Massage Therapy for Individuals Journeying With Cancer
By Beth Terhune, NP, RN, MA, LMT
Megan Belanger, LMT, knocks gently against the door and quietly enters a treatment room in Westborough, Massachusetts. The massage therapist is ready to engage. She could as easily be opening the door to provide support for athletes in training or to join patients receiving infusions at the Dana-Farber/Brigham and Women's Cancer Center at Milford Regional Medical Center.
What do Megan's clients share in common? They are individuals living with cancer. Some are actively in treatment. Others are multiple years into survivorship, but all benefit through safe, supportive care provided by a practitioner trained in oncology massage.
What Is Oncology Massage?
Over the last twenty years, massage adaptations designed specifically to support people living with cancer have arrived in hospital settings, in outpatient clinics, through integrative health care teams, and in rehabilitation facilities. Even spas and therapeutic massage clinics incorporate questions about lymph node removal, cancer history, surgeries, medications and herbal supplements to draw out information necessary for safe, supportive treatment.
Medical histories and intake interviews provide the framework for each session. Oncology massage therapists integrate additional input from clients' oncology medical teams in devising treatment plans. Modifications are made to client positioning, pressure used, or length of session to accommodate existing needs or restrictions based on treatment protocols or procedures.
In post-treatment cancer, individuals experience shifts in how their bodies function and hold tension. One of these changes can be the impairment of the lymphatic system. In treating various forms of cancer, lymph nodes can be irradiated, removed, or damaged during surgery. This creates a lifelong risk of lymphedema, a condition in which the lymphatic system's efficiency is compromised. Therapists trained in oncology work can work safely around the affected areas of the body. Those certified specifically in manual lymph drainage and lymphedema therapy can incorporate touch therapy safely within the impaired area.
Megan's athletic client, years out from diagnosis and treatment, is at risk for this condition because of lymph node removal during cancer diagnosis. Megan, in training to become a lymphedema therapist, already knows as an oncology massage therapist how to safely design the client's treatment around the risk, including which massage techniques to modify and which to avoid altogether. While clients seek support in all phases of cancer treatment, many continue to find oncology massage expertise comforting and intrinsic to their wellness programs post-treatment.
Evidence-based studies over the last twenty years range widely in scope and methodology but show quality-of-life improvements for cancer patients experiencing anxiety or depression, especially over multiple sessions. Peer-reviewed scientific journals like Seminars in Oncology Nursing (Feb. 2012), Psychooncology (2009), and the Journal of Alternative Complementary Medicine (2007) continue to reflect the dialogue and shifts within the field, crossing the spectrum from energetic or light touch therapies to those involving tissue manipulation. Additional studies are still needed to round out correlation between touch therapies, reduction of nausea and fatigue, and efficacy in pain management.
At present, most massage training schools touch on cancer work as part of physiology and pathology coursework. Some even introduce students directly to hands-on oncology work. Lynn Rochefort was first introduced to this work as a massage student during her clinical rotations at the Simonds-Sinon Regional Cancer Center at the HealthAlliance Hospital in Fitchburg, and she knew that she had found her calling. After graduation and advanced oncology-specific coursework, she joined the staff at the Simonds-Hurd Complementary Care Center at the hospital campus to provide onsite care for patients, staff, and caregivers.
Like Lynn Rochefort and Megan Belanger, over eight hundred New England massage therapists have pursued advanced training through Tracy Walton's Caring for Clients with Cancer workshops. Walton, one of the pioneers and leaders in the field, estimates that she has trained over 2,300 massage therapists through her workshops in Watertown and beyond. Trainings like these and others approved by the Society for Oncology Massage, a national organization promoting research, education, and consistent standards of care, result in practitioners ready and able to provide comfort-oriented, safe care for those living with cancer.
Additionally, oncology massage training programs provide support to typically underserved areas or populations through independent clinics or partnerships with New England medical centers. The Oncology Massage Program, jointly sponsored by the Boston Medical Center and the Cortiva Institute-Boston, trains therapists alongside hospital staff and explores the possibilities for integrated therapies in healthcare.
The Leonard P. Zakim Center for Integrative Therapies at the Dana-Farber Cancer Institute offers opportunities for touch therapy volunteers to provide care in chemotherapy infusion units in Boston and in Milford, Massachusetts. Winchester Hospital offers integrative care as well, through its community health initiative. Walton's New England trainings benefit the greater Boston area through community clinics incorporated into the workshops.
PinkHippy.org, a local nonprofit organization rooted in the community, brings integrative health practitioners, including oncology massage therapists, together with breast cancer patients to provide comfort and support at no cost to the patient. Services for cancer patients are available at Saint Vincent Cancer and Wellness Center in Worcester as well as outside of hospital settings in private practices and healing centers. Lucy's Love Bus, another Massachusetts non-profit organization, draws integrative health practitioners, including oncology massage therapists, together with pediatric oncology patients to provide comfort and support. The Virginia Thurston Healing Garden in Harvard, MA, offers people with breast cancer diagnoses an opportunity to explore integrative therapies, including oncology massage.
Initiatives to increase access to this kind of care have also resulted in programming developed to train families and caregivers in providing touch-based support for those living with cancer. William Collinge's work to develop a DVD-based tool, "The Touch, Caring, and Cancer Program," disseminates simple touch techniques for home use, based out of the research and supports collaboration between oncology nurses, social workers, massage therapists, and support groups. Collinge's efforts build continuity for safe, supportive touch between caregivers and those for whom they care even as treatment and post-treatment life evolves.
Beth Terhune is currently a Nurse Practitioner in the Division of Palliative Medicine, University of Massachusetts Medical Center, an associate of Lucy's Love Bus, and a staff RN at the Women's Health Clinic. She is also a licensed, nationally certified massage therapist and certified lymphedema therapist who has studied, practiced, and mentored in the field of oncology massage since 2004. Beth founded the Abbott Road Project in 2010 to create access to oncology massage for residents of Massachusetts, regardless of thier ability to pay. She is also the founder and director of Inner Spaces LLC where she develops and integrates multiple therapeutic bodywork modalities to assist individuals on complicated medical journeys.
* This article features excerpts from the original article which appeared in print in Spring 2012.