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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 2)

Editor's Note: The first part of this article appeared in last month's issue and ended with intake questions to help assess the disease, and subsequently make a decision about care. Here, Tracy resumes with changes to watch for and other complications.


Cognitive Changes

If there are significant changes in the client's mental status, your health questions may best be directed toward the client's caregiver. If your client's ability to communicate clearly is impaired, it will also be necessary to establish a form of communication for conveying the degree that your work is welcome, and if your pressure or approach are as they should be. Being on the constant lookout for nonverbal clues from the client's body, their facial expressions, their breathing, can help you determine if the work you are doing is being welcomed, and if your pressure or approach is as it should be.

Seizures

Not all seizures look the same; in my client, seizures were brief, numerous, and nearly unnoticeable. Yet some seizures due to brain involvement can be more serious. Unfortunately, because of space limits, a complete discussion of seizures, treatments, and massage implications are not possible here. However, I will highlight a few.

If your client has a history or possible risk of seizures, ask them in their intake interview questions such as:

  • What does a seizure typically look like to others?
  • What does your doctor or nurse advise you to do if this happens?
  • Do they advise that emergency services or someone else be called if a seizure were to occur, and if so, is there specific information I should give them?
  • Also, ask if they are taking any anti-seizure medications, and about side effects that you may need to take into account when planning massage adjustments.

When Cancer Involves the Brain (Part 2) - Copyright – Stock Photo / Register Mark One common guideline is to watch the clock and to note the duration of a seizure, so that you can report it to the client's caregiver and to emergency services if they become involved. Seizures that last longer than five minutes require a call to emergency services, as does a seizure of any length occurring in a client that has not identified themselves as having had seizures in their paperwork or intake interview. Do not put anything in the client's mouth during the seizure and move objects out of the way if necessary. Try to keep the client safe until the seizure is over.

Other Complications

If your client experiences headaches, ask if they can identify something that triggers a headache, and then have them avoid that trigger, whether it involves bright lighting, heat, scents … if it is within your control, adapt. Ask which positions are most comfortable for them, and consider an inclined position when supine, rather than a traditional face cradle.

For clients with dizziness or balance problems, you will want to reposition them gently and slowly, especially if they are turning from prone to supine or vice versa. Allow them to turn in small stages, and encourage a slow rise from the table at the end of the session.

Keep your transitions and stroke rhythms smooth, even and slow, nothing jarring or jostling. The same is wise for clients experiencing nausea. Sticking with slow, even speeds and staying away from any strong joint movement may be most comfortable for your client.

Possible Benefits

Safely adapted, massage has the potential to offer wonderful benefits to someone with brain involvement. It is a form of positive, safe, and comforting touch amidst a scene of diagnostic tests and a variety of treatments. Metastases to the brain means that a client's cancer is in advanced stages, and the treatment options in advanced cancer can be aggressive and difficult for the body to handle. Massage may help to lower a client's stress and anxiety; help with muscle aches that may occur following seizures; help them to sleep; and reduce their headache pain and/or nausea.

More Information

Brain involvement is one of many possible presentations to take seriously in oncology massage therapy. It underscores the need to become familiar with a client's whole health picture, as well as implications for massage therapy. A good background in massage for people with cancer is vital. Here's where face-to-face oncology massage training is ideal, and short of that, learning and reading everything you can on cancer, brain involvement, treatments, and effects. Start with the resources at the bottom of this column, but don't stop there. Keep reading, learning, and asking questions of clients and health care providers.

Over the years I have provided and supervised many sessions for clients with brain involvement, including the client I mentioned above. These sessions have been well-received.

We have the chance to make a difference to people dealing with a difficult disease and treatment. With the right information, clinical thinking, and hands-on modifications, we can provide safe, effective work.

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).
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