Mythbusters: Complementary and Alternative Treatments in Cancer

Massage

Proposition: Massage therapy reduces cancer patients' pain and anxiety.

What the science says: Massage, defined as the systematic manipulation of soft tissues, is increasingly being incorporated into integrative oncology programs as a way to reduce cancer-related stress and pain. More than 20% of patients with cancer use massage alongside their mainstream care.^[18]

The evidence in support of this practice, however, is mixed. Many studies report that massage alleviates a range of symptoms, including pain, nausea, anxiety, depression, and stress, but often the study methodology is flawed, making it difficult to provide definitive recommendations.

In one meta-analysis, Edzard Ernst, MD, Emeritus Professor of Complementary Medicine at the University of Exeter, evaluated evidence from 14 RCTs examining the extent to which classic massage (also known as Swedish massage) therapy improved cancer patients' quality of life.^[19] The most robust study, which compared classic massage to light touch in 380 advanced cancer patients with moderate to severe pain, found that both groups reported reductions in pain, but those in the classic massage group reported significantly greater relief.^[20] Still, Dr. Ernst noted, two of the studies did not show a significant benefit to massage in relation to pain, anxiety, depression, and sleep quality, while the remaining 11 were fraught with weaknesses, including small sample sizes and lack of a control group. Despite these flaws, Dr. Ernst concluded that overall the data suggest that massage can help reduce cancer-related pain, nausea, and anxiety.

Another systematic review assessing the potential benefits of massage in cancer patients came to a similar conclusion.^[21] Among the 10 RCTs evaluated, the authors reported that massage or aromatherapy massage may reduce cancer patients' anxiety, pain, and nausea in the short term, but "the lack of rigorous research evidence precludes drawing definitive conclusions."

Part of the difficulty is separating out the benefits of massage therapy and simple touch.^[20] Additionally, some experts have raised concerns over potential adverse effects of massage. In a 2005 review, Lisa Corbin, MD, from the Center for Integrative Medicine at the University of Colorado Hospital, found potential harmful effects of massage, ranging from bruising to internal hemorrhaging, fracture, and increased pain or infection.^[18] Although rare, these types of adverse events become more likely when a person is inadequately trained or is using a more forceful technique, such as shiatsu or Rolfing.^[22]

Generally, the evidence points to massage being an effective tactic to control symptoms and improve quality of life, but in order to minimize risk for injury, massage must be shaped to the needs of each patient.

What the expert says: According to Dr. Gorski, "Massage is perfectly fine for patients who enjoy it, and if massage makes cancer patients feel better and improves their quality of life, then it is worthwhile." But, he noted, "I take issue when massage is co-opted and turns into massage therapy. Medicalizing the things we do normally to feel good can lead to exaggerated or false claims about their benefits."

Verdict: Plausible.

Medscape Oncology © 2014  WebMD, LLC

Cite this: Mythbusters: Complementary and Alternative Treatments in Cancer - Medscape - Sep 02, 2014.