Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

ABSTRACT
Massage therapy is a newly introduced form of treatment for patients with
cancer; it increased in popularity when natural forms of medicine began to be the used
more often by individuals. For centuries, massage was viewed as a luxurious method of
relaxation and rejuvenation for the wealthy. Recently, it began to be prescribed to
athletes as part of their physical therapy after they have endured an injured because new
studies have shown massage to improve blood circulation, accelerate the healing
process, and decrease pain in muscles. Several decades ago, physical therapists would
never have deemed massage as an adequate form of treatment for an injured athlete ,

but today, many athletes receive regular massages to prevent intense injuries . People
mainly get massages when they are suffering from pain in certain parts of their body like
back or arm. Massage is mostly thought to get rid of knots in muscles which causes the
muscle to relax and loosen up making the individual feel calm and pain free . Massage
can be used on cancer patients to reduce pain, many cancer patients experience an
exuberant amount of pain while going through their treatments like chemotherapy . This
causes them to be irritable and short tempered. Although a massage will not get rid of
all the pain, it will minimize the pain making it more manageable . The patient will also
be more relaxed and joyful after the massage. However this effect wont last long, the
length of time that the patients experienced the change in mood will vary from person to
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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

person. This scenario creates the question of whether or not massage can be used as an
alternative pain treatment for cancer patients. If so, how much of an effect will it have
on patients?

BODY
Massage is said to begin in the ancient cultures of China and Egypt for its medical
benefits (Natural Healer, n.d.). Egyptian tomb paintings demonstrate how they used
massage therapy in their medical practices in 2500 BCE, these civilizations realized that
massage could heal injuries, prevent illnesses, and relieve pain . It can also reduce stress
and relaxes people. Some patients say it creates an emotion of being cared for,
comforted and connection. It started as a sacred art of natural healing , in 3000 BCE
India began to use a type of massage known as Ayurveda as a holistic message system .
At this time, massage was orally passed down from generation to generation . It was
developed by centuries of research, studies, and experiments . Their massage is known
as Ayurveda. In the early 1800s, a Swedish doctor, educator, and gymnast created a
system of movement called the Swedish Movement System . This is the foundation of
the Swedish massage which is most often used in the West today along with Shiatsu, the
Japanese massage practice. In World War I, massage was used to treat American
soldiers who had been injured on the battlefield but it was still viewed as a luxury for the
wealthy for many years and it would not be accepted as a form of treatment for many
more decades. When the option of natural healing methods began to increase in
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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

popularity, the use of massage as a type of treatment did as well . Today massage
therapist use massage for many different reasons ranging from healing to relaxation .
Massage therapy is the manipulation of muscles to make the individual feel
better. Massage therapists also instruct their patients on different stretches and
exercises they can perform at home for a quicker recovery (Natural Healers, n.d.) . The
most common type of massage used in the West is Swedish massage which includes long
strokes, kneading, deep circular movements, vibrations, and tapping . Athletes also
receive massages for their sore muscles and to release chronic muscle tension . The type
of message that is given is always adapted to match the athletes needs . Massage
therapists also use trigger points, areas in the body that are painful when pressed, to
locate painful areas in the body. There are two main types of massages; relaxation and
rehabilitation. Relaxation massage includes Swedish massage and it often practiced in
setting similar to spas and resorts. Rehabilitation massage is used in hospitals,
chiropractic, and physical therapy offices. This type of massage only focuses on deep
tissue because the patients tend to have larger knots and often experience greater levels
of pain that are caused by issues in the outer muscle and the underlying issues as well .
Different types of massage are widely being accepted by health professionals as a
form of treatment for their patients. It is used in hospitals, clinics, chiropractic and
physical therapist offices. Massage has been used to treat a number of illnesses
including sleep, arthritis, pain, and cardiovascular health (Currin, 2008) . Research on

Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

the effects of massage continues, and new information is constantly being revealed . The
results of the research are often conflicting but there are more results that suggest there
are numerous benefits provided to the patients.
Massage isnt always the right treatment option for patients (Corbin 2008) .
Those with bleeding disorders or who take blood-thinning drugs shouldnt receive a
massage because it increases circulation in your blood which can be incredibly risky .
Patients with burns or healing wounds would find a massage to be a very uncomfortable
experience since their injured areas are still very sensitive. People with deep vein
thrombosis also should not turn towards massage as a form of treatment because a
massage might cause the clot to travel towards the patients lungs or heart and block
blood flow to these areas. It could also damage the vein in the leg causing the leg to
swell, ache and change color. This illness requires immediate medical attention that will
remove the clot in the vein. Individuals who have experienced a fracture cannot get a
massage because they are meant for those with muscle injuries, not bone injuries .
People who have severe osteoporosis would find any level of massage to be painful
instead of soothing because their weakened bones might break when any amount of
pressure is placed on them (Cassileth, 2009). Patients with severe thrombocytopenia
should not get a massage because their decreased amount of thrombocytes might not be
able to handle an increased level of circulation in the blood which would increase the
patients likelihood of bleeding.

Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

Recent research has found certain cancer patients tend to benefit from receiving
a massage. Caution must be taken when offering a massage to a cancer patient because
it may not interact well with certain medications, chemotherapy of other treatments
they may be taking. Massage therapy, along with other complementary therapies is
starting to be used to reduce certain cancer symptoms as well as certain side effects
associated with certain treatments. It can also improve the patients quality of life and
overall well-being. A recent survey performed by Deng stated approximately 20% of
cancer patients use massage therapy to reduce anxiety, pain, and tension (Cassileth,
2009). Massage therapy provokes physiological and physiological responses in the
patients by applying pressure on the muscles. Studies have shown massages reduce
nausea, distress, anxiety, and diastolic pressure in patients going through bone marrow
transplant. In patients with breast cancer, it reduced anger, pain, and anxiety (Billhult,
2007). Massage therapy decreases pain and fatigue while also improving the moods of
many cancer patients unlike what a friendly visit could do. For pediatric patients who
have been recently diagnosed with leukemia, massage therapy is the most commonly
used method of pain management. Patients receiving Swedish massage have reported a
significantly greater decrease in symptoms related to cancer than with other any other
massage method (Cassileth, 2009). The reason behind why massage decreases
symptoms is not fully known. Some guesses include an increase in dopamine and
serotonin and a decrease cortisol levels. In patients with breast cancer, there was an
increase in lymphocyte cells and natural killer cells. But other studies have shown that
many factors may impact the results of a massage like the intensity of the massage,
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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

chemotherapy, and radiation. Massage therapy is not used as the main method of
treatment for cancer but as a way to management pain and reduce the symptoms
associated with cancer.
Approximately 40%-90% of cancer patients main complaint with cancer is pain
which often leads to psychological distress . Doctors have found massage therapy to be
an excellent form of treatment for the pain because it significantly decreased the
patients pain level compared to no massage and other forms of treatment (Lee, 2015) .
In the meta-analysis study done by Lee, patients with treatment-related cancer pain
displayed significant effects to massage therapy, especially in those who had just
undergone surgery. Patients with a wide variety of cancers, from breast to digestive, all

presented significant effects to massage therapy. Body massage had more success in the
patients than food reflexology and aroma massage had combined . Studies that used
VAS, BPI, NRS, and PPI to monitor the pain levels of patients all experienced significant
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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

pain reductions in the patients. Massage appears to be extremely effective in the short
run but its effects in the long run are still undergoing research . It is said that at first,
massage is extremely beneficial to the patient, soothing and relaxing the patient , but
overtime, the patient begins to experience less and less satisfaction from the massages .
This may be due to several reasons including the patient is getting accustom to the
massages, treatment is progressing and becoming more intense causing the pain to be
worse, or the pain the patient is decreasing lessening the effect of the massage . If the
patients condition is neither improving nor worsening in a certain period of time, the
massage may not be as beneficial as it was the first time they received it . The patients
has become accustom to the massage and now needs a stronger form of pain relief .
Many patients must continue with chemotherapy for a large amount of time. When the
cancer in a patients is progressively worsening, the doctor will prescribe higher doses of
chemo to help the patients (Billhult, 2007). These increased levels of chemo often
exhaust the patient and leave the patient experiencing much higher levels of pain
compared to the first set of chemo. Since massage is only an external source of pain
relief and only works on the muscles, it will not completely relieve internal pain .
Pediatricians prescribe integrative therapies (IT) to their cancer patients for a
variety of reasons, one being the known fact that it reduces cancer symptoms and
relaxes the patients (Jacobs, 2014). It controls the side effects making the pain and
treatments manageable. These therapies are great because they dont disturb many of
the other medications that cancer patients must take, unlike some other pain and

Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

anxiety medications. Many pediatric oncology patients use integrative therapies as an

additional form of treatment. Studies performed by Bishop used meta-analysis to survey
the use of IT in pediatric oncology patients. Unfortunately, these studies did not present
consistent results. The definition for survey and IT varied from study to study. The
results came from different studies that most like practiced alternate forms of therapies
on the patients. Since this study was published, many new studies have been done on
the same topic. One thing is clear; patients tend to refrain from performing integrative
therapies because they do not receive approval from their doctors , but most patients
have reported IT has helped them. Hunt began evaluating the use of IT on pediatric
oncology patients and concluded that the evidence strongly supports massage to
increase sleep hours (Lee, 2015). Massage is commonly used for children with cancer
because it has been found to decrease anxiety, pain, nausea, anger, depression, and
fatigue. Most of these are often

Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

short-term effects of massage but some long-term effects have been found (Jacobs,
2014). Many doctors are reluctant to prescribe massage therapy for their patients
because of the limited amount of research and knowledge there is surrounding this
topic, but numerous patients are eager to try this method of treatment for pain relief
and decrease the amount of medication they must intake. This study revealed parents
who asked their physicians about alternative treatments were more likely to use IT. 68%
of parents and 55% of adolescences were confident IT treatment had beneficial effects
(Jacobs, 2014).
There are many conflicting information circulating in the world today concerning
the use of massage therapy on oncology patients . Some heavily promote the use of
massage therapy, others strongly advise against it. Almost all cultures have incorporated
a method of treatment similar to that of massage therapy into their healing methods .
Many countries use touch as a way of treatment for painful muscle areas . There are

Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

currently many different methods of massage but most share the intention of calming
and relaxing the patient. Certain techniques may be more appropriate for certain
patients than others depending on many different factors like the type of cancer and
form of treatment they are receiving. Depression has been said to be four times more
likely in patients who have cancer (Corbin, 2005) , and anxiety tends to increase in
cancer patients over time. Massage therapy has been proven on many occasions to
decrease depression and anxiety in patients. Many studies have shown oncology
patients to be intrigued by the option of massage therapy. Overall, massage has been
found to be a very safe form of treatment because it doesnt usually interfere with the
medication oncology patients are given. Some massage therapists use certain herbs,
lotions, or oils that may put some patients in danger but those can easily be withdrawn
from the treatment. Results from several studies have shown massage to increase sleep,
decrease pain, anxiety, and heart rate in patients. Abdominal massage has been proven
to reduce constipation in individuals (Currin, 2008). Other studies have stated that
massage can promote wound healing, reduce scar tissue, and help release metabolic
waste by improving circulation in cancer patients.
Cancer survivors are often anxious about the reoccurrence of their cancer which
causes them to experience much stress. Massage therapy is being used as a way to
alleviate the stress these survivors experience. It relieves both physical and
psychological complaint while also improving the health-related quality of life (Billhult,
2007). A recent trial performed by UMIN Clinical Trails Registry measured the effects of
continuous Anma therapy, a form of Japanese massage therapy, and determined the
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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

immediate effects of a single Anma session for cancer survivors. The participants were
cancer survivors over the age of 20 who have a history of gynecological cancer and have
no experience any reoccurrence in the three years after completing medical treatment.
The information gathered will provide health professional with a way of explaining the
benefits of Anma massage to cancer survivors and better inform patients with quality
information on whether or not they would like to attempt this form of therapy.
Numerous studies that focus on massage therapy on patients imply massage therapy can
help improve the psychological and physical symptoms of cancer patients. Anma is one
of the most popular contemporary therapies in Japan; it has been used to relieve
psychological and physical pain for many years. Anma is performed through clothing
while the participant is lying on a massage table. The participant will receive a full body
massage excluding the face, head and abdomen. The intensity of the massage pressure
will be determined by each participant and areas where they patient experiences an
increased level of physical discomfort will be focused on based on the patients desires.
This trail separated the participants into two groups, one that received Anma massage
and one who did not; each groups level of stress, psychological and physical symptoms
were measured at the end of the trail. The group that didnt receive massages chatted
with a massage therapist while lying on a massage table and only got one massage at the
end of the trail. Data was collected before and after the first and last massage was given
for those who received the massages. For those who didnt receive a massage, their data
was collected before and after each chat and before and after their only massage session.

