Effects of Massage Therapy on Cancer Patients Receiving Chemotherapy

Brandi Perry
August 6, 2014

Summary Statement
Cancer is a disease that affects hundreds of thousands of Americans each year. In 2013,
10,810 Utahans were affected by cancer (Society, 2013). This disease requires patients to make
heavy decisions about personal health choices and treatment options. Many decide to receive
chemotherapy and radiation to fight the cancer cells, but at a great price. According to the
National Cancer Institute, chemotherapy causes negative side effects in the body, such as
anemia, extreme fatigue, nerve changes, and pain (Institute, 2012).
Massage therapy helps reduce pain and nerve issues while helping the muscles to relax,
encourage rest, increase circulation, and improve immune function. The proposed research
study will expose the effects of massage therapy on relatively healthy individuals, individuals
with non-terminal, chronic health issues, and cancer patients receiving.
Research Problem
In 2013 there were 10,810 people in Utah living with some form of cancer (Siegel,
Naishadham, & Jemal, 2013). This means that one half of one percent of the population in the
state of Utah suffered from cancer during that year. Along with the chemotherapy that people
with cancer receive, they experience a number of other symptoms that affect their physical and
emotional wellbeing. These symptoms include: anxiety, fear, pain, and poor sleep patterns.
Background
In a study conducted at the University of Texas from May 2011 to December2013,
cancer patients completed a survey before receiving their chemotherapy treatment to rate

their most uncomfortable issues; the rating system was based on three different scales ranging
from 0-100 (Lopez, 2014). During the chemotherapy treatment they received a 30-60 minute
hand massage. The patients then completed the same survey after the treatments using the
same scales.
Another study conducted in 2005, offered 1076 15 minute massages to cancer patients
receiving chemotherapy treatments at Dana-Farber Cancer Institute in Boston, MA. The main
purposes of these small massages were to enhance relaxation and reduce stress (DohertyGilman, 2014).
What is massage therapy? And what are the benefits of massage? Massage therapy is
manual manipulation of soft body tissues (muscle, connective tissue, tendons and ligaments) to
enhance a person's health and well-being (University). Many people seek massage therapists
to relieve muscle pain and tension, increase blood circulation, and rehabilitate injuries
(University).
Purpose Statement
The purpose of this study will be to examine effects of massage therapy on 100
individuals, ages 18 years to 75 years, who are in relatively good health (lack of terminal illness,
exercise at least 3 times per week, are on no medications related to physical ailments), 100
individuals, ages 18 years to 75 years, who are living with non-terminal, chronic health issues
(high cholesterol/triglycerides, obesity, etc.), and 100 individuals, ages 18 years to 75 years,
who are currently receiving chemotherapy treatments. Specifically, this study will explore the
relationship between massage therapy and pain.

Research Questions
Research Question #1: Is there a statistically significant association between receiving massage
therapy once per week and level of pain in individuals, ages 18 to 75 years, who are in good
health?
Hypothesis #1: There is a statistically significant association between weekly massage therapy
treatments and pain in individuals, ages 18 to 75 years, who are in good health.

Research Question #2: Is there a statistically significant association between receiving massage
therapy once per week and level of pain in individuals, 18 to 75 years, who are living with nonterminal, chronic health issues?
Hypothesis #2: There is a statistically significant association between weekly massage therapy
treatments and pain in individuals, ages 18 to 75 years, who are living with non-terminal,
chronic health issues.

Research Question #3: Is there a statistically significant association between receiving massage
once per week and level of pain in individuals, ages 18 to 75 years, who are currently receiving
chemotherapy treatment?

Hypothesis #3: There is a statistically significant association between weekly massage therapy
treatments and pain in individuals, ages 18 to 75 years, who are currently receiving
chemotherapy treatment.

Significance of the Study

By conducting this research study, the benefits of massage will be brought to cancer patients
suffering from pain and anxiety due to chemotherapy treatments and being sick. When people
get the news that they have cancer there is a new load of stress placed on them; whether or
not they are going to survive. The pain associated with chemotherapy is excruciating and
leaves patients lying in bed for hours, sometimes days, at a time. Not only will the information
help those people with cancer, but also people who suffer from chronic fatigue, pain, and stress
on a regular basis. Massage therapy is a great tool for reducing the stress and tension in ones
life, regardless of their overall health (University).
Once the benefits of massage on chemotherapy patients becomes public knowledge,
there may be programs put into place across the country, designed specifically to help ease the
pain and suffering of those receiving chemotherapy. If the comfort of cancer patients can be
increased even by a small margin, there will be more patients not focused on the negative
aspects of their situations; allowing their bodies to properly heal by releasing the tension,
increase the blood flow and delivery of nutrients to their bodies, and rehabilitate the immune
system to fight the disease affecting their body. When patients have a more positive outlook

