Oncology massage is typically light in pressure. This can be really frustrating to cancer patients who crave the firmer pressures of Swedish massage, or even deep tissue massage. We know now that skilled massage doesn’t cause cancer to spread, so why the gentle approach?
I understand the frustration, but the truth is that cancer, its associated complications, and its treatments are a lot for your body to handle, and so therapists have to take into account the risk that massage could overload it further.
Firstly, we know it is important not to disturb known tumor sites, so in the event that there is any doubt over the location of the cancer then only very gentle pressure will be used all over until the situation becomes clear. Further complications could be the spread of cancer to the bone. This can have a destabilising effect on the bone tissue. It can cause bone to breakdown and can increase the risk of pathologic fracture. Needles to say, under such circumstances gentle pressure is essential. Radiotherapy, too, can weaken tendons and bones (cancer survivors are at heightened risk of osteoporosis), which gives another good cause to be cautious with pressure. Radiotherapy can also make the skin fragile, and it can remain so for years, again necessitating a lighter touch.
The health of the clients’s vital organs must also be taken into account. Metastasis to a vital organ can impair its function, and so can some cancer treatments, so we don’t want to do anything to make it work harder. Massage is often claimed to boost circulation. At the moment there is little evidence to support this claim, but massage strokes of a firm pressure or greater are typically thought to increase the body’s circulation. If we assume this is true then we must dial down the pressure when treating someone with impaired organ function. If the kidneys are affected, for example, their blood filtering function will be compromised, so massage strokes that could overload them are undesirable. If liver function is impaired, a possible complication could be easy bruising or bleeding. Under such circumstances only gentle pressure can be tolerated.
Common side effects of chemotherapy are nausea and fatigue. Someone with very low energy levels can only tolerate gentle strokes. Anything firmer could worsen these symptoms. Fatigue can be a very long-term side effect, lasting years after the treatment is finished.
Chemotherapy can also cause diminished sensation in the hands and feet, yet another requirement for a gentler touch as client feedback under such circumstances is unreliable. It can also affect blood count. Low blood counts can cause fatigue, compromised immune systems, and easy bruising and bleeding – all red flags signalling the need for lighter pressure.
Some cancer survivors live with the lifelong threat of lymphoedema
. If any of their lymph nodes were surgically removed or damaged by radiotherapy then they are in this category. Lymphoedema can be extremely uncomfortable and is incurable, so if there is any risk at all the therapist will modify his strokes to make sure the condition is not triggered. Those at risk are advised what triggers to avoid and it is a long list. It includes temperature differences, such as getting in a hot shower (which is why this person would also be precluded from treatments such as warm bamboo or hot stone massage), carrying too much weight on the side at risk, wearing clothing that is too tight, having blood pressure taken on the side at risk, burns, cuts, and even insect bites. The list goes on. Needless to say, a delicate touch will be required.
Having a history of cancer also increases the client’s risk of blood clots. Deep vein thrombosis is a real concern, regardless of the presence of classic symptoms (DVT can be asymptomatic). While the risk is elevated, only gentle pressure will be applied during massage. Unless the risk level improves, as determined by a doctor, this cautious approach will need to continue.
So I think it’s clear that when dealing with cancer we are in fact dealing with all of its associated complications and treatment side effects as well. Cancer medicines are seriously strong, and ultimately cancer patients can end up feeling weakened, fatigued, and very ill indeed. As we have seen, some of the risk factors associated with cancer and cancer treatment can be lifelong, such as lymphoedema. This means that years after you complete your course of treatment, even though you may be feeling well, your therapist will still need to work cautiously. Though your cancer treatment is over, internal cellular repairs are ongoing. The risk is that firm strokes will aggravate your symptoms, and even create further complications. At best you may feel sore or nauseated afterwards. At worst you may sustain a fracture or lymphoedema may be triggered.
Yes it may be frustrating, but ultimately we therapists aim to ‘do no harm’. We will not do anything that overloads a system that is already struggling, and we won’t do anything to heighten any risks to your wellbeing.
It is really important if you have a history of massage that your therapist has specific training in oncology massage. If anyone offers to massage you without asking questions about your cancer background, then I would suggest you politely decline, as the treatment will not take into account the possible health risks.
While you may be disappointed with these massage restrictions you should take heart from the fact that the effects of gentle massage can be profound.
Don’t underestimate how beneficial a relaxation massage can be.