Research History

Question 1

Why is massage therapy gaining acceptance in cancer patient care?

Answer 1

Massage therapy offers physical, emotional, and inner-being benefits, making it well-suited as a complementary therapy for cancer patients.

Question 2

How long has research been conducted on massage therapy for cancer patients, and what does it provide?

Answer 2

Over 30 years of research and clinical knowledge guide how massage therapy can help cancer patients manage symptoms, mitigate treatment effects, and cope with the disease.

Question 3

Why was massage therapy initially not researched for cancer patients?

Answer 3

Massage therapy was once believed to promote cancer metastasis, making it seen as a non-viable therapy.

Question 4

When did research into massage therapy for cancer patients begin to change, and in what field?

Answer 4

Research began to change in the 1980s-90s, emerging from the nursing profession, often focusing on “slow stroke back massage.”

Question 5

What did Sims’ 1986 study on slow stroke back massage find?

Answer 5

Massaged patients reported reductions in nausea, anxiety, and overall symptom distress, with enhanced effects in people with massage experience.

Question 6

What did Meek’s 1993 study on slow stroke back massage find?

Answer 6

All participants showed statistically significant reductions in heart rate, systolic and diastolic blood pressures, and increases in skin temperature post-massage.

Question 7

What gaps in oncology care does massage therapy help address?

Answer 7

Massage therapy provides hope, comfort, and relaxation for patients overwhelmed by cancer symptoms, treatment side effects, and the existential reality of living with cancer.

Question 8

What are common symptoms experienced by cancer patients throughout the disease course?

Answer 8

Symptoms include pain, physical and emotional distress, nausea, vomiting, mood disturbances, and treatment-related side effects like depression and anxiety.

Question 9

How does complementary therapy like massage fit into cancer care?

Answer 9

Complementary therapies, combined with mainstream care in an integrative medicine approach, can relieve symptoms and improve physical and emotional well-being.

Question 10

What were the key viewpoints of massage therapy for cancer patients at the time?

Answer 10

• Symptom relief
• Nurturing support
• Rehabilitation
• Palliation

Question 11

What does the emerging integrative medicine viewpoint suggest about CAM therapies for people with cancer?

Answer 11

CAM therapies are supportive care aimed at:

• Symptom management
• Stress and anxiety reduction
• Pain control
• Enhanced feelings of well-being

Question 12

What was the focus of the 2004 study by Cassileth and Vickers?

Answer 12

• It analyzed 1,290 massage treatments at Memorial Sloan-Kettering Cancer Center for cancer patients.
• Massage types included Swedish, light, or foot massage.
• The study assessed changes in symptoms like pain, fatigue, anxiety, nausea, depression, or “other.”

Question 13

What were the outcomes of the Cassileth and Vickers study?

Answer 13

After one treatment:
• Anxiety improved by 52% (highest).
• Nausea improved by 21% (lowest).

For symptoms rated moderate or above before treatment:
• Anxiety improvement reached 60%.
• Fatigue improvement was 43%.

• Sustained effects were longer in outpatients.
• Conclusion: “Major, clinically relevant, immediate improvements in symptom scores were reported following massage therapy.”

Question 14

What were the key details of the Fellowes, Barnes, and Wilkinson (2004) study on aromatherapy and massage?

Answer 14

• It was a systematic review of 10 studies out of 1,322 references.
• Study criteria included RCTs, controlled before-and-after series, and interrupted time series studies.

Question 15

What were the findings of the Fellowes et al. (2004) study regarding aromatherapy and massage?

Answer 15

• No significant additional effects from the aromatherapy component were detected.
• Most consistent effect: anxiety reduction.
• Beneficial effects on depression, nausea, and pain were replicated in at least three studies.

Question 16

What was the focus of the Hernandez-Reif et al. (2004) study on breast cancer patients and massage therapy?

Answer 16

The study assessed improved immune and neuroscience functions in breast cancer patients following 15 massages over 5 weeks compared to standard medical care.

Question 17

What were the key design details of the Hernandez-Reif et al. (2004) study?

Answer 17

• Participants: 34 females with Stage 1/2 breast cancer (18 massage, 16 control).
• Location: Non-hospital setting with licensed massage therapists (500 hours, Florida).
• Protocol: 30-minute massages designed by an expert.

Question 18

What were the immediate effects of massage therapy in the Hernandez-Reif et al. (2004) study?

Answer 18

Reduced anxiety, depression, and anger.