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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

CONCLUSION
Massage therapy should be offered in more clinics and hospitals as a form of
treatment for oncology patients because it reduces pain, anxiety, depression, nausea,
and increases sleep. It also doesnt interfere with many cancer medications so it is a very
safe type of medication. Many oncology patients are forced to take a variety of different
of medications after they leave the hospital because of their weakened state, but most
dont want to keep track of so many pills and would rather get a massage once a week to
treat the pain as well as possibly increase circulation in their systems rather than take
more medication. Although there is contradicting information and not much is known
about the long-term effects of massage on patients, much of the current information
promotes introducing massage therapy as a form of treatment. Most of the patients
benefit from massage therapy, especially those who have just come out of surgery or
chemotherapy. Cancer is very difficult on the patient and family members, anything that
can be done to make it easier should be considered.

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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

References

Jacobs, S. S., (2014). Integrative Therapy Use for Management of Side Effects and
Toxicities Experienced by Pediatric Oncology Patients. Childrens National
Medical Center, 1, 424-440.
Summary: The effects of a massage dont always last long for patients and
this shouldnt be used as a long term form of pain treatment. Patients showed a
decrease in irritably and were more joyful. There appears to be a more positive
effect to massage than a negative effect.
Corbin, L., (2005). Safety and Efficacy of Massage Therapy for Patients with Cancer.
The Center for Integrative Medicine at the University of Colorado Hospital, 12,
158-164.
Summary: Some cancer patients cant handle a massage with the
medication they must take for their cancer so consulting with their oncologist is a
priority. Integrative therapy that uses herbs and similar items must first be
approved by the oncologist to prevent any negative side effects on the patient.
Lee, S.-H., Kim, J.-Y., Yeo, S., Kim S.-H., Lim, S., (2015). Meta-Analysis on Massage
Therapy on Cancer Pain. Integrative Cancer Therapies, 1, 1-8.
Summary: Patients experienced a large decrease in pain levels after
receiving a massage. Many patients said they would use massage as a form pain
treat because it works so well.

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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

Currin, J., Meister, E. A., (2008). A Hospital Based Intervention Using Massage to
Reduce Distress Among Oncology Patients. Walters Kluwer Health, 31, 214-221.
Summary: There are many different results found from research done on
massage on cancer patients some saying it is beneficial while others saying it is
dangerous and should be avoided. Many doctors are wary of this kind of
treatment because of the limited amount of research performed on it and the
shaky evidence that has been presented on this topic. But there are more results
that suggest massage is a worthy alternative for cancer patients as a form of pain
treatment.
Billhult, A. (2007). The Effects of Massage for Women with Breast Cancer. Institute of
Neuroscience and Physiology, 1, 1-50.
Summary: Women with breast cancer were shown to enjoy massage
sessions. They experienced a larger decrease in pain and anxiety than with the
other integrative therapies.
Cassileth, B., Heitzer, M., Gubili J., (2009). Integrative Oncology: Complementary
Therapies in Cancer Care. Cancer and Chemotherapy Reviews, 4, 204-217
Summary: Massage reduces stress, nausea, and anxiety in cancer patients.
These are the symptoms cancer patients experience most often while undergoing
extensive treatments.
Natural Healers. History of Massage Therapy. Natural Healers. All Star Directories
2016. n.d. Web. February 20, 2016.

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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

Summary: Massage has been used as a form of treatment for centuries.

The exact location of where it first began in unknown but many countries have
their own version of a massage in their history. Massage began to viewed as a
form of relaxation instead of treatment in the past century but it now being used
to heal many different types of illnesses.
Donoyama, N., Satoh, T., Hamano T., (2013). Effects of Amna massage therapy
(Japanese massage) for gynecological cancer survivors: study protocol for a
randomized controlled trail. UMIN Clinical Trails Registry, 14, 223-247
Summary: A group of randomly selected cancer survivors were
examined to determine the effects of massage on cancer patients compared to no
massage. Some survivors received a massage while others did not and each group
was observed after. The group that got the massages were experiencing lower
levels of pain and discomfort and they seemed to less stressed and grumpy.
Kesseir R. C., Soukup, J., Davis R. B., (n.d.). The use of complementary and alternative
medicine to treat anxiety depression in the United States. The Article Journal of
Psychiatry 2011. 158, 24-34.
The graph that reveals how massage effects anxiety.
Fernet L., Lively B., Arondekar B,. Black C., (2002). Massage therapy in controlling high
dose chemotherapy nausea in stem-celled transplant patients on economic
evolution. Vincent Mercy Medical Center and The University of Toledo Ohio,
College of Pharmacy.

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Effects of Massage on Patients with Cancer

Margaret Omulindi
Research Paper

The Comparison of Responses for Chemotherapy Patients Receiving

Massage Therapy graph.

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