Massage

When family members and friends offer touch to a person with cancer through holding hands, hugging and sitting close by this physical contact is valuable and important.

Another way you can receive touch is through massage. When people think of massage they may relate it to sore muscles or a chance to unwind. It feels good after a stressful day, as part of a beauty treatment or after exercise. Infants to the elderly thrive on massage.

For the person receiving treatment for cancer or recovering from it, massage takes on other meanings. Massage may become a way to lower anxiety and pain, improve energy or decrease nausea. It can help someone to feel loved. It can also help to re-establish a connection with oneself and others. It may ease the discomfort of a medical procedure or help pass the time while waiting to see the doctor.

Massaging a tumour site should be avoided as pressure on the affected area and underlying organs is not beneficial and is often uncomfortable.

Some people worry that massage can spread cancer cells throughout the body via the lymphatic system (a part of the body’s immune system).

However it is well documented that comfort-oriented massage does not contribute to the spread of cancer. Researchers have shown that the development and spread of cancer is as a result of genetic mutations (changes to a cell’s DNA) and other processes in the body.

The lymphatic system is a complex network of vessels, organs and nodes. It transports and filters waste products, returns excess protein to the circulatory system (heart and blood vessels) and works with the immune system.

Lymphatic circulation occurs naturally due to skeletal muscles contracting which compresses lymph vessels and forces the movement of lymph. Gentle massage does not increase lymphatic circulation any more than activities such as exercising, shopping or gardening.

Although cancer may metastasise (spread) into the lymphatic system via the lymph nodes, or it sometimes starts in the lymphatic system itself, the circulation of lymph—from massage or other movement—does not cause cancer to spread.

Lymphoedema is swelling in the tissues caused by a build-up of fluid which may occur after surgery or radiotherapy to the lymph nodes.

Bodyworkers trained in manual lymph drainage can often help reduce the swelling. Bodyworkers not trained in this technique should only use gentle touch in the affected area.

For more information see www.lymphoedema.org.au

Massage is one of the most popular complementary therapies.

Complementary therapies are used in conjunction with the conventional interventions of mainstream medicine. They are not used as an alternative to chemotherapy, radiotherapy or surgery. While massage is not a cure for cancer it may help diminish the side effects of conventional treatments and improve quality of life.

Receiving comforting, attentive touch can remind you that your body can still be a source of pleasure. Some benefits people have described from receiving massage include feeling whole again, being able to share feelings in an informal setting, re-establishing a positive body image and rebuilding hope.

Many scientific studies have been conducted on the effect of various bodywork techniques on people undergoing cancer treatment particularly chemotherapy and surgery.

Scientific research shows that massage can reduce:

• pain;
• fatigue;
• anxiety;
• depression; and
• nausea.

Other benefits may include improvements in:

• sleep;
• neuropathy (nerve damage or disturbance);
• quality of life;
• mental clarity and alertness; and
• meaningful social interaction.

Between friends, family members or a partner, massage can be a form of non-verbal communication to show love, acceptance, comfort and care.

A variety of approaches are commonly used by qualified therapists for people with cancer or those recovering from it. The key is the type of treatment and the therapist’s ability to adjust it, depending on a person’s medical history, age, constitution and individual requests.

Massage therapies requiring adjustments to stroke pressure:

• Acupressure—pressure points on the body are massaged in order to relieve physical symptoms manifesting in different organs.
• Aromatherapy—aromatic essential oils are blended in a carrier oil and applied to the skin during a massage to release stress and tension.
• Lomi lomi or ka huna massage—Hawaiian style of massage that stimulates the flow of energy and releases stress and tension.
• Myofascial release—sliding pressure gently stretches and heats tissue to release tension in and between the muscles.
• Reflexology—the feet are massaged in specific areas that correlate to different parts of the body in order to reduce imbalances.
• Seated chair massage—massage is focused on the head, neck, shoulders, back and arms to release stress and tension.
• Shiatsu—pressure points are massaged lightly with the fingers, thumbs, elbows, knees, hands and feet to restore vitality.
• Swedish massage—long, flowing strokes balance and tone soft tissues, stimulate circulation, improve oxygen flow and relax the muscles.
• Trigger point therapy—specific points in the soft tissue of the body are compressed and stretched to reduce muscular pain.

Gentle bodywork therapies requiring minimal or no change:

• Bowen technique—through gentle touching and the movement of soft tissue, the body is rebalanced.
• Craniosacral therapy—subtle manipulation of the head and spine encourages the release of stress and tension from the body.
• Healing touch—soft touch helps restore harmony and balance by working with the flow of energy in the body.
• Jin shin jyutsu—fingertips or hands are placed on key parts of the body and special breathing techniques are used to balance the body’s energies.
• Polarity therapy—using gentle touch, the hands help clear blockages in energy flow around the body, leading to a feeling of well-being.
• Reiki—meaning ‘universal life energy’, this system of light touch or no-touch movements turns blocked or negative energy into positive energy.
• Therapeutic touch—soothing touch calms the body by restoring its flow of energy.

Cancer treatments place a great deal of demand on the body so a person undergoing chemotherapy or radiotherapy isn’t going to be given the same type of massage as the person who has just completed a triathlon.

