get Started

      If you're not certain how to find an oncology massage therapist, talk to your oncologist. Many of the large cancer centers have massage therapists on staff, and some also offer classes to help your loved ones learn how to do massage for you when you return home.

      If you need to find an oncology massage therapist outside of your cancer center, make sure to find a licensed therapist who specializes in working with people with cancer (there is a special certification). You can search for hospitals that have incorporated oncology massage by state or search for individual oncology massage therapists via the Society for Oncology Massage.

      Other Alternative Treatments

      There are a number of alternative therapies that have been incorporated into cancer treatment as a way to reduce the symptoms of cancer and cancer treatments, and many cancer centers now practice an "integrative approach" in which they combine the best alternative therapies with traditional treatments in order to improve the quality of life for people living with cancer. Guidelines from 2017 (based on a systematic literature review from 1990 to 2015) have found that therapies that appear to be particularly effective based on symptom include:

      • Anxiety/stress reduction: Music therapy, meditation, stress management, and yoga
      • Depression/mood disorders: Meditation, relaxation, yoga, massage therapy, and music therapy
      • Nausea and vomiting due to chemotherapy: acupressure and acupuncture
      • Improvement in quality of life: Meditation and yoga

      A Word From Verywell

      It's only been in recent years that we've begun to address ways to help people live with cancer. Though alternative treatments have received a bad rap due to the use of unproven methods for treating cancer, it's important not to throw the baby out with the bathwater. While traditional treatments ranging from surgery to immunotherapy are the mainstay of treating cancer, many of these "alternative" practices may be helpful in reducing your pain or at least lifting your spirits while being treated. Check out the options offered by your cancer center. Even if massage therapy isn't your thing, there are many options that may offer the opportunity to improve your quality of life during treatment.

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