Massage and Cancer

When I was in massage school 9 years ago, our instructors and textbooks wisely argued for a great deal of caution when cancer was present in a massage client, and many people with cancer were told to avoid all massage. Fear that massage could spread cancer around the body was still a strong concern. Currently, that fear is largely discounted and doctors and others working with cancer patients focus on figuring out the best ways to bring massage and people with cancer safely together.

Gayle MacDonald is a massage therapist bringing the massage and medical far worlds greatly closer with her passion for massage and deep understanding of the many needs of people with cancer. Her book Medicine Hands: Massage Therapy for People with Cancer, is the bible for any therapist interested in oncology massage training and she also offers intensive training programs which include hospital supervision. Medicine Hands is also a superb resource for people facing cancer and their family members. Reading the book, I wanted to jump on a plane and study with her immediately. Maybe someday... but for now I plan to study with one of her former students and leader in this field on her own right, Tracy Walton, who is more conveniently for me located on the East Coast.

U.S. News and World Report writes last month about a positive study on massage with advanced cancer patients here. The outcomes find that massage did reduce pain compared with the control group in the short term. Massage (by therapists trained in oncology procedures) was compared to simple touch, which probably has wonderful benefits on its own, especially for people suffering physically and emotionally from disease. I don't know if the majority of massage schools will include oncology training soon, but if they do, I hope they strive for the quality and scientific thoroughness of Macdonald's and Walton's instruction.

Massage Eases Pain, Anxiety After Surgery

Hopefully all hospitals offer massage to patients in the near future, and it's great to see research to back up the benefits. Massage used to be a part of nursing but became lost in the current high-technical system, where nursing staff are far too overburdened to take back this work. Massage therapists working in hospitals will help bring touch to those in the greatest need, and allow a greater number of people to have access to healing touch.
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Business Week, December 17, 2007, 16:00 EST

It's now standard post-surgical practice at some U.S. hospitals

By Ed Edelson
HealthDay Reporter

MONDAY, Dec. 17 (HealthDay News) -- A 20-minute evening back massage can help relieve the pain and anxiety that often follows major surgery, new research shows.

"In patients getting massage, the acute response was equivalent to a [dose] of morphine, which was pretty remarkable," said study senior author Dr. Daniel B. Hinshaw, professor of surgery and a member of the palliative care team at the VA Ann Arbor Healthcare System in Michigan.

According to Hinshaw, the idea for the study originated years ago, when he would ask nurses to give elderly patients a massage to augment pain relief medication. "Over the years, I have been concerned about the kind of pain and suffering that surgeons produce," he said. "How could we improve pain relief and reduce suffering?"

The massage trial included 605 veterans undergoing chest or abdominal surgery, randomly assigned to one of three groups. One group of 203 veterans received standard care, while another 200 got a daily 20-minute back massage. A third group of 202 got 20 minutes of individual attention but no massage. They were asked to quantify their feelings of pain and anxiety on a scale of 1 to 10.

"It's normal for a patient to have peak pain in the first day, which then declines," Hinshaw noted.

But, according to the study, "The rate of decline was faster by about a day for patients in the massage group," he said. Patients also experienced short-term declines in anxiety following massage, the team found.

Reporting in the December issue of the journal Archives of Surgery, Hinshaw's team found no differences in longer-term patient anxiety, length of hospital stay or the amount of pain-relieving medication used among the three groups.

Massage will now become part of the post-surgical routine at the Ann Arbor facility and related VA facilities in the region, Hinshaw said. His group is exploring its use to reduce the incidence and length of delirium experienced after surgery. Delirium, which is difficult to treat, can often lengthen the time spent in the hospital after surgery, he said.

A similar program of post-surgical massage has been in place at the Mayo Clinic in Rochester, Minn., for the past few years, said Susanne Cutshall, a clinical nurse specialist there.

"Ours is for cardiac surgery," Cutshall said. "We have a full-time therapist available. If there is a suggestion of back, shoulder or neck pain, the therapist can come and see them. Patients get a brochure about it before they come here, so they can ask for it."

The Mayo massage program "started about five years ago, when we were looking at pain medication," Cutshall said. "We stopped to listen to what the patients were saying about back, neck and shoulder pain. It seems to be muscular in origin."

A massage session at the Mayo can last from 20 minutes to 40 minutes, depending on what the patient might need, Cutshall said.

"Most people, it helps," she said. "It may make the pain a little better, they might sleep better, they might be less anxious."

More information

There's more on post-surgical pain treatment at the U.S. National Library of Medicine.

SOURCES: Daniel B. Hinshaw, M.D., professor, surgery, University of Michigan, Ann Arbor; Susanne Cutshall, R.N., clinical nurse specialist, Mayo Clinic, Rochester, Minn; December 2007, Archives of Surgery

Copyright © 2007 ScoutNews, LLC. All rights reserved.

http://www.businessweek.com/lifestyle/content/healthday/610946.html?chan=autos_executive+health+--+lifestyle+subindex+page_alternative+medicine

Interesting Massage and Sleep Article

from the Institute for Inegrative Healthcare Studies website
http://www.integrative-healthcare.org/mt/archives/2005/08/insomnia_seroto.html

Insomnia is associated with a lack of serotonin. Massage increases serotonin levels. Read about the neurochemistry of sleep and the logical connection indicating bodywork for the sleep deprived.

