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Cancer and Massage

By Tracy Walton, LMT, MS

About the Columnist
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When Cancer Involves the Brain (Part 1)

Some years ago, a client whose breast cancer had spread to her brain was struggling with the effects of the disease, and her treatment at the same time. I remember her struggle as the disease advanced, and her having to cope with stronger and multiple treatments. She told me that frequent massage helped her cope with her condition and managed her stress.

When someone mentions "brain cancer" they may be referring to a tumor that originated in the brain (primary brain cancer), or, in this client's case, to tumors that started someplace else in the body but then spread to the brain (metastatic brain disease). Metastatic disease is more common than primary brain cancer, but both can be devastating to brain function.

The brain is the fourth most common site of metastatic cancer spread (the liver is the most common site, followed by lung and then bone), and primary tumors of the lung, breast, and kidney often metastasize to the brain, as do colorectal cancer and melanoma. Some central nervous system (CNS) tumors can be benign while others can be malignant and can grow very quickly. While the mere presence of a tumor does not necessarily affect brain function, it can be impaired as the disease progresses.

When Cancer Involves the Brain (Part 1) - Copyright – Stock Photo / Register Mark Signs, Symptoms & Complications

The U.S. National Cancer Institute reports that both primary and metastatic brain cancer can cause the following problems:

  • Headaches that are often worse in the morning
  • Changes in vision, speech, or hearing
  • Problems with balance and dizziness
  • Cognitive problems (confusion or trouble remembering things)
  • Nausea and/or vomiting
  • Neuropathy in extremities
  • Involuntary muscle movement, such as jerking or twitching

Most signs and symptoms develop gradually, although acute symptoms can occur when lesions cause bleeding in the brain, such as with a stroke. Headaches and seizures are often the most common effects.

Treatments

The National Cancer Institute lists five standard types of treatment for brain cancer:

  1. Watchful waiting. Also called active surveillance, this involves closely monitoring a patient's condition without administering treatment to see if signs and symptoms change.
  2. Surgery to remove malignant tissue.
  3. Radiation therapy. In brain tissue, it is especially vital that surrounding healthy tissue not be affected by the radiation beams. This can be done with 3-D radiation therapy or with stereotactic radiosurgery, where a single large dose of radiation is aimed directly at the tumor.
  4. Chemotherapy. Because chemotherapy may not cross the blood-brain barrier, it may be delivered via a wafer placed in the tissue during surgical removal of the tumor tissue, or intrathecally, into the space holding the cerebrospinal fluid.
  5. Targeted therapy. This is medication designed to target cancer cells without affecting other, healthy cells in the body.

When Cancer Involves the Brain (Part 1) - Copyright – Stock Photo / Register Mark Most of these approaches can have side effects for the massage therapist to consider.

What It Means for Massage

In massage therapy, working with a client with brain involvement, the therapist should address the effects of the disease and of the treatment. These can vary from client to client, as well as session to session. When sitting down for an intake interview with a client who reports "cancer in the brain" you'll want to find out first if there are other areas of the body with cancer, as primary brain cancer is not as common. You will also want to find out how the disease itself, its possible complications, and the method(s) of treatment are affecting their body, both in the past and currently.

Nine Essential Questions for the Intake

Here are nine helpful questions to ask in an interview:

  1. Did the cancer originate in the brain or somewhere else? Are there other sites of cancer in your body?
  2. How does the cancer affect you? What signs and symptoms have you felt? Which are you feeling today?
  3. Are there any complications from your cancer? Any effects on other organs?
  4. How is the cancer being treated?
  5. How are the treatments affecting you?
  6. Do you have a history of seizures? How do they affect you? When do they occur? When was your last seizure?
  7. What are the indicators that a seizure may be coming on? How and when should I respond if you have a seizure during our massage session?
  8. How long do the seizures last? What have you been told about seizures and the need for emergency services, and at what point?
  9. Are you taking anti-seizure medication? How does this medication affect you?
Resources
  • The Society for Oncology Massage (S4OM).
  • MacDonald G. Medicine Hands: Massage Therapy for People with Cancer (Third Edition). Forres, Scotland: Findhorn Press, 2014.
  • The National Cancer Institute's Physician Data Queries (NIH).
  • American Brain Tumor Association (ABTA).

Editor's Note: Part two of this article will appear in next month's issue and will resume with cognitive changes, seizures and other complications.

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