resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
How Much is Enough?
One of the primary arguments used against acupuncture care is the overuse of treatment. Some people say, "once you go, you have to go forever."
No Whining on the Yacht
This admonition – no whining on the yacht – may sound familiar to you. Many claim its origination.
News in Brief
In Remembrance: A Moment of Silence for Dr. Dick Versendaal; NYCC Named Chiropractic College of the Year by ACA; National University Partners With Indiana VA Facility.
Alternatives to the Rainy Day Fund: Better Things to Do With Your Money
Google "rainy day fund" and you'll find the predominant and traditional advice given today is that you need to have three months of living expenses saved for an emergency. Some even recommend six months or more.
Your Chance to Go Back to High School
As the father of a student who recently entered high-school sports (soccer), I have come to recognize an untapped opportunity for the chiropractic profession.
We Get Letters & E-Mail
Shouldn't the Pentagon Know More About Chiropractic Care? Office Flow: Have You Reviewed the Patient Experience Lately? Let's Stop Confusing the Public About Chiropractic; Cutting Down the Cherry Tree.
AAAOM: Facing An Ultimatum
On the heels of the growing discontent with leaders of the AAAOM, the Council of State Associations (CSA) recently took it upon themselves to present the organization with an ultimatum: for all board members to resign from the board and turn the organization over to the CSA or they will proceed on their own to become the primary representative of the AOM profession.
Environmental Toxins: Cause of Modern Illness (Part I)
Environmental toxins have created burdens on the human body that put demands beyond our evolutionary development. Modern diseases that historically did not exist to any great degree have been rising sharply in the last 40 years.
Enhancing TCM with Enzymes
Herbal formulations are an integral component for most Traditional Chinese Medicine (TCM) practitioners. One of the best ways to enhance their effectiveness is the addition of plant-based enzymes.
Colorado to Have the First Acupuncture Medical Reserve Corps in the U.S.
In the summer of 2012, Colorado was on fire. Literally. Many acupuncturists from around the state, especially those who had received disaster response training through AWB, wanted to help those affected by the fires as well as the first responders and tireless state and local officials, with the healing and stress-relief of acupuncture.
Making Sense of Chronic Inflammation
Inflammation is big business, evidenced by not only the laundry lists of medications patients bring me aimed at managing inflammation, but also the never-ending stream of advertisements for anti-inflammatory supplements that constantly find their way to my desk.
Revisiting the Neurological Exam
In spinal trauma or disease, the neurological exam chiefly aims to determine whether one (or more) of three basic neurological conditions is present: myelopathy, radiculopathy and peripheral nerve disorder.
Dry Needling is Acupuncture: Anatomy of a Legal Victory in Oregon
On January 23, 2014, the Oregon Court of Appeals overturned the Oregon Board of Chiropractic Examiners "dry needling" administrative rule, which allowed chiropractic physicians to perform acupuncture after only 24 hours of training.
Chiropractic Management of Sports-Related Tendinopathy
Tendinopathy is increasing in prevalence and accounts for a substantial percentage of sports injuries. Despite the magnitude of the disorder, research on chiropractic treatment is limited.
Shoulder Strategies: Reduce Pain, Improve Function With Proper Taping
Shoulder pain / dysfunction is a common problem for chiropractic patients. Clinicians who utilize elastic therapeutic taping as part of their treatment approach know it can be effective for a variety of shoulder problems.
Through the Eyes of a Child
Once upon a time there was a girl name Lucy. Lucy had cancer, but she had a heart filled with love and compassion. Please come along to hear this story of an amazing child, her tenacity and her dream to help other children.
San Zhen Protocols Part II: Case Studies
In my last article, I presented a collection of three-point acupuncture combinations which can provide effective clinical results.
Anti-Aging: Educating Your Patients About The Skin
We know that cosmetic acupuncture works but what then? Education is a key part to the practice of Chinese medicine and when you practice cosmetic acupuncture, facial rejuvenation, etc., it is time talk about skin with your patients.
Dietary Supplement Research: Contradictions, Bias, Misinterpretation and Confusion
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Recliner Test
"Hi, Bill, how are you?" "Oh, I'm OK, Doc. I've got pain down the leg again, so I thought I would stop by and get you to check it."
Arch Height and Running Shoes: The Best Advice to Give Patients
Because runners with different arch heights are prone to different injuries, running shoe manufacturers have developed motion-control, stability and cushion running shoes for low-, neutral- and high-arched runners, respectively.
Evaluating Prenatal and Pediatric Automobile Injuries
Often in a family practice, one of your patients or an entire family is in an automobile accident and you are sought out to provide care for their soft-tissue injuries.
Are You Driving Patients Toward Dependence on Big Pharma?
Over the years I have had the opportunity to talk to doctors of chiropractic about health promotion, wellness and preventive care in chiropractic practice.
Socializing In My Slippers
When I graduated college, I had grandiose dreams of becoming an amazing acupuncturist. I wanted to build a great practice and make a good living. For four years, 13 semesters to be exact, I had a spreadsheet.
Chinese Herbs Debut at the Cleveland Clinic
Chinese herbal medicine is now being prescribed at the Cleveland Clinic thanks to a trailblazing team of people.