Insomnia, Serotonin and Massage

Insomnia means trouble either falling asleep or staying asleep. The prevalence of insomnia is staggering, with more than 30 percent of American adults suffering from occasional bouts of insomnia and 10 percent of Americans experiencing chronic insomnia. While insomnia may be a symptom on its own, it also can be connected to a long list of healthcare problems.

Chronic insomnia is poor sleep every night or most nights for more than six months. This endless cycle can cause extreme fatigue, problems with concentration and can adversely affect a person’s mood and well-being. Recurring insomnia should be evaluated by a healthcare professional or a sleep disorder specialist.

Methods of treating insomnia cover a wide span of lifestyle adjustments, psychological services, Western medical treatments and complementary/alternative medical choices. Under that last category, complementary/alternative medical choices, be certain to include massage therapy as a viable option to help the sleep deprived. While it may not be the first appointment that an insomniac thinks to make, looking at the neurochemistry of sleep, and the effect massage has on that neurochemistry, may provide a solid link between massage and insomnia treatment.

The neurochemistry of sleep is very complex. While there are many aspects of the brain and its chemicals that contribute to sleep, we will look at the serotonin component of sleep.

Serotonin is an extremely important neurotransmitter that is essential to our survival. Serotonin plays a role in mood, behavior, body temperature, physical coordination, appetite and sleep. Derived from the amino acid tryptophan, serotonin can also be converted by the brain into melatonin.

The involvement of serotonin in sleep has been repeatedly proven. However, the mechanism of that involvement remains unclear. A number of studies revolve around a specific area of the brain that mediates deep sleep. This area of the brain is called the raphe nuclei. The raphe nuclei contain nerve cells that use serotonin to communicate with each other. In laboratory experiments using cats as subjects, destruction of the cats’ raphe nuclei resulted in their inability to sleep. Another experiment consisted of blocking serotonin synthesis with a drug (p-chlorophenylalanine). Administration of this drug produced insomnia, an effect which was reversed by the subsequent administration of serotonin.(1) These studies all demonstrate the necessity of serotonin for healthy sleep.

Serotonin is a precursor to the body’s rendering of melatonin. Melatonin is a hormone released by the brain’s pineal gland to quiet and reset the part of the brain (the suprachiasmatic nucleus) that directs circadian cycles to prepare for sleep. According to Charles Czeisler, professor and chair of the Division of Sleep Medicine at Brigham and Women’s Hospital, Boston, MA, circadian cycles are internal periodic rhythms that profoundly affect sleep and wakefulness.(2)

The chemistry of sleep is relevant to massage therapists because massage can directly influence the body’s production of serotonin. A study on back pain, conducted in January 2000 by the Touch Research Institute in conjunction with the University of Miami School of Medicine and Iris Burman of Miami’s Educating Hands School of Massage demonstrated that in addition to a decrease in long-term pain, subjects receiving massage experienced improved sleep and an increase in serotonin levels.(3)

This massage study employed twice-weekly, 30 minute massages for five weeks. Starting in the prone position, the following techniques were used:
• Kneading and pressing the back muscles
• Stroking both sides of the spine and hips
• Gliding strokes to the legs
• Kneading and pressing the thighs

In the supine position, participants received:
• Gliding strokes to the neck and abdomen
• Kneading of the rectus and oblique muscles that help bend the trunk of the body forward
• Stroking of the legs
• Kneading of the anterior thighs
• Flexing of the thighs and knees
• Gentle pulling on both legs

In addition to other assessments, a sleep scale to measure quality of sleep and urine samples to measure levels of serotonin were used. The results of this study were originally published in the International Journal of Neuroscience in 2001.

Massage is an intelligent, healthy and substance free choice to help the scores of people that have insomnia. Because serotonin plays a role in sleep in multiple areas of the brain, it is logical to seek ways to increase serotonin levels for people that are sleep deprived. In addition, serotonin is needed for our bodies to produce melatonin. As melatonin influences the sleep stage of our circadian rhythm, a natural way of boosting serotonin is a positive sleep inducing option. This connection calls for further research showing the direct affects massage therapy has on serotonin and sleep. In the meantime, the existing evidence is certainly enough to condone regular massages for sleepless clients.

References:

1. Shepherd, Gordon M., MD, D.Phil., Neurobiology, Oxford University Press, 1988.
(pp 517-528).

2. Lambert, Craig, PhD. “Deep into Sleep,” Harvard Magazine, July/August 2005.

3. “Research: Massage Eases Lower Back Pain, Increases Range of Motion,” Massage Magazine, January/February 2002.

Tibetan prayer

May I become at all times, both now and forever
A protector for those without protection
A guide for those have lost their way
A ship for those with oceans to cross
A bridge for those with rivers to cross
A sanctuary for those in danger
A lamp for those without light
A place of refuge for those who lack shelter
And a servant to all in need.

