Article of the Month
Effect of massage therapy on stress levels and quality of life in brain tumor patients - observations from a pilot study
Keir, Stephen Thomas
Supportive Care Cancer 2011;19:711-715
Data in the literature show that patients with brain tumours experience more stress, anxiety, and depression across the disease continuum than any other cancer population. This is probably due to the poor prognosis and the suffering caused by physical, emotional, cognitive and neuropsychiatric problems.
Among available complementary therapies, massage is considered a suitable therapy to reduce psychological stress and to improve the quality of life (QoL) of cancer patients.
The National Cancer Institute (NCI) defines massage therapy as “a treatment in which the soft tissues of the body are kneaded, rubbed, tapped, and stroked. It also involves the application of specific physical manipulations applied in a systematic way, with varying intensity, direction, rate, and rhythm”. The NCI recognizes that massage therapy may help people relax, relieve stress and pain, lower blood pressure, and improve circulation.
Dr. Keir prospectively studied a sample of 25 patients with a histological diagnosis (newly diagnosed, or advanced malignancy) of brain tumours, with a life expectancy ≥ 3 months and Karnofsky Performance Score ≥ 70, who were able to speak, read and write English, lived close to the Hospital and were diagnosed as “stressed” on the Perceived Stress Scale -10 (PSS-10) and who signed an informed consent.
The patients were treated at the Duke Center for Living where massage was performed in a quiet setting. Each participant received two massage therapy sessions of 45 minutes each/week for a total of 4 weeks = 8 sessions. Swedish massage techniques were employed by two highly trained therapists.
The assessments were performed at baseline, after 1, 2, 3, 4 weeks and 1 week following the last therapy using 2 validated tools such as 1) the PSS-10 to assess stress; and 2) the Functional Assessment of Cancer Therapy – Brain (FACT-Br) to assess the QoL.
After the start of the massage therapy the stress intensity significantly decreased between weeks 2 and 3 (p ≤ 0.010) with the trend continuing through week 4 (p ≤ 0.063). The intensity was below threshold for stress at the end of week 4.
Although the stress scores increased 1 week after massage therapy, it was below the baseline score. At week four (i.e., the end of the massage sessions) improvements were registered in the following:
- the emotional well-being ( p ≤ 0.001) (continued one week after study),
- additional brain tumours concerns (p ≤ 0.013),
- social/family well being ( p ≤ 0.024),
- physical well-being ( p ≤ 0.078) (continued one week after study).
Stress is frequent in patients with brain tumours and massage therapy represents a useful therapeutic tool to reduce its intensity and improve the well-being of patients.
Why I chose this article
While treating the physical and psychological symptoms in cancer care, the pharmacological approach, unfortunately, is often considered first, and by some the only approach. This could be because of a lack of knowledge about other treatment modalities directed at suffering, and/or because of a paucity of human resources.
Data in the literature show that massage therapy is useful in reducing stress, distress, depression, anxiety, pain, fatigue, chemotherapy-related nausea and it increases immune function in various cancer populations. For these reasons some authors advocate that massage therapy should be considered from among the conventional care options for cancer patients.
This study provides additional data on the beneficial effects of massage therapy in the treatment of patients with brain tumours. This should be an incentive to consider a non-pharmacological therapy in patients with a poor prognosis who are already on multiple drugs. Reviewed by Dr. Carla Ripamonti (Italy).
Dr. Ripamonti is a member of the IAHPC Board and her bio may be viewed at http://www.hospicecare.com/Bio/c_ripamonti.htm |