on the health issues they are affected with there is an easier path to coping with the disease
(Stress, Coping, and Hope, 2013).
Definition of Terms
massage therapy- manual manipulation of soft body tissues (muscle, connective tissue, tendons
and ligaments) to enhance a person's health and well-being (University).
cancer- diseases in which abnormal cells divide without control and are able to invade other
tissues (American Cancer Society, 2013).
chemotherapy- the use of any drug (such as aspirin or penicillin) to treat any disease, but to
most people chemotherapy refers to drugs used for cancer treatment. Its often shortened to
chemo. Two other medical terms used to describe cancer chemotherapy are antineoplastic
(meaning anti-cancer) therapy and cytotoxic (cell-killing) therapy (American Cancer Society,
2013).
Study Design
The research design of this voluntary experimental study will be conducted at the
convenience of the patients receiving chemotherapy. By designing this study to take place when
patients enter the hospital to receive treatments, it will be more convenient for patients to enjoy
their massages without extra scheduling and scheduling conflicts. They can fill out the short
questionnaire shortly after receiving their massage treatments. This study has been approved by
the approved by the Weber State University Institutional Review Board (IRB).
Setting

The study will be conducted at the University of Utah Hospital, named one of 100 Great
Hospitals in America in May 2013 issue of Beckers Hospital Review. The University Hospital
started in 1965 with one single hospital and is now an extensive health care system that includes
four hospitals and 10 neighborhood health centers staffed by 1,000 board-certified University of
Utah physicians trained in 200 medical specialties (Clinics, 2014). University of Utah Hospital
accepts patients from around the country for cutting edge research studies, top quality medical
care by outstanding physicians, and innovative treatments (Clinics, 2014).
The patients receiving chemotherapy will receive their 30 minute massage therapy
treatments simultaneously with their chemotherapy treatments in the oncology section of the
hospital. The individuals that have non-terminal, chronic health issues and the relatively healthy
individuals will schedule their weekly appointments and receive their 30 minute massages in a
designated room at the University Hospital. This will help to keep all of the information and
participants in a single location.
Sample
The researchers will be using non-probability sampling. 300 participants, ages 18 to 75,
will be asked to volunteer for this study. The participants will be divided into three equal
groups: individuals in relatively good health, individuals with non-terminal chronic health issues,
and individuals receiving chemotherapy treatments.
Data Collection Procedures
Because of the nature and setting of this study, the researchers will inquire within the
University of Utah hospital and clinics. Physicians will approach patients that fit the criteria and
will be asked if they would like to be involved in the research study.

Once the participants have been educated on the purpose of this study and signed the
informed consent agreement, they will receive an identification number and fill out a
questionnaire on an iPad based on their initial feelings of pain/anxiety/stress to serve as a
baseline for the rest of the study.
Using a Sample Attitude Scale Questionnaire on an iPad, each participant will record
how they felt one day after the previous massage treatment, how they felt as they arrived for the
current massage treatment, and how they feel immediately after the massage treatment using a
semantic differential scale of 1-5.
1= no pain/anxiety/stress; no interference with daily tasks
2= little pain/anxiety/stress; little interference with daily tasks
3= some pain/anxiety/stress; some interference with daily tasks
4= fair amount of pain/anxiety/stress; fair amount of interference with daily tasks
5= constant pain/anxiety/stress; constant interference with daily tasks
As the questionnaires are completed, the individuals results will be graphed on their own page
as a visual aid to monitor the amount of pain/stress/anxiety they feel for the remainder of the
study.
Data Management and Analysis
Participants will have a folder designated for their personal profiles and each of the iPad
questionnaires they have filled out will be printed out and placed in the file. The answers will
also be entered into and saved on a computer, in a file that coordinates with each participant file,
to be retrieved electronically. Each day will be backed up and stored on thumb drives, just to
make sure all information will be accessible should any issues or inconsistencies occur. Once

