Date Published: 25 August 2011
Massage therapy for reducing pain, anxiety and depression in palliative cancer care
Many cancer patients receive therapies such as massage, reflexology, aromatherapy, Bach flower remedies or any of a wide range of other types of treatment, primarily to reduce the sensation or effects of symptoms such as pain, anxiety, or depression associated with the cancer for which they are receiving conventional (allopathic) medical treatment. When used in this way, i.e. merely to support the person or body rather than to actively cure, remove or resolve the main problem, such therapies may be referred to as 'complementary'.
A recent academic study1 by experts based in Italy and Austria has reviewed published research into the benefits, or otherwise, of massage therapy to reduce pain, anxiety and depression in cancer patients. This systematic literature analysis included consideration of material published between the years 2000 and 2010 and made available through several leading databases including:
- The Cochrane Library
- CINAHL (Cumulative Index to Nursing and Allied Health Literature)
- PsychInfo (Ebsco)
- Medline (National Library of Medicine)
- Embase
- Amed (Ebsco)
- Tripdatabase
The bibliographical references of the authors and selected journals were also examined for further references.
In order to assess the effectiveness of massage therapy to support patients receiving palliative cancer care - that is, medical treatment of cancer patients such that the main purpose of that medical treatment is to improve the quality of life of both the patient and his or her immediate family, the researchers posed three specific questions which they sought to answer from the information in the published literature. The questions were:
- Can massage therapy reduce the level of pain in patients receiving palliative oncological care?
- Can massage therapy reduce the level of anxiety in patients receiving palliative oncological care?
- Can massage therapy reduce the level of depression in patients receiving palliative oncological care?
Sixty-nine articles were identified in the first stage of the literature search, of which thirty-eight documents were considered relevant then, removing duplicates and applying tighter criteria, twenty articles were considered appropriate for further study to help to answer the three questions stated above.
The authors of this literature review found that although massage therapy did seem to have some effect to reduce pain, that was difficult to quantify because the different studies described outcomes and measured data, e.g. consumption of analgesics, in different ways. Overall, the relevant studies indicated that massage therapy can achieve a reduction of pain lasting up to 18 hours. There was also a suggestion that the dosage of analgesics fluctuated less after massage therapy - although that was based on only one research paper2.
Anxiety was considered in some of the published studies but as the authors of those studies did not actually define anxiety, comparison was difficult. In some cases an attempt to gather measured data had been made via the association between reduction in anxiety and physiological relaxation, which could be assessed in terms of heart and respiratory rates before and after massage therapy. Although that approach did not result in statistically significant data, the patients' own perception of anxiety immediately after the intervention had decreased statistically significantly3. One study4 detailed a statistically significant reduction of the perception of anxiety after only a five minute hand massage. The authors of the review study explained that physical contact alone can have a soothing effect to help reduce anxiety. Considering the physical contact between the massage therapist and the patient, such treatment is only likely to help to reduce anxiety if the patient is accepting of this close physical contact.
Overall, the literature review suggested that massage therapy has a positive effect on reducing anxiety and depression, with the type of massage and the setting also contributing to the effectiveness of the experience.
Opening their discussion of the literature reviewed, the authors1 stated:
" Massage therapy has proven to reduce the subjectively perceived symptom of pain in oncological patients receiving palliative care. Remission of the symptoms of anxiety and depression, examined secondarily, was also achieved."
They went on to comment about the importance of empathy and the relationship between the patient and massage therapist, and to observe that the "desired or undesired effects of a massage are not only dependent on the interventions themselves but also on the time of the day, the setting, the position of the patient, and the type of massage". They also noted that the common assumption that massage therapies should be considered contraindicated in cases of malign / malignant tumours due to concerns about the possibility of tumour growth and that metastasizing may be accelerated was refuted by several authors of the studies published during 2000-2010. Several studies indicated that patients who lack strong social networks or who experience little physical contact may be particulary responsive to massage therapy, hence recommedations that it be made available for socially isolated patients.
Finally, the authors of this literature review concluded that further research is needed in order to confirm (or, presumeably, deny) the effectiveness of massage therapy for reducing the symptoms of cancer patients receiving palliative care. They indicated that ideally such studies should consider different types of massage therapy and that consistent treatments and methods of assessment should be used to facilitate the comparability of outcomes.
This research has been published in the Aug 2011 issue of the journal ISRN Nursing - full reference below.
Source(s): 
US National Library of Medicine
http://www.ncbi.nlm.nih.gov
