Massage Helps Children with Cancer

Massage Helps Children with Cancer

Contributed by Elizabeth Barberree, RMT, BA; April Neufeld, BS, LMT; Derek Austin, MS, CMT

The Massage Therapy Foundation shares the love we have for our children. Pediatric cancer cases continue to grow in numbers and managing symptoms of both the illness and its treatment lead health care providers to seek affordable palliative treatment options. In line with that, complementary and alternative modalities, like massage therapy, are also increasing in popularity.

In 2009, the International Journal of Therapeutic Massage and Bodywork published a pilot study conducted at the University of Florida, Gainesville Shands Hospital Cancer Center. Previous research describes positive effects of massage therapy for a variety of pediatric and adult oncology populations. The authors report findings that massage therapy may improve circulation and immune function, dissolve soft adhesions, reduce swelling and relieve the pain and stress associated with many illnesses. However, little research has been done on the effects of massage therapy on pediatric oncology or haematology patients. The purpose of this study was to measure the physical and psychological effects of massage therapy on pediatric oncology and hematology patients, and to determine the feasibility of implementing this care as a palliative treatment option in a cancer clinic setting.

The research design was a randomized, non-blinded prospective study. When recruiting for this project, care was taken to maximize the external validity by seeking gender equality and diversity in age, disease and inpatient or outpatient status. Thirty children, aged six months to 17 years, with cancer or blood diseases were recruited for the study. Their parents provided reporting support as needed. Adverse physical and psychological symptoms associated with cancer and cancer care were measured before, during and after the massage therapy intervention.

In the treatment group, four 20-minute sessions of Swedish massage were delivered once daily for approximately four days for inpatients or once weekly for about four weeks for the outpatients. Treatment was delivered by a nationally certified massage therapist, licensed in the state of Florida, with five years of experience. The massage therapy treatment consisted of effleurage, kneading, percussion, compression and friction. The treatment was applied to the areas most comfortable for the participant, on the hands, feet, arms, neck, back and shoulders. To ensure participant comfort, treatments were delivered while the participants remained in their hospital robes and covers were provided. The control group received no massage.

Before and after each session, the participant’s vital signs, discomfort level, muscle soreness and emotional data were recorded. The general clinical progress scale was also completed after the second, third and fourth sessions. Standardized measures were selected for their validity and applicability for this participant population, the State–Trait Anxiety Inventory for Children (STAIC) and the Child Health Questionnaire–Parent (CHQ-Parent) were used. These were completed by the participants, parents or both before the first and after the final session. The data collection schedules were the same for the treatment and control groups. The control participants were seen in the same environment, for the same period of time for conversation and play with the therapist. For a detailed description of these measures, please access the free full-text article at PubMed Central. Data analysis appropriate to the study design was carried out by the research team with many interesting results.

No significant differences were observed between the treatment and control groups at baseline before the treatment intervention. However, after treatment, a number of the measures yielded significant mean changes for the treatment group versus the control group. After the treatment series, participants who had received massage therapy care showed decreased muscle soreness, discomfort, respiratory rate, state and trait anxiety and Faces "I Feel ..." scores.

On the CHQ-Parent questionnaire, the researchers found no significant differences between the treatment and control groups for physical and psychological health before or after treatments. The same was found for the physiological measures of pulse rate and blood pressure.

The findings of this pilot are consistent with that of related cancer studies and indicate a general improvement in physical (i.e. reduced muscle soreness, discomfort, respiratory rate and improved muscle relaxation), psychological well-being (i.e. reduced state and train anxiety and overall emotional well-being) and, thus, quality of life. Although the current study did not examine this effect directly, the researchers argue that when the effects are considered together, massage therapy could also promote optimal immune system functioning. This assertion is consistent with the work by Dr. Mark Rappaport et al., which was summarized in the MTF Research Column titled, "Massage Benefits Immune and Neuroendocrine Function" in the August edition of Massage Today.

This study suggests that despite the hectic nature of cancer clinics and oncology wards, massage therapy treatment can be successfully added into that environment. Replication of this project with a larger sample would allow for a more detailed analysis of whether different types of patients have similar response to massage therapy. Potential is there to investigate the effects of treatment on a broader range of symptoms and to better generalize the study results.

To learn more about the effects of massage therapy, you can review the archives of the Massage Therapy Foundation Research Column, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies. If you find this article of interest, please share it with friends and loved ones, especially those who are touched by kids with cancer.