the information has been entered, filed, and saved, the data will be transferred to a spread sheet
that will list the names of all participants alphabetically by last name and their scores
chronologically by date. The information will then be graphed: x = chronological date and y =
differential scale score 1-5. At the end of the research study, the graphs will be printed and
placed in the corresponding participant file and a digital copy in their file on the computer.
Graphs will be created for each group of individuals, age groups and gender, and the correct
participants scores regarding the groups.
Study Trustworthiness
The research study volunteers will be a small group of 5-10 students from Weber State
University who are in need of an internship or volunteer credits. Two licensed massage
therapists will also be recruited to perform the 30 minute massages on the participants. The
students will be closely monitored by the director of the project to ensure the information is
being entered correctly. The director will also go through each day of entries to compare the
questionnaires with the data entered into the computer. A large whiteboard will be available in
the main office area with the names of all the volunteers listed and the percentages of correct
data entry for each week, which will give the volunteers a visual of their progress and accuracy.
This information will also be recorded by and remain in the possession of the director so that the
information will be kept up to date and compared to maintain accuracy. The object of the visual
aid on the whiteboard is to keep the excitement level up and to help the volunteers work their
hardest. There will also be an incentive rewarded to those who maintain an accuracy of 95% or
better.
Ethical Considerations

The participants and volunteers will have as little contact as possible. This will help to
ensure that there is no emotional attachment to the participants and the volunteers will have no
reason to alter any information they are entering. This will also give the participants more secure
feeling of anonymity, because this is a tender subject for many people experiencing cancer and
chemotherapy.
Another area that will be heavily monitored is the approach taken to ask patients to
volunteer for the study. As stated above, this is a tender subject that does not need to increase
the level of fear and anxiety that patients feel. This study has been designed for the purpose of
reducing the fear and anxiety of chemotherapy.
There may be some massage therapists attending school for health related degrees which
could affect the data entry if they are not morally driven and want to see honest outcomes. So
many massage therapists understand the deeper benefits of massage therapy and have been
known to force their opinions on others. This will not be accepted and instant removal from the
research study will be enforced.
Role of Researchers
This is an area that I have been interested in for a while. Massage therapy has been my
passion and career for six years and the benefits of receiving massage have become important to
me. When a person receives a massage they are ultimately asking the massage therapist to fix
an ailment from which they are suffering. Massage has been shown to increase circulation,
improve immune function, and decrease stress and tension in the body, which is why I want to
see how massage effects those who are dealing with cancer and chemotherapy, which affects the
immune system and tension in the body.

Because of the passion I have about massage therapy I want to see this succeed. This
research study will, hopefully, help others who may be skeptical of massage therapy to
understand that there are many benefits to receiving massages for more than muscle tension and
relaxation. However, I do not want to see the results altered to win people over or turn them
away from massage.
People do not trust what they do not understand. When people feel lied to about
information there becomes a lack of trust and a decreased desire to experience what they have
been lied to about. The more accurate and honest the results of the study are, the more likely
people are to turn to massage therapy when they see that it helps people suffering from cancer
and chemotherapy. I just want people to be healthy and happy, and massage is a great way to
experience that.

Works Cited
American Cancer Society. (2013, February). Retrieved from American Cancer Society Web Site:
www.cancer.org
Clinics, U. o. (2014). University Hospital. Retrieved from University Hospital:
healthcare.utah.edu/hospital/
Doherty-Gilman, A. (2014, May). Development of a Hand Massage Service for Cancer Patients
Undergoing Chemotherapy. The Journal of Alternative and Complementary Medicine, 20(5), A73.
doi:10.1089/acm.2014.5190.abstract
Institute, N. C. (2012, 12). National Cancer Institute. Retrieved from www.cancer.gov
Lopez, G. (2014, May). Impact of Outpatient Massage on Symptom Expression. The Journal of Alternative
and Complementary Medicine, 20(5), A23-A24. doi:10.1089/acm.2014.5058.abstract
Siegel, R., Naishadham, D., & Jemal, A. (2013, January/February). Cancer Statistics, 2013. CA: A Cancer
Journal for Clinicians, 63(1), 11-30. doi:10.3322/caac.21166
Society, A. C. (2013). Cancer Facts & Figures 2013. Atlanta: American Cancer Society.
(2013). Stress, Coping, and Hope. In S. Folkman, Psychological Aspects of Cancer (pp. 119-127). Springer
US. doi:10.1007/978-1-4614-4866-2_8
University, N. H. (n.d.). Northwestern Health Sciences University. Retrieved from Northwestern Health
Sciences University: https://www.nwhealth.edu