December, 2013, Vol. 13, Issue 12
Know What You Are Dealing With: Radiation Therapy and Massage
By Tracy Walton, LMT, MS
Radiation therapy, often abbreviated as XRT for "X-Ray Therapy," is sometimes brushed aside as having fewer side effects than other cancer treatments. But radiation therapy can have strong effects on the body and some require significant adjustments in the massage session.
Myths and misinformation about massage and cancer treatment prevent patients from receiving good, supportive massage therapy care.
Radiation therapy is roughly classified as external beam radiation therapy (EBRT or EBT) and internal radiation therapy. External radiation is the more common of the two, where the patient lies on a surface and a machine, called a linear accelerator, delivers a beam of radiation to the tumor.
It can be used to shrink a tumor before surgery, prevent recurrence after surgery, or it can be used as palliative care when lesions cause pain.
Two Types of Radiation Therapy
External radiation treatments are usually only a few minutes long — most of the patient's session is spent making sure they are properly lined up on the treatment table.
A radiation oncologist typically maps out a specific field of treatment to treat the tumor from a number of angles. This is done to best target the tumor and spare the healthy tissue surrounding it. The sessions themselves are also usually painless.
Internal radiation often involves the placement of small radioactive implants inside the body near the tumor cells. This internal application, also called brachy therapy, allows for a higher dose of radiation and a more focused approach without the risk of damaging too much neighboring tissue.
Internal radiation seeds can be implanted and left in the body (such as with prostate cancer), a wand can be placed and removed (such as with gynecologic cancer), or a radioactive iodine solution can be ingested (as with thyroid cancer).
Touch and Radiation Therapy
Education about massage and cancer is limited in most basic training programs. As a result, a common misconception among massage therapists is that any client going through radiation therapy is "hot" and "radioactive" and either the practitioner should only touch them while wearing gloves, or the client should not be touched at all.
But the truth is that, in the case of EBRT, the radiation source is the linear accelerator which stays in the room. The client is not "contaminated" and the therapist should make appropriate massage adjustments for other factors in cancer treatment. It is safe for a massage therapist to touch the client.
In the case of internal radiation therapy, clients are considered "hot" if the implants are still in and if they are still radioactive (and not expired seeds, as in the case of prostate cancer). You should ask the client ahead of the session.
Ask where and when the internal radiation was implanted, and if there are any contact precautions in place. Most people are already following these precautions and clients are unlikely to seek out massage unless they are cleared for contact.
Radiation is aimed at the cancer cells, but nearby tissues in the path of the beam may be affected as well. Clients can experience swelling, reddening or change in pigmentation and dry and/or itchy skin. They may lose hair in the radiation field.
Another common side effect is overall fatigue. It often starts up a few weeks after treatment begins and can linger for weeks or even months after treatment is complete.
Some side effects depend on where the radiation field is located. Here are some examples:
One complication of XRT is of particular note for massage therapists: Radiation treatment can injure lymph nodes, and lymph nodes in the neck, axilla or groin are often included in the field. This can put a client at lifelong risk for lymphedema, a disfiguring, debilitating and often painful condition that can cause a host of complications.
There is little specific research on massage for clients in XRT, but our clients tell us that the contact of skilled touch can be healing. Relaxation during a stressful time and relief from side effects such as nausea, fatigue and pain provide welcome possibilities for clients.
The key is making sure we apply this touch safely. Finding out how to best serve our clients going through radiation therapy, or who have recently completed therapy, starts with asking the right questions in the intake interview. Here is a "starter list" of questions for these clients:
Therapists will find many massage adjustments for radiation treatment echo common sense: On a current or recent radiation field, we use no friction, pressure, no heat, hot stones or cold therapy, nothing besides hospital-approved lubricants (metals are contraindicated and fragrances can be irritating) and generally no direct contact if it's a current field.
A simple hold through the drape may be possible over a dry radiation field, and the hands-on contact may be soothing. Any other sort of technique brings with it the risk of disturbing healing skin and other tissues, or further exacerbation of skin changes such as flaking, itching, blistering or weeping.
Because the risk of lymphedema is very real in many clients after XRT therapy, it is important to fully understand the condition before attempting to work with clients with histories of cancer treatment. Lymphedema risk is an example of a "hidden contraindication." The adjustments are not intuitively obvious and working safely requires good interviewing and hands-on skills.
If key lymph nodes were in the radiation field, there are strict massage adjustments in pressure, stroke direction, joint movement and position.
It is essential to avoid anything that would redden the skin or injure the intact lymphatic structures. "Just working lightly" is not a complete guideline here and the wrong pressure, thermal application, joint movement or stroke direction could trigger irreversible, chronic lymphedema.
For specifics, refer to Gayle MacDonald's Medicine Hands: Massage Therapy for People with Cancer.
Language is Important
When speaking with a client, we do not ask about "radiation burns" or refer to any areas as "burned." Although we essentially treat these areas as if burned, in cancer care these areas are referred to by more neutral terms: "skin changes" or "skin effects."
For complete massage therapy guidelines, therapists are referred to the Society for Oncology Massage, to the literature on oncology massage and to the growing availability of specialized training.
Because radiation treatment can place a significant demand on the body and effects are often cumulative, oncology massage therapy is careful and does not introduce any more stressors.
Click here for more information about Tracy Walton, LMT, MS.
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