Question 19

What were the effects of massage therapy over the 5-week protocol in the Hernandez-Reif et al. (2004) study?

Answer 19

• Reduced stress, depression, and hostility in the massage group.
• Increased anger and depression in the control group.

Question 20

What were the longer-term effects of massage therapy noted in the Hernandez-Reif et al. (2004) study?

Answer 20

• Increased urinary serotonin and dopamine levels (improved mood).
• Increased numbers of natural killer (NK) cells and lymphocytes (immune effects).
• Control group had increased norepinephrine levels (stress effects).

Question 21

What concerns were raised about the immune effects in the Hernandez-Reif et al. (2004) study?

Answer 21

It is unclear if the increases in NK cells and lymphocytes are clinically relevant.

Question 22

What was the focus of the Post-White et al. (2003) study on cancer patients?

Answer 22

It compared therapeutic massage (MT), healing touch (HT), and the presence of a caring professional to standard care in outpatients undergoing chemotherapy.

Question 23

What were the design details of the Post-White et al. (2003) study?

Answer 23

• Participants: 230 cancer outpatients.
• Interventions: 4 weekly 45-minute sessions of MT, HT, or presence of a caring professional, plus 4 weeks of standard care.
• MT group: 68 participants, treated by nurses who were also massage therapists, using a full-body Swedish massage protocol.

Question 24

What were the findings of the Post-White et al. (2003) study regarding therapeutic massage and healing touch?

Answer 24

• Both MT and HT were more effective than standard care in inducing relaxation and improving mood.
• MT reduced anxiety and NSAID use.
• HT was more effective in reducing fatigue.
• Vital signs consistently improved with both MT and HT.

Question 25

What was the design of the Smith et al. (2002) study on therapeutic massage for hospitalized cancer patients?

Answer 25

• Pre-test/post-test comparison.
• Patients were hospitalized for chemotherapy or radiation.
• 20 participants in the massage group (first 8 months) and 21 in the nurse interaction (NI) group (second 8 months).

Question 26

What was the demographic focus of the Smith et al. (2002) study?

Answer 26

Conducted in a VA hospital with 95% male subjects.

Question 27

What was the intervention protocol in the Smith et al. (2002) study?

Answer 27

• Massage and nurse interaction provided by the same nurse certified in hospital-based massage therapy.
• Minimum of 3 massages during a week-long hospitalization.
• 15-30 minutes of light Swedish massage focused on effleurage and petrissage.

Question 28

What were the outcomes of the Smith et al. (2002) study for the massage group?

Answer 28

• Significant improvements in pain perception, symptom distress, and anxiety.
• Sleep quality was unchanged.

Question 29

What were the outcomes of the Smith et al. (2002) study for the nurse interaction (NI) group?

Answer 29

• Slight improvement in anxiety.
• Worsened scores for pain and symptom distress.
• Sleep quality worsened significantly.

Question 30

What was the design of the Billhult & Dahlberg (2001) study on massage in cancer care?

Answer 30

• Qualitative study using a phenomenological approach.
• 8 female cancer patients received daily 20-minute light massages for 10 days in a Swedish hospital.
• Massage focused on stroking arms, hands, legs, and feet, performed by healthcare workers.

Question 31

What were the key findings from the Billhult & Dahlberg (2001) study?

Answer 31

Massage provided:

• A feeling of being “special,” counteracting isolation and anonymity.
• Positive relationships with practitioners, extending to other hospital staff.
• A sense of strength and increased body possibilities, leading to interest in self-massage.
• Increased sense of autonomy and choice.
• Descriptions of massage as “natural,” “normal,” “comfortable,” and “feeling good.”

Question 32

What was the design of the Grealish, Lomasney, and Whiteman (2000) study on massage for cancer patients?

Answer 32

• Crossover Randomized Controlled Trial (RCT) with 87 participants hospitalized with cancer.
• Participants randomized into 3 groups for order of 2 massage sessions and 1 control period (quiet time).
• Foot massages given by nurses trained in the techniques.

Question 33

What were the outcomes of the Grealish et al. (2000) study?

Answer 33

Significant improvement in pain, nausea, and relaxation scores following massage compared to control.

Question 34

What was the design of the Wilkie et al. (2000) study on massage for cancer pain?

Answer 34

• RCT pilot study in a hospice setting.
• 29 patients; 15 in the massage group and 14 in the control group, none of whom had prior massage.
• Massage provided twice per week for 2 weeks by licensed therapists (Washington State – 1000 hours).
• 30-50 minutes of Swedish massage with a specific design allowing for some therapist judgment.

