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. The various forms of massage that are commonly practiced include Swedish massage, reflexology, reiki, neuromuscular therapy, myofascial release, shiatsu, tui na, and manual lymphatic drainage, or MLD.

Swedish massage is the most common and consists of five basic strokes and their variations. Reflexology involves massaging reflex points on the hands, feet, or ears that correspond to particular regions in the body. It is utilized frequently and effectively for nausea, constipation, and peripheral neuropathy in the acute setting. Reiki promotes the healing of physical and emotional ailments through gentle touch. Shiatsu and tui na originated in Japan and China, and involve manual stimulation of acupuncture points and meridians to ensure proper flow of energy and blood to facilitate healing. Neuromuscular therapy uses pressure and friction to relieve areas of strain or trigger points. Myofascial release applies gentle sustained pressure to connective tissue to release muscular tightness and soreness. MLD uses a light rhythmic technique that encourages the natural movement of lymph fluid throughout the body.

In cancer patients, clinical studies show that massage can alleviate symptoms such as stress, anxiety, depression, nausea, pain, fatigue, and insomnia ^{(1) (3) (7) (8) (9) (12) (41)}, and reduce neurological complications ⁽²⁾. In breast cancer patients, Swedish massage relieved persistent fatigue ⁽⁴⁰⁾, and massage therapy alone or in combination with meditation appeared to help reduce postoperative stress ⁽²¹⁾. A preliminary study of Swedish massage prior to each paclitaxel infusion suggests it may help reduce or prevent chemotherapy-induced peripheral neuropathic pain, and improve nerve conduction and quality of life  ⁽⁴⁶⁾. Other preliminary data indicate that postoperative arm massage can decrease pain and discomfort after lymph node dissection ⁽⁵⁾ and that MLD may reduce lymphedema ⁽⁶⁾, but studies on whether it can prevent lymphedema are mixed ^(10) (47). A small study evaluating a parotid gland massage technique taught to patients suggests it may help reduce radiation burden to salivary glands from I therapy ⁽⁴⁸⁾, but additional studies are needed.

Studies indicate that reflexology can alleviate pain and nausea ⁽⁴⁾ and reduce anxiety ^{(14) (15) (16)}, dyspnea, and fatigue in cancer patients ⁽¹³⁾. Some studies show that massage and reflexology sessions have benefit and clinical utility, particularly for pain or anxiety associated with surgery and procedural interventions ^{(20) (25) (26) (27) (28) (29) (30) (31) (52)}. Gentle abdominal massage was found to improve depression, anxiety, wellbeing, and perceived abdominal bloating in cancer patients with malignant ascites ⁽²²⁾. In addition, clinical practice guidelines from the European Society for Medical Oncology (ESMO) determined there is some evidence abdominal massage may reduce GI symptoms and improve bowel efficiency, although the studies assessed were in noncancer populations ⁽⁴⁹⁾.

In a retrospective study comparing a single first-time session of either music therapy or massage therapy for adult cancer inpatients, both interventions reduced depressive symptoms, although music therapy was associated with greater reductions ⁽⁵³⁾.

Massage has also shown some benefits for pediatric cancer patients and caregivers. In a study of hospitalized adolescents with cancer, massage was well received with trends towards increased nighttime and overall sleep ⁽²³⁾. In family caregivers of patients with cancer, it reduced anxiety, cortisol levels, blood pressure, and pulse rate, and improved sleep quality ⁽²⁴⁾.

Massage therapy is also effective in treating chronic back pain ⁽¹¹⁾, knee osteoarthritis ^(17) (50), neck pain ^(18) (42), headaches ⁽³²⁾, and to reduce blood pressure ⁽¹⁹⁾. Both aromatherapy massage and inhalation aromatherapy reduced anxiety and pain in burn patients ⁽³³⁾. In HIV patients, massage improved pain, anxiety, and hyperventilation ⁽³⁴⁾. Reflexology reduced anxiety, labor pain, and duration among first-time mothers ⁽³⁵⁾. Self-care massage improved mental health and blood pressure ⁽³⁶⁾ and reduced stress ⁽³⁷⁾ in some populations.

Clinical trials are evaluating massage therapy for conditions such as peripheral neuropathy, preoperatively for breast surgery patients, and combined with music therapy for hospice patients. A trial is also underway to determine whether massage can facilitate stroke recovery ⁽³⁸⁾. And the IMPACT trial at MSK is comparing the long-term effects of massage therapy versus acupuncture treatments for pain and related symptoms in patients with advanced cancer.

Current oncology guidelines recommend using massage for depression and mood disorders ^(44) (45). Massage is generally safe and 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. The Integrative Medicine Service at MSK offers many of these therapies to support the recovery and wellbeing of cancer patients.