Massage and Cancer by Andrea S. Blevins Primeau, PhD, MBA

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  An overview of the research regarding the use of massage to improve cancer- or treatment-related symptoms and overall quality of life for patients with cancer.
  Massage therapy uses manual manipulation of soft tissue, including muscle and connective tissue, to improve well-being. This can be done in a relaxing or rehabilitative setting. The Society for Oncology Massage provides training and licensing specific to oncology, such as clinical assessments and adaptations for a patient with cancer or a history of cancer treatment; as well as recommendations based on tumor site, metastasis and/or lymph node involvement, fragile or unstable tissue, medical devices, treatments and their late effects; and therapies tailored to potential symptoms of cancer or cancer treatment.1
  Massage therapy has been studied as a methodology to improve cancer- or treatment-related symptoms and overall quality of life, particularly among patients with breast cancer.
  
  
  Cancer- or Treatment-Related Symptoms
  Breast Cancer
  Multiple small randomized controlled trials (RCTs) have evaluated the effect of massage on breast cancer̶related symptoms and quality of life, but the results are mixed. A meta-analysis that included 18 RCTs with 950 patients found that regular massage significantly improved anger and fatigue, but not depression, anxiety, pain, upper limb lymphedema, health-related quality of life, or cortisol levels.2 Anxiety, however, was found to be significantly improved compared with control in another meta-analysis (mean difference, -0.50; 95% CI, -0.77 to  -0.24).3 Several individual RCTs showed that massage improved anxiety, anger, and depressed mood immediately after the session compared with control, with some benefits persisting after massage therapy ended, such as less hostility and reduced depression and anger.4-7 One study found that five 20-minute massage visits significantly reduced nausea compared with control ― but there was no difference observed in levels of anxiety or depression.8
  
  
  Some RCTs evaluated the effect of massage on the immune system. One study of ten 20-minute effleurage massage visits found no effect on the number of natural killer (NK) cells, CD4+, or CD8+ T cells,8 and another study found no significant difference in cytokine concentrations or the Th1/Th2 T-cell ratio.6 In contrast, another study found that massage therapy increased NK cell and lymphocyte numbers by the end of the study.5 Massage therapy was also found to ameliorate the NK cell deterioration associated with radiation therapy.9
  Massage therapy was found to improve quality of life measures and symptom concerns.10,11Markers of stress, such as cortisol levels and blood pressure, were improved in some studies, but not others.7-9
  According to a subjective study, patients with breast cancer who received massage therapy reported that they felt relaxed, cared for, and a general sense of well-being.12 Patients also noted that massage provided a distraction from the anxiety of chemotherapy.
  
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