Question 35

What were the findings of the Wilkie et al. (2000) study?

Answer 35

• Significant improvement in physical relaxation response indicators post-treatments 1, 2, 4.
• Pain intensity reduction significant or approaching significance after treatments 1, 3, 4.
• Emotional distress decreased after each treatment, but not at significant levels.
• Control group had consistently lower beneficial responses.
• Authors suggested that a sample size of 80 would produce significant results for massage on pain intensity, reducing/stabilizing analgesic dosages and improving quality of life.

Question 36

What were the specific techniques used in the massage protocol in the Wilkie et al. (2000) study?

Answer 36

Swedish massage techniques with some flexibility in therapist judgment.

Question 37

How did the participants in the Wilkie et al. (2000) study react emotionally to the massage therapy?

Answer 37

Emotional distress decreased after each massage treatment, although these changes were not statistically significant.

Question 38

What was the design of the Ahles et al. (1999) study on massage therapy for patients undergoing autologous bone marrow transplantation?

Answer 38

• Randomized Controlled Trial (RCT) with 34 participants.
• Massage therapy (MT) group (16) received 4-9 sessions of 20-minute massages during hospital stay.
• Control group (18) had quiet time in their rooms.
• HNS Swedish/Esalen massage with acupressure points, provided by a trained healing arts therapist.

Question 39

What were the findings of the Ahles et al. (1999) study on massage therapy?

Answer 39

• Immediate significant improvement in symptom distress, nausea, and state anxiety (STAI) in the MT group compared to control.
• Fatigue showed significant improvement in the MT group by final assessment.

Question 40

What specific techniques were used in the massage therapy protocol in the Ahles et al. (1999) study?

Answer 40

• HNS Swedish/Esalen massage combined with acupressure points.
• Provided by a trained healing arts therapist.

Question 41

What was the design of the Billhult et al. (2007) study on massage during chemotherapy for breast cancer patients?

Answer 41

• Qualitative study with cancer patients receiving 20-30 massages (arm/hand or leg/foot, their choice) during chemotherapy treatments at a chemotherapy clinic.
• Each patient received 5 treatments over a 15-week period (chemotherapy sessions were every 3 weeks).

Question 42

What were the primary benefits of massage reported by participants in the Billhult et al. (2007) study?

Answer 42

• Distraction from the frightening, distressing experience of chemotherapy, described as an “oasis of normalcy.”
• Energy shift from negative to positive.
• Relaxation reducing physical symptoms, tension, and fear associated with chemotherapy.
• A sense of caring that counterbalanced feelings of being “sick and ugly.”
• Overall feelings of well-being, with participants often looking forward to each massage.

Question 43

How did participants in the Billhult et al. (2007) study describe the impact of massage on their emotional state during chemotherapy?

Answer 43

• Massage provided a sense of caring, helping counterbalance feelings of being “sick and ugly.”
• Participants described feeling “good” and experiencing relaxation that promoted well-being.

Question 44

How did the Billhult et al. (2007) study address the choice of massage areas for the participants?

Answer 44

Participants had the option to choose between arm/hand or leg/foot massages.

Question 45

What methodology was used in van der Riet’s (1999) study on massaged embodiment of cancer patients?

Answer 45

• Qualitative study using a poststructuralism methodology.
• Focused on understanding the complex experience of cancer patients’ embodiment.

Question 46

How many cancer patients participated in van der Riet’s (1999) study, and what was the massage protocol?

Answer 46

• 18 cancer patients, many of whom were dying.
• Received 1-8 massages from the researcher, a nurse.
• This research was part of her doctoral work.

Question 47

What were the key findings regarding the effects of massage on cancer patients in van der Riet’s (1999) study?

Answer 47

Massage was observed to:

• Free minds from worries and negative thoughts.
• Produce feelings of relaxation, comfort, peace, calmness, and better coping.
• Create more energy and improve sleep quality.
• Reduce pain and edema.
• Open up feelings and reduce disconnection.
• Promote more acceptance of the new body.

Question 48

What is the current situation of massage therapy in oncology research?

Answer 48

• Massage therapy is well accepted and continuously studied in oncology research.
• Thousands of citations on variations of “massage therapy and cancer” are available in OVID searches.
• A current area of interest is whether massage can mitigate or prevent chemotherapy-induced peripheral neuropathy.