Touch Matters: Massage for Children With Cancer
, LMT, CPMMT, CPMT, CIMT
Touch Matters: Massage for Children With Cancer
Tina Allen, LMT, CPMMT, CPMT, CIMT
Receiving a thank you call is one of the biggest compliments you can receive from your client, post massage. Even better though, is when the call comes from a parent after you have massaged their child. However, the thank you changes and becomes even more meaningful when the parent calls to thank you for massaging their child so they could finally be free of pain, fall quietly to sleep and pass while they rested. This has been my experience, time and time again, as I work with children with a variety of medical diagnoses, in hospice and palliative care.
Initially reading this, many people will feel sad or have grief at the loss of a child. However, there is a very positive side. What would be better, a child passing comfortably or in agonizing pain?
Not Necessarily a Death Sentence
Not all children with cancer will die. The American Cancer Society states that approximately 12,060 children in the United States under the age of 15 will be diagnosed with cancer in 2012, with an estimate of one in 330 children to develop cancer by age 20.
Due to the major advances in treatment and care, 80% of diagnosed children will survive five years or more. This is a significant increase from the survival rates of the 1970's when the five year survival rate was less than 50%. Although the five year survival rate is steadily increasing, one quarter of children will die within five years from the time of diagnosis. Different types of cancers have different rates of survival, and cancer kills more children each year than cystic fibrosis, muscular dystrophy, asthma and AIDS combined.
Luckily, childhood cancers are rare, making up less than 1% of all cancers diagnosed each year. However, childhood cancer rates have been rising slightly for the past few decades. Despite its rarity and the major advances in treatment and supportive care, cancer is still the second leading cause of death, after accidents, in children younger than 15 years old. Approximately 1,340 children are expected to die from cancer in 2012.
Complementary therapies are increasingly integrated into mainstream cancer programs and centers. According to Harvard Medical School researchers, almost 12% of children and adolescents in the United States use complementary or alternative medicines, known as CAM. About 66% of children with cancer use some type of CAM. Although most studies have reported the effects of massage in adult patients, pediatric cancer patients also experience reduced pain after massage therapy. Massage is one of the most commonly used pain management strategies for pediatric patients newly diagnosed with leukemia.
Research has suggested that massage therapy can ease both physical symptoms, as well as emotional discomforts associated with pediatric medical conditions. Studies conducted by the Touch Research Institute at the University of Miami School of Medicine show that massage can alleviate pain, anxiety and depression in pediatric clients. No one likes to think of a child being in pain, let alone having anxiety or depression. However, it is a reality for these children and their families.
For cancer patients, especially pediatric cancer patients, even just a little relief can mean a lot. In general, about a third of all cancer patients experience significant pain. According to the National Cancer Institute, 15% to 25% of cancer patients become clinically depressed at some point during their illness. And of course, the very nature of possible hospitalization, isolation and the treatment for this very serious illness often makes things worse.
During massage, levels of feel-good neurotransmitters such as serotonin and dopamine spike, oxytocin (nurturing, cuddle hormone) is increased, while measures of the stress hormone cortisol drop. Massage can be just the supportive therapy a pediatric oncology client needs.
Massage therapy can be readily applied, most effectively by specially trained massage therapists or by parents who have learned massage techniques from a skilled, educated pediatric massage therapist.
When using massage therapy for children with cancer, your work does not need to be aggressive to achieve its maximum potential. Most types of massage (i.e. Swedish massage, light nurturing touch) result in various levels of symptom relief for patients; however, those patients receiving Swedish or light touch massages report significantly greater reduction in symptoms.
Not only is it imperative that you are trained in pediatric oncology massage prior to working with this population, but you must also consider all of the emotional and physical aspects associated with illness.
When working with children, you must always ask their permission to provide massage and nurturing touch. You are never to provide touch "to" a child, but rather with their absolute permission. As you are providing care to a minor, their parent's and physician must also be involved in this consenting and permission process.
Parents may be under an enormous amount of stress and anxiety, which causes the task of relating accurate information to be clouded. It is possible that they may not fully understand all of our questions, or may answer them incorrectly. They may give the wrong medication names, or even fail to mention something that we need to know to make the best care plan for the child. So, it is always a good idea to do a professional assessment and get further consent from the child's physician with express permission from the family to discuss private health information.
Working with the Healthcare Team
Communicating with physicians is not always easy. Many massage therapists feel their credentials are not comparative to that of a medical doctor. This can create tension during a conversation, as the massage therapist may doubt their ability to communicate in a manner familiar to medical personnel. This is why it is even more important to take the time needed to adequately asses the situation, diagnosis, possible indications and contraindications and write up a detailed care plan based on your assessment. When you present a physician with clear, concise information that has been well thought out, you can more effectively communicate the need for the noninvasive care pediatric massage therapy can provide.
Even just the act of holding a sick child's hand, communicates they matter. Finding your passion and believing that what you are doing is making a difference, makes getting up and going to work each day possible. When I started Liddle Kidz Foundation, I began with the thought that one person can truly make a difference and I have found this to be true. We all have the ability to make a difference everyday and should practice with this thought: "Children are our greatest gift, and should be treated with extraordinary care!"