Comfort Oriented Massage for People Living with Cancer

iStock_000010850883SmallMassaging cancer patients and those who are medically frail is not a new concept. For decades, it was done in hospitals by nurses. As medicine increased in sophistication so did the responsibility of the nursing profession. Eventually, massage was simply left behind. However, that has slowly been changing over the last twenty years or so. Massage and its effects have been gaining more and more attention by doctors and hospitals as a viable way to improve their patient’s quality of life. For many years, massage therapist were told they could not touch people with cancer. As of 2006 that changed. With greater interest in alternative forms of treatments, there is a growing desire for this group of people wanting massage. Not much training has been given in the massage profession concerning this subject and therefore, there exists much fear. Fortunately, that is changing as well.

It is not widely known that there is a field of study in massage called Oncology Massage. This is a study designed to train massage therapists and various other body workers how to give massage to people with all types of cancer as well as those with mild to severe medical issues. Oncology massage is a comfort oriented massage aimed at relieving the physical, mental and emotional symptoms associated with various forms of cancer and cancer treatments. Comfort Oriented massage is different from regular therapeutic massage in various ways, but none more important than in relation to the demand placed on the body.

When massage therapists perform therapeutic massage, there is an implication that something needs fixing. When massage therapists perform Comfort Oriented massage, there is only an attempt to meet the patient where they are emotionally and physically. In this way, massage can help to facilitate the patients own healing abilities. Various forms of massage are used. Swedish Massage is the most common modality used along with, Myofascial release for improving scar tissue, Manual Lymph Drainage for reducing edema and lymphedema and acupressure for relief of pain, just to name a few. Occasionally, patients cannot or do not want to receive massage. In these cases, other modalities such as Reiki, Polarity, or Healing Touch are used. All are forms of energy work in which the therapist positions his/her hands on or above the client in various places around the body. These modalities often produce deep calming affects useful in relieving anxiety, nausea
and pain.

Comfort Oriented massage is given in much the same setting as regular massage: on the table with minimum clothing (patient is always covered except for the part being worked on), in a regular chair, massage chair, or hospital bed. Comfort Oriented massage can be given before, after or even during some forms of cancer treatments such as chemotherapy. As previously mentioned, Oncology massage is primarily concerned with providing relief while minimizing demand on the body. Therefore, the massage is done in a very mindful manner with lighter pressure than what the patient might expect or perhaps is used to. The difference between regular massage and Oncology massage is primarily two fold. First is in the degree of pressure used. Since the demand on the body from cancer and cancer treatments is already high, the last thing that the body needs is to have to recover from to vigorous of a massage. Too vigorous a massage can cause fatigue, nausea, other flu-like symptoms, skin damage, bleeding (internal and/or external), and lymphedema. Second is in the knowledge of what information to gather about the patient. Such information as type of illness, date diagnosed, type and date of treatment/s, medical devices implanted, presence of edema, presence of or at risk for lymphedema, energy level, and blood counts are all important information for the therapist to know in order to give safe and effective massage. As a side note, the importance of timing massage in relation to treatments should not be underestimated. A massage given to soon after a treatment such as chemotherapy may do more harm than good. The following is an explanation of the terms pressure, site, and position as they pertain to Oncology massage. Since massage therapists are not doctors or nurses, these terms act as a springboard by which to launch an investigation of the medical history of a patient. These terms will shape the massage session and should be considered each time a massage is given.

Pressure concerns: This will determine what level of pressure a client needs or if massage is appropriate at that time.
 When were you diagnosed?
 Are you currently being treated?
 How long has it been since you have been treated?
 Do you have a history of blood clots?
 What is your energy level?
 What are your platelet count levels?
 What is your white blood cell (WBC) count?
 Have you had any lymph nodes removed/radiated?
 Where is the location of removed/radiated nodes?
 Do you have lymphedema?
Site concerns: This will determine what areas can or cannot be massaged.
 What type of cancer do you have?
 Where is the cancer?
 What type of treatment is being or has been used?
 When is your next treatment scheduled?
 What type of medical device is being used and where is it located?
 What, if any, skin conditions are present?
 Are there any DVTs (Deep Vein Thrombosis) or blood clots?

Position concerns: This will determine which techniques are appropriate and how those techniques are implemented.
 What type of medical device is being used and where is it located?
 Do you have lymphedema?
 Where is your lymphedema?
 What is your energy level?
 What is your platelet count?
 Are there any DVTs or blood clots?
 Are you currently experiencing nausea?

There are still instances where massage is not advised (contraindicated), but for the most part it is thought to bring aid and comfort to a group of people that suffer greatly with such an exhausting, scary and life threatening illness. Oncology massage is a specialized field of bodywork and those who have cancer or have had cancer and desire massage should seek out those persons trained specifically in Oncology massage as well as Manual Lymph Drainage.

Debra Curties. Massage Therapy & Cancer. Cuties-Overzet Publication 1999
Gayle McDonald. Medicine Hands: Massage Therapy for People Living With Cancer. Findhorn Press, 1999