Health Care Professional Information

Clinical Summary

Music as therapy has been used since ancient times. It emerged as a formal discipline in the United States in the late 1940s. Currently, there are over 5,000 music therapists working in clinical settings throughout the country. Patients listen to or perform music under the guidance of a professionally trained music therapist. Music can promote relaxation and provide distraction from pain. It has been used to reduce postoperative pain (13) and to help alleviate anxiety and stress (1) (2). Conclusions of a systematic review support music therapy in alleviating pre-operative anxiety (20).
Music may also help in improving social and emotional aspects in patients with Alzheimer's disease (3) (4) (5) and improved quality of life in patients with dementia (6) and stroke (7). A randomized trial showed the positive effects of group music therapy on improving mild to moderate dementia in elderly individuals (21).
Music was also shown superior to standard care in reducing anxiety among intensive care unit patients receiving acute ventilatory support for respiratory failure (23).

Music therapy may also help alleviate symptoms associated with cancer and its treatments. It reduced mood disturbance (10), improved coping and social integration (24) in cancer patients undergoing autologous stem cell transplantation, a procedure known to cause significant psychological distress . Other data indicate that music alleviates pain (15) and anxiety in breast cancer patients (14), in those receiving chemotherapy (16) and radiation therapy (11), and improves the quality of life in people with terminal cancer (12). Music also reduces pain and anxiety, and increases comfort in hospitalized children with cancer (9) (17). Women undergoing colposcopy reported reduced anxiety and pain perception after listening to slow-rhythm music (8) (22).
Conclusions from systematic reviews, however, question the clinical significance of music therapy for treating pain (18), and also point to the poor methodology in several music therapy trials (19).

Because music therapy is noninvasive and free of side effects, it is integrated into standard care in major cancer hospitals to help relieve pain and physical and psychological discomfort.

Purported Uses
  • Cancer-related symptoms
  • Mood disturbance
  • Pain
  • Stress
Literature Summary and Critique
Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2011 Aug 10;(8):CD006911.
This systematic review involving 30 clinical trials and 1891 subjects was conducted to compare the effects of music therapy or music medicine interventions and standard care with standard care alone, or standard care and other interventions in improving psychological and physical outcomes in patients with cancer. Databases used for the review included the Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Library 2010, Issue 10), MEDLINE, EMBASE, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, www.musictherapyworld.net, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, and the National Research Register.

Results indicate beneficial effects of music on anxiety, pain, mood, and quality of life in cancer patients. However, the authors point to the lack of a robust study design in several trials included in the review. Additional studies with strong methodology are needed to establish use of music therapy.

Cassileth BR, et al. Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Cancer 2003;98(12):2723-9.
This study involved 69 patients with hematologic malignancy scheduled to undergo high-dose therapy with autologous stem cell transplantation (HDT/ASCT), a procedure that causes significant psychological distress. Patients were randomized to receive music therapy given by trained music therapists or standard care. Patients who received music therapy reported less mood disturbance compared to the control group. Researchers suggest that music therapy can be used as an effective intervention to reduce mood disturbance in patients undergoing HDT/ASCT.

Hilliard RE. The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther 2003;40(2):113-37.
Eighty patients with terminal cancer were randomly assigned in this study to receive music therapy or routine care. All participants received at least two visits and quality of life assessments. Patients who received music therapy experienced increased quality of life compared to those who received only routine care. Although there were no significant differences between the two groups in physical functioning or length of life, music therapy improved the quality of life in patients with terminal cancer.