–Tenzin Gyatso, the 14th Dalai Lama

Great article: The Tao of Exercise and Self-Care

Here's a link to an amazingly articulate article originally from the Rolf Institute Journal by Gael Ohlgren and Robert Litman. Rolfblog.com also has a lot of useful info. Below is the poem by taoist master Lao Tzu that begins the article.

http://rolfblog.com/exercise-breath/

All beings, grass and trees, when alive, are soft and bending

When dead they are dry and brittle.

Therefore the hard and unyielding are companions of death,

The soft and yielding are companions of life.

Under heaven nothing is more soft and yielding than water.

Yet for attacking the solid and strong, nothing is better;

It has no equal.

The weak can overcome the strong;

The supple can overcome the stiff.

Lao Tzu

more from Pema Chodron

In cultivating compassion we draw from the wholeness of our experience - our suffering, our empathy, as well as our cruelty and terror. It has to be that way. Compassion is not a relationship between the healer and the wounded. It's a relationship between two equals. Only when we know our own darkness well can we be present with the darkness of others.

--Pema Chodron

Compassion

Compassion practice is daring. It involves learning to relax and allowing ourselves to move gently toward what scares us. The trick to doing this is to stay with emotional distress without tightening into aversion; to let fear soften us rather than harden into resistance.

--Pema Chodron

Nice words about massage

While I generally find most health/beauty magazines articles about massge too superficial too be useful, this one from Health's February 2007 issue is short, sweet and has some good info.

Health, February 2007

Massage: It’s Real Medicine

An hour on the table can fight pain, boost your immunity, help you sleep, and more.

by Kristyn Kusek Lewis

Having your honey rub your back is sweet, but it’s tough to compete with the hands of a pro. A good massage therapist can make you feel like a new woman. And now research suggests massage can ease insomnia, boost immunity, prevent PMS, and more. Maybe that’s why hospitals are making it a standard therapy.

“All of our surgery patients are offered the treatment—I call it ‘service with a smile’—and it’s a mandatory weekly prescription I give myself,” says Mehmet C. Oz, MD, director of the Cardiovascular Institute at New York Presbyterian Hospital–Columbia Presbyterian Medical Center and a member of the board at LLuminari, a health-education company.

Our advice: Enjoy your hands-on time with your sweetie, but set aside some Me Time for a real massage, too. Here are six feel-good reasons.

Goodbye, pain
It sounds like a no-brainer, but rubdowns are especially effective for aches like low-back pain. Researchers at the Group Health Center for Health Studies in Seattle found that massage works better than common treatments like chiropractic therapy and acupuncture. It’s not clear why, but several studies show massage reduces levels of the stress hormone cortisol while boosting the feel-good hormones serotonin and dopamine. Those changes slow your heart rate, reduce blood pressure, and block your nervous system’s pain receptors. Massage also increases blood flow to the muscles, which may help them heal.

A bonus: Massage also seems to ease distress from migraine, labor pain, and even cancer, as well as the body tenderness seen with fibromyalgia, says Tif-fany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine. Plus, the benefits may last as long as a year after just a few treatments, explains Partap Khalsa, PhD, a chiropractor and a program officer at the National Institutes of Health’s National Center for Complementary and Alternative Medicine (NCCAM), the agency funding many major studies on massage.

Hello, dreams
Fluctuations in several types of brain waves either relax you or wake you up. Massage increases delta waves—those linked with deep sleep—according to a study at the Touch Research Institute. That’s why it’s easy to drift off on the massage table, Field says.

Nice to have you back, brain power
The Touch Research Institute study that connected massage to sleep also found that a 15-minute chair massage boosted alertness. “Subjects reported that it felt like a runner’s high,” Field says. Tests also show that brain-wave activ-ity stimulated by massage is linked to improved attention.

Take that, colds
Massage helps ward off bugs by boosting your “natural killer cells,” the immune system’s first line of defense against invading illness. “We know that cortisol destroys natural killer cells,” Field explains. “Therefore, since massage decreases cortisol, your immune cells get a boost.” Massage even seems to boost immunity in those people with severely compromised immune systems, such as breast-cancer patients.

Blues, be gone
Less cortisol and more serotonin and dopamine in your system may also mean less stress, anxiety, and depression. “We know that the right side of the frontal lobe of the brain is more active when we’re sad, and the left side’s activated when we’re happy,” Field says. “Our studies have observed that massage decreases activity in the right lobe and increases functioning ?in the left.” The well-being people feel after a massage is a big reason why some hospitals offer it to anxious patients preparing for surgery and cancer patients going through chemo.

Shove off, PMS
A small study of 24 women with severe PMS found that massage reduced symptoms such as pain, water retention, and mood swings. Try it with proven remedies like exercise (and who-cares-if-they-work solutions like a little dark chocolate).

http://www.health.com/health/article/0,23414,1591705,00.html

Happy New Year!

I wish all a healthy, joyous, peaceful and prosperous year in 2008.