Massage Therapy Eases Advanced Cancer Pain and Anxiety

Massage therapy (MT) has been seen as a possible complementary treatment for the pain and anxiety associated with advanced cancer. Information from a new study suggests that massage may help alleviate those symptoms, at least in the short run.

“Patients with advanced cancer have many well-documented symptoms, and the medications we use to treat one symptom may cause another one,” says Jean Kutner, MD, associate professor in the Division of General Internal Medicine at the University of Colorado-Denver School of Medicine. “For instance, when we use morphine for pain, we may cause constipation. We are always looking for ways to provide symptom relief without causing side effects. Massage was a potential candidate.”

Another reason to undertake this study was that many patients were undergoing massage therapy treatments on their own.

“We know that a number of cancer patients are already turning to massage treatments,” Kutner says. “But we have very little or no evidence that it works, aside from anecdotal stories from our patients.”

The researchers enrolled 380 adults, 90% of whom were hospice patients, with advanced cancers experiencing moderate-to-severe pain. They were prospectively randomized to receive either a standard massage treatment or simple touch (ST). ST was designed to control for time, touch, attention, and healing intention. Six 30-minute sessions of either ST or MT were given over a 2-week period.

“One of the most difficult parts of any trial of complementary therapies is the control exposure,” says Dr. Kutner. “ST was designed to control all the other aspects of massage that are not massage. Among these are the time another person was spending with the individual, attention, and touch itself. We want to make sure that we were seeing the effects of the therapy rather than the fact they were having extra human contact.”

Immediate outcomes were obtained just before and immediately following each session. Sustained outcomes were gathered at baseline and weekly for 3 weeks.

Both groups showed an immediate improvement in pain and mood when measured by standardized scales, although MT was superior for both immediate pain and mood. No between-group differences occurred over the week-long time period in any of the measurements.

“Immediately after the session, the patients did tend to have more improvement in their mood and pain if the had received MT as compared to ST,” says Dr. Kutner. “That was not sustained, however in the weekly measurements. One of the big questions that remains is where in that timeframe is the difference extinguished.”

She says that given the results of her study, MT is probably something that oncologists should at least offer their patients. It appears to be something that is beneficial with little downside and few risks.

“What we heard from patients after the study was officially completed was that even having a short period of relief was worth the time and effort,” she says. “We were also told anecdotally by patients that they benefited from having something to look forward to because they knew they were going to feel good during that time.”

Wolf Mehling, MD, is a physician at the Osher Center for Integrative Medicine and assistant clinical professor at the University of San Francisco School of Medicine. He thinks this study is the best and most rigorous written on the subject to date.

“Many prior studies have shown massage therapy is helpful in cancer patients,” he says. “However, most of them used waiting lists or usual therapy as their control group, if any. This is the very strongest study to date that makes an evidence-based statement on MT.”

It is also important to note that both groups improved.

“In hospice patients, it seems that attention and touch seem to have a positive impact on pain and mood by themselves,” he says. “But the results also point out that there is a greater benefit that comes from the specialized touch of massage. While having a friend or relative rub their back may help a patient, massage’s benefit is greater and should be strongly considered as an additional therapy.”

Kutner JS, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer. Ann Intern Med. 2008;149:369-379.

Kurt Ullman is a veteran health and medical writer based out of Indianapolis.