Florence Nightingale, the founder of the modern nursing profession, understood the importance of touch as an expression of compassionate nursing care. Massage – the therapeutic manipulation of soft tissue – is one form of touch which can provide an effective coping mechanism for cancer treatment.
Not so long ago it was the belief that massage, through the stimulation of the circulatory and lymphatic system, could actually contribute to metastasis and spread of the disease. But in the last two decades, there is clinical evidence that this is not the case. The site and survival of disseminated cancer cells depends rather on the qualities and properties of the tumour cell itself rather than the anatomy of circulation. Otherwise, we would see that hot showers, exercise, sexual activity and other lifestyle habits which stimulate the circulation would also contribute to metastasis. Instead patients are encouraged to exercise and remain as active as possible.
Massage techniques have now been adapted to accommodate the special needs and requirements of patients experiencing cancer or its treatments. The 1990s saw the first organised trainings in “oncology” massage. Massage is now one of the most popular modalities of complementary therapies amongst cancer patients in hospitals. Reasons most cited are stress reduction (71%), pain management (66%), cancer patient support (57%), and palliative care (41%), amongst others.
Anxiety and depression are common sources of distress in people with cancer and focus of many quality-of-life interventions. Studies have consistently demonstrated the potential of massage to improve mood and quality of life. Based on the evidence of 14 clinical trials, massage can alleviate a wide range of symptoms, including pain, nausea, anxiety, depression, anger, stress and fatigue. Even over the short-term massage contributes to improved psychological wellbeing (in particular reduced anxiety) and in some cases reduced severity of physical symptoms. Evidence of ongoing massage (inpatient and subsequently outpatient) treatment indicate that the benefits of massage are cumulative, with outpatient improvements exceeding inpatient symptom scores, even from a high baseline.
Several studies have examined the effects of massage in breast cancer patients. For 5 weeks an intervention group received bi-weekly 30-minute massages in the back and head-neck areas. The massage consisted of stroking, squeezing, and stretching techniques. Immediate effects included reductions in anxiety, depressed mood, and anger. Long-term effects included reduced depression and hostility, and increased urinary dopamine, serotonin values, natural killer cell numbers and lymphocytes (a type of white blood cell important in the human immune system). Another randomised trial with 39 women with breast cancer undergoing chemotherapy found significant reduction in nausea after massage.
Breast surgery is often a key part of breast cancer treatment. This may include the dissection of the axillary (armpit) lymph nodes, which are essential to the drainage of lymph. The side-effects of breast surgery is therefore lymphedema. This is a condition of localised fluid retention and tissue swelling caused by a compromised lymphatic system. A massage routine of lymph drainage, stroking of scar tissue and progressive active and action-assisted shoulder exercises typically lead to a significant reduction in the development of lymphedema over an extended period of time.
In terms of radiation therapy and chemotherapy, a study found that using three 30-minute treatments with Swedish massage, patients had significant improvements in pain, sleep quality, and symptom distress.
It is important to note, however, that traditional Swedish massage techniques need to be adapted to deal with the symptoms of cancer and side effects of treatment. The main differences are in the use of pressure, joint movement, and the position of the massage recipient. Further adjustments are made in terms of length and timing of the sessions (working within or around cyclical side effects or symptoms), type of lubricants, speed and rhythm of massage strokes. The most important of these is pressure, especially where tissues are identified as fragile or unstable. Lighter or very gentle pressure (and/or heavy lotioning) is normally recommended, especially around sites of bone metastasis with fracture risk, sensation changes from peripheral neuropathy, over surgical scars, at sites of deep vein thrombosis or lymphedema risk and in areas of cancer pain and discomfort. Pressure is an important consideration over both the short-term and over the longer term of cancer care. Slower massages strokes are also recommended when a patient is experiencing nausea.
It is therefore important that you receive a massage from a therapist who is trained in the modification of massage for cancer care. Angela Green at MindBody Oasis has worked many years in an NHS trust hospital, delivering cancer-focused therapy treatments. She has not only received such specialist training, but is also qualified to deliver such training to other therapists interested in this modality.
To book a massage adapted to your needs, please call Angela on 07764 928616 or contact us using the contact form on this page. Your pre-treatment consultation with Angela will determine the type and length of massage treatment best suited to your needs or indeed if a reflexology treatment would be more appropriate.