Download Cancer Nurs - LA Institute of Massage Therapy

Susan G. Salvo
Massage Defined
• Massage is manipulation of soft tissue
• MTs can:
– Encourage healthy lifestyles habits
– Suggest general dietary modifications
– Teach self-care massage
– Perform general assessments & formulate a plan
of care
– Use hydrotherapy & aromatherapy to enhance
massage
Incidence and Prevalence
Cancer, a complex and
frightening disease, is a leading
cause of death in the U.S., and
the incidence increases
markedly with advancing age.
The American Cancer Society estimates that
nearly 1.4 million people in the U.S. are diagnosed with
cancer, and over 550,000 die of cancer, each year.
A Life Affected By Cancer
The thought of cancer brings
fear, anxiety, and stress,
including:
• Fear of death
• Fear of the treatment and
disfigurement
• Anxiety related to long-term
disability
• Financial stress
How Massage Can Help
A knowledgeable, skilled therapist can help the
client by
• Reducing muscle tension
• Decreasing pain
• Promoting relaxation
• Improving sleep
Massage Can Help, cont’d.
Massage also
• Bolsters immune function
• Reduces or prevents edema
• Decreases nausea
• Reduces fatigue that affects
many patients with cancer
• May improve the quality and
survival of skin during radiation
therapy
Research: Pain and Nausea
Foot massage on
hospitalized patients
with cancer was
found to reduce pain
and nausea.1
Research: Fatigue
Gentle back massage was given
to patients with breast cancer
who were undergoing
radiation therapy. They
reported increased degrees
of tranquility and vitality and
reduced tension and fatigue
after the massage.2
Research: Increased Natural Killer Cells
Massage reduced anxiety and
depression and improved
immune function, including
increased natural killer cell
number in women with
breast cancer.3
Women diagnosed with
breast cancer received
massage therapy, which
increased their dopamine
levels, natural-killer cells,
and lymphocytes.4
Research: Depression, Anxiety, and
Pain
Massage given to hospitalized patients with ovarian
cancer, who were undergoing chemotherapy.
Patients who received massage indicated
reductions in anxiety, depression, and pain.5
Children with leukemia were provided daily
massages by their parents. After a month,
depressed mood decreased in the children's
parents, and the children's white blood cell and
neutrophil counts increased.6
Teach Massage to Caregivers
Sometimes, receiving massage from
a caregiver is more advantageous
for the client.
Caregivers often feel helpless…
…and giving caregivers this loving
tool allows them to offer
something special to their loved
one in the form of a simple hand
or foot massage.
This approach benefits the giver and
the receiver of massage.
Teaching Self Massage
Teaching self-massage may help
manage uncomfortable
symptoms. This may include
simple instructions in
–
–
–
–
Neck massage
Shoulder massage
Foot massage
Abdominal massage
General Guidelines
• Note discomfort and use
appropriate pressure
• Avoid
– Known tumor sites
– Cancerous lesions (e.g., skin
cancers)
– Enlarged lymph nodes
– Irritated skin
– Ports
General Guidelines, cont’d.
• Note signs of fatigue
• Take your clients
where they are at
General Guidelines, cont’d.
• Document
– Client symptoms and
therapist your observations
– Areas of the body worked
and avoided
– Techniques used
– How your client tolerated
prior massage sessions
Cancer Treatments Take Their Toll
• These are enormously taxing
on the body and have
undesirable side effects,
which include
– Hair loss
– Loss of organs or limbs
– Fatigue
– Anemia
– Skin changes from radiation
Specific Guidelines: Surgery
• Blood clots: avoid massage to
the lower extremities as well
as over the incision site for a
wk to 10 days after the client
is ambulatory
• Edema: elevate, light stroking,
massage proximal area first,
avoid use of heat
Specific Guidelines: Radiation
• Avoid massaging
irradiated areas
• If fatigued, reduce
massage to 30 minutes,
and use lighter-thannormal pressure
Specific Guidelines: Chemotherapy
• Postpone massage in
cases of fever
• Reduce risk of exposure to
infections
• Remind client to move
slowly and carefully and
assist if needed (i.e., dizzy
spells)
Chemotherapy, cont’d.
• If nauseated, avoid rocking
motions and aromatherapy
• If mouth sores, avoid prone
position and facial massage
Chemotherapy, cont’d.
• If hair loss, respect
client wishes about
having scalp exposed
or unexposed and
touched
Give the Gift of Touch
• Your manner and presence are as important as the
touch you offer.
• Some clients need to cry, some need to express
anger, and others need to convey their fears.
• Provide space for your clients to express their
feelings with your attitude of compassion.
• Give your client respectful, attentive touch – it will be
a welcomed gift.
• Cancer is a word, not a sentence. ~ John Diamond
References
• Coussens LM, Werb Z: Inflammation and cancer, Nature 420(6917):860867, 2002.
• Frazier MS, Drzymkowski JW: Essentials of human diseases and conditions,
ed 3, Philadelphia, 2004, WB Saunders.
• Gould BE: Pathophysiology for the health-related professionals, ed 3,
Philadelphia, 2006, WB Saunders.
• Kern SE: Progressive genetic abnormalities in human neoplasia. In
Mendelsohn J et al, editors: The molecular basis of cancer, Philadelphia,
2001, WB Saunders.
• Kochanek KD et al: Deaths: final data for 2002. In: National vital statistics
reports, vol 53, no 5, Hyattsville, Md, 2004, National Center for Health
Statistics.
• McCance KL, Huether SE: Pathophysiology: the biologic basis for disease in
adults and children, ed 5, St Louis, 2006, Mosby.
• Microsoft Office Clip Art
Research References
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6.
Grealish L, Lomasney A, Whiteman B. Foot massage. A nursing intervention to
modify the distressing symptoms of pain and nausea in patients hospitalized
with cancer, Cancer Nurs 23:237-243, 2000.
Sims S:Slow stroke back massage for cancer patients, Nurs Times 82:47-50,
1986.
Hernandez-Reif M et al: Breast cancer patients have improve immune and
neuroendocrine function following massage therapy, J Psychosom Res 57:45-52,
2003.
Hernandez-Reif M et al: Natural killer cells and lymphocytes are increased in
women with breast cancer following massage therapy, Int J Neurosci 115:495510, 2005.
Lawvere S: The effect of massage therapy in ovarian cancer patients. In: Rich G,
editor: Massage therapy: the evidence for practice, New York, 2002, Mosby
Elsevier.
Field T et al: Leukemia immune changes following massage therapy, J Bodywork
Mov Ther 3:1-5, 2001.