Health Care Professional Information
Clinical Summary
Massage is an ancient technique that involves manual manipulation of muscles and soft tissues of the body. It increases circulation and promotes relaxation. In addition, it has important emotional and psychological benefits as well. The various forms of massage that are commonly practiced are Swedish massage, Shiatsu, Reflexology, and Tuina. Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging specific areas (reflex points) on the hands or feet that are believed to correspond to particular regions in the body. Shiatsu and Tuina are techniques that originated in Japan and China, and involve stimulation of acupuncture points and meridians to ensure proper flow of energy and blood to facilitate healing.
Clinical studies show that massage can alleviate symptoms such as stress/anxiety, nausea, insomnia, pain, fatigue, and depression (1) (3) (7) (8) (9) (12) in cancer patients, and reduce psychological and neurological complications associated with bone marrow transplantation (2). Reflexology (foot massage) was also found to alleviate pain and nausea in cancer patients (4). Preliminary data indicate that post-operative arm massage can decrease pain and discomfort after lymph node dissection (5). Manual lymphatic drainage or MLD, which involves specialized light rhythmic massage, reduced lymphedema (6) and prevented secondary lymphedema (10) in breast cancer patients. But further research is needed. Massage therapy is effective in treating chronic back pain (11).
Massage is generally safe and being increasingly used as a complementary therapy to provide relief from certain symptoms of cancer and other illnesses. However, patients suffering from cancer, heart disease or arthritis should consult a qualified massage therapist for treatment.
Purported Uses
- Cancer-related symptoms
- Headache
- Pain
Literature Summary and Critique
Listing M, Reisshauer A, Krohn M, et al. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psychooncology. 2009 Dec;18(12):1290-9.
Eighty-six women with primary breast cancer were randomized to receive bi-weekly 30-minute massages (in the back and head-neck areas) or routine care for five weeks. Patients were administered standard questionnaires at baseline (T1), at the end of the study period (T2), and at a 11-week follow-up (T3). Researchers observed a significant reduction in physical discomfort at T2 and T3, and mood disturbances at T2. There was also a reduction in fatigue levels. However, the sample size differed between the intervention and the control groups due to high nonparticipation rate in the control group. Future studies should address this.
Cassileth BR and Vickers AJ. Massage therapy for symptom control: Outcome study at major cancer center. J Pain Symptom Manage 2004;28(3):244-249.
This study included 1,290 cancer patients over a 3-year period. Patients received massage in 20-minute (for inpatients) or 60-minute (for outpatients) sessions. The variations of massage administered were Swedish massage, light-touch massage and reflexology (foot massage). Researchers observed that massage significantly improved pain, nausea, fatigue, depression, and anxiety in the patients with benefits lasting longer (up to 48 hours) in outpatients compared to inpatients. They also found that Swedish and light-touch massages were more effective than reflexology. Since massage is noninvasive and inexpensive, it can be used to alleviate several symptoms associated with cancer.
References
- Cassileth BR and Vickers AJ. Massage therapy for symptom control: outcome study at a major cancer center. J Pain Symptom Manage 2004; 28(3):244-249.
- Smith MC, et al. Outcomes of touch therapies during bone marrow transplant. Altern Ther Health Med 2003; 9(1):40-49.
- Soden K, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med 2004; 18(2):87-92.
- Grealish L, Lomasney A, Whiteman B. Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nurs. 2000 Jun;23(3):237-43.
- Forchuk C, et al. Postoperative arm massage: a support for women with lymph node dissection. Cancer Nurs 2004; 27(1):25-33.
- Williams AF, et al. A randomized controlled crossover study of manual lymphatic drainage therapy in women with breast cancer-related lymphoedema. Eur J Cancer Care (Engl) 2002; 11(4):254-261.
- Listing M, Reisshauer A, Krohn M, et al. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psychooncology. 2009 Dec;18(12):1290-9.
- Noto Y, Kitajima M, Kudo M, Okudera K, Hirota K. Leg massage therapy promotes psychological relaxation and reinforces the first-line host defense in cancer patients. J Anesth. 2010 Dec;24(6):827-31.
- Krohn M, Listing M, Tjahjono G, et al. Depression, mood, stress, and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy. Support Care Cancer. 2010 Jul 20. [Epub ahead of print]
- Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010 Jan 12;340:b5396.
- Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2011 Jul 5;155(1):1-9.
- Toth M, Marcantonio ER, Davis RB, et al. Massage Therapy for Patients with Metastatic Cancer: A Pilot Randomized Controlled Trial. J Altern Complement Med. 2013 Jan 31. [Epub ahead of print]
Consumer Information
How It Works
Bottom line: Massage is effective in reducing some symptoms associated with cancer.
Massage helps reduce muscle soreness, stiffness, spasms, and promotes relaxation. The various forms of massage that are commonly practiced are Swedish massage, Shiatsu, Reflexology, and Tuina. Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging specific areas on the hands or feet that are believed to correspond to particular regions in the body. Shiatsu and Tuina are techniques that originated in Japan and China. They are used to stimulate acupuncture points and meridians to ensure proper energy and blood flow to facilitate healing.
Clinical trials have shown that massage therapy helps reduce pain, mood disturbance, and fatigue in cancer patients undergoing chemotherapy. It can reduce psychological and neurological complications and provide comfort to patients undergoing bone marrow transplantation. Massage also improves sleep and reduces depression in patients with advanced cancer.