Adjustments to the massage technique will need to be made, the most common of which is decreased pressure and speed of strokes.

After such a massage you will probably feel relaxed, more energetic and nurtured. If a bodywork session is too vigorous or deep you may feel fatigue, pain, flu-like symptoms, bruising or a sense of invasiveness. These side effects can be minimised or avoided altogether by being open about your medical history and your individual needs.

Eventually you may be able to return to a more vigorous type of bodywork but make sure you ask your therapist to massage using less pressure in any area that you are still experiencing discomfort.

Some conditions, listed below, will require adjustments to the massage technique for a long period of time.

• Risk of lymphoedema—f part of your treatment or diagnostic process included the removal of lymph nodes from the neck, armpit or groin, you should only have gentle massage in that quadrant of the body.
• Bone fragility—some treatments, such as radiotherapy or medications, or the disease itself may cause the bones to become more fragile. Care should be taken in those areas so that undue pressure or extreme stretching is avoided.
• Neuropathy—certain chemotherapies can cause long-term numbness in the hands and feet. A lighter pressure is best for those areas.

The goal of receiving massage during treatment and recovery should be comfort, support, physical nourishment of the skin and emotional nurturing. It is in this restful state that side effects from cancer treatments, such as pain, fatigue and anxiety, are reduced and your overall well-being can improve.

It is important to talk about your medical history with your therapist, even if the massage is part of a beauty routine such as a facial or pedicure. This will help the therapist make the right adjustments to the session so that it is both safe and comfortable for you.

A number of the side effects caused by chemotherapy, radiotherapy and surgery require the therapist to decrease the pressure of their strokes and to be mindful of areas affected by such things as medical devices or fragile bones.

Let the therapist know if you are affected by any of the following conditions:

• fatigue;
• risk for easy bruising or bleeding;
• low white blood cell count;
• bone metastases or fragile bones as a result of osteoporosis;
• recent blood clot;
• oedema or lymphoedema;
• nausea;
• medical devices such as a catheter or stoma bag;
• pain;
• wounds;
• neuropathy; and / or
• skin conditions such as rashes, broken areas of skin or fungal infections.

Most professional massage sessions last for 30 minutes to an hour. You can have a one-off treatment or a series of regular sessions.

It is recommended that you choose a therapist who is a member of a professional association that represents massage therapists, such as the Australian Traditional-Medicine Society, Australian Natural Therapists Association or Australian Association of Massage Therapists.

These associations ensure that therapists who hold membership with them have received adequate professional training in massage, undertake continuing professional education and have a current first aid certificate and professional indemnity insurance policy.

Ask a potential massage therapist about their specific training and experience in working with people who have cancer. For example:

• What types of massage or touch therapies have you been trained in?
• What kind of training have you done to work with someone with a history of cancer?
• What type of precautions would you take for me?
• What type of clients do you most often work with? (Ideally they are people who require special adjustments such as infants, the elderly or those with serious illness.)
• Would you be able to work with my doctors or other health professionals if required?
• Are you able to treat me at home if I am unwell?

When starting a massage program it is important for the therapist to begin with moderately light pressure.

Gauge the effects of the session not only on how the massage strokes feel in the moment but on how you feel 24 hours afterwards. The massage may be enjoyable as you are receiving it but a few hours later you may feel excessively tired or in pain, even if the pressure was light.

If you do not feel any side effects from the massage within 24 hours and want to increase the pressure of the strokes, do so in small, incremental steps until you find the right level of pressure for you.

During the treatment and recovery period, your energy level may be different from day-to-day. The massage should be adjusted to match how you are feeling on the given day

You should feel safe, respected and comfortable during a massage. It is important to communicate your needs to the therapist.

For example, let them know if their pressure is too strong or if you are feeling cold. If you do not feel comfortable for whatever reason and the therapist is unable to make the adjustments you have requested, stop the session.

A letter from your oncologist about your diagnosis and treatment will assist your massage therapist to develop an appropriate massage plan for you.

Professional massage usually costs between $60 and $100 an hour. Prices do vary depending on the therapist’s location, the type of therapies they practise, their training and experience. If you have private health insurance check with your fund to see if you are eligible for a rebate.

Apply lotion to the feet with slow strokes using full-hand contact. Rest one foot between the hands and apply moderate pressure with the thumbs along the sole of the foot.

Applying pressure to these areas is calming, reduces pain and may help with sleep. Using moderate pressure, gently rotate fingertips all around the crown. Move to the top of the ears, gently tweaking them between the thumb and forefinger, down to the lobes. Work the fingers behind the ears and across the back of the skull.

Sit down for this massage—or do it yourself.

Apply lotion to the back using long, slow strokes with full-hand contact. Gently squeeze muscles with moderate and controlled pressure along the length of the back. You may prefer to lie on your side rather than face down for this massage.

The organisations below are good sources of reliable information about complementary therapies including massage.

Australian Association of Massage Therapists
Call 1300 138 872 or visit www.aamt.com.au

Australian Natural Therapists Association
Call 1800 817 577 or visit www.anta.com.au

Australian Traditional-Medicine Society
Call 02 9809 6800 or visit www.atms.com.au

International
American Cancer Society www.cancer.org