References
  1. Salamon E, et al. The effects of auditory perception and musical preference on anxiety in naive human subjects. Med Sci Monit 2003; 9(9):CR396-CR399.
  2. Allen K, et al. Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosom Med 2001; 63(3):487-492.
  3. Brotons M and Marti P. Music therapy with Alzheimer's patients and their family caregivers: a pilot project. J Music Ther 2003; 40(2):138-150.
  4. Quoniam N, et al. Implicit and explicit emotional memory for melodies in Alzheimer's disease and depression. Ann N Y Acad Sci 2003; 999:381-384.
  5. Suzuki M et al. Behavioral and endocrinological evaluation of music therapy for elderly patients with dementia. Nurs Health Sci 2004; 6(1):11-18.
  6. Gotell E, et al. Influence of caregiver singing and background music on posture, movement, and sensory awareness in dementia care. Int Psychogeriatr 2003; 15(4):411-430.
  7. Schauer M and Mauritz KH. Musical motor feedback (MMF) in walking hemiparetic stroke patients: randomized trials of gait improvement. Clin Rehabil 2003; 17(7):713-722.
  8. Chan YM, et al. The use of music to reduce anxiety for patients undergoing colposcopy: a randomized trial. Gynecol Oncol 2003; 91(1):213-217.
  9. Barrera ME, et al. The effects of interactive music therapy on hospitalized children with cancer: a pilot study. Psychooncology 2002; 11(5):379-388.
  10. Cassileth BR, et al. Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Cancer 2003; 98(12):2723-2729.
  11. Smith M, et al. Music as a therapeutic intervention for anxiety in patients receiving radiation therapy. Oncol Nurs Forum 2001; 28(5):855-862.
  12. Hilliard RE. The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther 2003; 40(2):113-137.
  13. Good M, et al. Relaxation and music reduce pain after gynecologic surgery. Pain Manag Nurs 2002;3(2):61-70.
  14. Bulfone T, Quattrin R, Zanotti R, et al. Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. Holist Nurs Pract. 2009;23(4):238-42.
  15. Li XM, Yan H, Zhou KN, et al. Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial. Breast Cancer Res Treat. 2011 May 3. [Epub ahead of print]
  16. Lin MF, Hsieh YJ, Hsu YY, Fetzer S, Hsu MC. A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety. J Clin Nurs. 2011 Apr;20(7-8):988-99.
  17. Nguyen TN, Nilsson S, Hellström AL, Bengtson A. Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. J Pediatr Oncol Nurs. 2010 May-Jun;27(3):146-55.
  18. Cepeda MS, Carr DB, Lau J, Alvarez H. Music for pain relief. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004843.
  19. Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2011 Aug 10;(8):CD006911.
  20. Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database Syst Rev. 2013 Jun 6;6:CD006908.
  21. Chu H, Yang CY, Lin Y, et al. The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia: A Randomized Controlled Study. Biol Res Nurs. 2013 May 2. [Epub ahead of print]
  22. Galaal K, Bryant A, Deane KH, Al-Khaduri M, Lopes AD. Interventions for reducing anxiety in women undergoing colposcopy. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006013.
  23. Chlan LL, Weinert CR, Heiderscheit A, et al. Effects of patient-directed music intervention on anxiety and sedative exposure in critically ill patients receiving mechanical ventilatory support: a randomized clinical trial. JAMA. 2013 Jun 12;309(22):2335-44.
  24. Robb SL, Burns DS, Stegenga KA, et al. Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: A report from the Children's Oncology Group. Cancer. 2014 Jan 27. doi: 10.1002/cncr.28355.

Consumer Information

How It Works

Bottom Line: Music can promote relaxation and distraction from pain associated with many illnesses.

Music therapy has emerged as a formal discipline in the United States in the 1940s. Currently, there are over 5,000 trained therapists working throughout the country. Patients listen to or perform music under the guidance of a professionally trained music therapist. Studies have shown that music reduces anxiety, stress and pain after surgery. Music is thought to reduce blood pressure in the listeners. It improves coordination in stroke and Parkinson's disease patients. Music helps improve social and emotional aspects in patients with Alzheimer's disease and improved quality of life in patients with dementia. A recent study has shown that music is effective in improving depressive symptoms. Music has clinically significant benefits for premature infants in intensive care units. It also helps to change behaviors in children with autism and to reduce anxiety and increase comfort in hospitalized children with cancer. Music therapy can reduce mood disturbance in cancer patients undergoing stem cell transplantation. It also reduced anxiety in patients receiving radiation therapy and improved the quality of life in people with terminal cancer.
Because music therapy is noninvasive and free of side effects, it is being added into the standard care in major cancer hospitals.

 

Purported Uses
  • Pain
    Several clinical trials have shown that music therapy can help to reduce pain.
  • Stress
    This use is supported by clinical trials.
  • Cancer-related symptoms
    Several studies support music therapy for reduction of many symptoms associated with cancer and its treatments including pain, anxiety and mood disturbances.
Research Evidence

Cancer
In one study, blood cancer patients receiving music therapy during autologous stem-cell transplantation had less mood disturbance when compared to those in the control group.
 

Another study showed that terminal cancer patients who received music therapy experienced improved quality of life compared to the control group.
But a systematic review of music therapy trials showed that many studies are poorly designed with small sample size leading to biased reporting of results. 

E-mail your questions and comments to aboutherbs@mskcc.org.