Although massage is being increasingly used as a complementary therapy for various illnesses, patients suffering from cancer, heart disease, or arthritis should consult a qualified massage therapist for treatment.
Purported Uses
- Pain
Several studies show effectiveness of massage in reducing pain.
- Headache
Massage helps relieve headaches.
- Cancer-related symptoms
Several clinical trials support use of massage in reducing pain, fatigue, and mood disturbances associated with cancer and its treatment.
Research Evidence
Cancer-related symptoms:
A major study including 1,290 cancer patients was conducted over a 3-year period to assess the benefits of massage in reducing cancer symptoms. Swedish massage, light-touch, or foot massages were given to patients in 20 minute (for inpatients) or 60 minute (for outpatients) sessions. Researchers found that Swedish and light-touch massages were more effective than foot massage in relieving pain, nausea, fatigue, depression, and anxiety. Outpatients reported longer lasting benefits from massage therapy compared to inpatients. Researchers suggest that massage is safe and can be used to reduce some symptoms caused by cancer.
Another study included 230 patients with cancer receiving chemotherapy. Patients received 4 weekly 45-minute sessions of therapeutic massage, healing touch, caring presence, or standard care alone. Patients who received massage and healing touch had lowered anxiety, fatigue, and mood disturbance compared to those in the caring presence group. Massage and healing touch appear to have short-term benefits in cancer patients, although more studies should be conducted to assess the long-term effects.
Last updated: May 8, 2013
acupuncture (AK-yoo-PUNK-cher)
The technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)advanced cancer (ad-VANST KAN-ser)
Cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)anxiety (ang-ZY-eh-tee)
Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)arthritis (ar-THRY-tis)
A disease that causes inflammation and pain in the joints.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)baseline (BAYS-line)
An initial measurement that is taken at an early time point to represent a beginning condition, and is used for comparison over time to look for changes. For example, the size of a tumor will be measured before treatment (baseline) and then afterwards to see if the treatment had an effect.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)bone marrow (bone MAYR-oh)
The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)bone marrow transplantation (bone MAYR-oh tranz-plan-TAY-shun)
A procedure to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (an individual's own marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)breast (brest)
Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)breast cancer (brest KAN-ser)
Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)chronic (KRAH-nik)
A disease or condition that persists or progresses over a long period of time.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)clinical (KLIH-nih-kul)
Having to do with the examination and treatment of patients.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)control group (kun-TROLE groop)
In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)depression (dee-PREH-shun)
A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)Ensure (en-SHER)
A nutritional drink that may help people who cannot get everything they need in their diet from foods and other drinks. It may be taken by mouth or given through a small tube inserted through the nose into the stomach or the small intestine. It may also be given through a small tube that is put into the stomach or intestinal tract through an opening made on the outside of the abdomen. Ensure is a type of dietary supplement. Also called polymeric enteral nutrition formula.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)fatigue (fuh-TEEG)
A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)follow-up (FAH-loh-up)
Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)healing touch (HEEL-ing tuch)
A form of complementary and alternative medicine based on the belief that vital energy flows through the human body. This energy is said to be balanced or made stronger by practitioners who pass their hands over, or gently touch, a patient's body. Healing touch is being studied in patients receiving cancer therapy, to find out if it can improve quality of life, boost the immune system, or reduce side effects. Healing touch is a type of energy therapy. Also called therapeutic touch.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)intervention (IN-ter-VEN-shun)
In medicine, a treatment or action taken to prevent or treat disease, or improve health in other ways.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)lymph (limf)
The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)lymphedema (LIM-fuh-DEE-muh)
A condition in which extra lymph fluid builds up in tissues and causes swelling. It may occur in an arm or leg if lymph vessels are blocked, damaged, or removed by surgery.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)massage therapy (muh-SAZH THAYR-uh-pee)
A treatment in which the soft tissues of the body are kneaded, rubbed, tapped, and stroked. Massage therapy may help people relax, relieve stress and pain, lower blood pressure, and improve circulation. It is being studied in the treatment of cancer symptoms such as lack of energy, pain, swelling, and depression.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)nausea (NAW-zee-uh)
A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)noninvasive (NON-in-VAY-siv)
In medicine, it describes a procedure that does not require inserting an instrument through the skin or into a body opening. In cancer, it describes disease that has not spread outside the tissue in which it began.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)psychological (SY-koh-LAH-jih-kul)
Having to do with how the mind works and how thoughts and feelings affect behavior.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)randomized
Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments.
(http://www.cancer.gov/dictionary)reduction (ree-DUK-shun)
A chemical reaction that takes place when a substance comes into contact with hydrogen or another reducing substance.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)reflexology (ree-flek-SAH-loh-jee)
A type of massage in which different amounts of pressure are applied to specific points on the feet or hands. These points are believed to match up with certain other parts of the body. Reflexology is claimed to cause relaxation and healing in those parts of the body, but this has not been proven.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)significant (sig-NIH-fih-kunt)
In statistics, describes a mathematical measure of difference between groups. The difference is said to be significant if it is greater than what might be expected to happen by chance alone. Also called statistically significant.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)therapeutic (THAYR-uh-PYOO-tik)
Having to do with treating disease and helping healing take place.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)therapy (THAYR-uh-pee)
Treatment.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)transplantation (tranz-plan-TAY-shun)
A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)
