SLOAN-KETTING CANCER CENTER, NEW YORK
MASSAGE OUTCOME STUDY
Massage Therapy for Symptom Control:
Outcome Study a Major Cancer Center
Barrie R. Cassileth, PhD and Andrew J. Vickers, PhD
Intergrative Medicine Service (B.R.C., A.J.V.) and Bioslatistics Service (.AJ.V.), Memorial
Sloan-Kettering Cancer Center, New York, New York, USA
Abstract
Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and “other”. Changes in symptom scores and the modifying effects of patient status (in – or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48 hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients’ symptom scores.J Pain Symptom Manage2004;28:244-249. © 2004
Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Table 1
Types Of Massage Therapy Received
Inpatients Outpatients Total
Therapy n (%) n (%) n (%)
Massage 316 (33) 244 (74) 560 (43)
Light Touch Massage 69 ( 7) 21 ( 6) 90 ( 7)
Foot Massage 536 (56) 49 (15) 585 (45)
Results
Cards were returned for 3,609 episodes of care; post therapy data were available for 3,359 (93%). Of these, 2,465 (74%) involved care of an MSKCC patient, with smaller numbers for cancer patients from other hospitals (94.3%), family members (78.2%), staff (345, 10%) and members of the public (377, 11%). Data reported below reflect the initial episode of care for the 1,290 different MSKCC patients who provided post-treatment data.
As indicated in Table 1, the most commonly administered touch therapies were standard (Swedish) massage or foot massage, with far fewer patients receiving light touch massage. Fifty five patients received more than one type of touch therapy during the same session, i.e., some foot massage and some Swedish massage during a single session. Foot massage was predominantly used for inpatients; standard and light touch massage was more equally balanced between in-and outpatients. The most common presenting symptom was anxiety (397, 31%), followed by pain (366, 28%) and fatigue (312, 24%) Fewer than 10% of patients reported greatest distress from depression, nausea or another symptom.
The immediate effects of massage therapy on symptoms are shown in Table 2. Although major improvements in symptom scores are apparent – severity of the presenting symptom was reduced by a mean of 54% (95% G.I. 52%, 56%) – Table 2 may actually underestimate massage effects. Patients did not necessarily experience high levels of all symptoms. Therefore, the data for each symptom includes a significant number of zero or near zero scores. A patient presenting with depression, for example, may have reported no pain or nausea. For such a patient, no improvement in pain and nausea would be possible, thus diluting the apparent effects of treatment on these symptoms at the group level.
Table 2
Improvements in Symptom Scores Following Massage Therapy
Symptom * Baseline Post-Treatment Change Improvement
Presenting* 1290 6.6 (2.5) 3.2 (2.7) 3.4 (2.6) 54.1% (43.1)
Pain 1284 3.6 (2.9) 1.9 (2.2) 1.7 (2 ) 40.1% (40.9)
Fatigue 1263 4.7 (2.9) 2.7 (2.7) 2.1 (2.2) 40.7% (39.1)
Anxiety 1273 4.6 (3.1) 1.8 (2.2) 2.8 (2.5) 52.2% (39.5)
Nausea 1255 1.4 (2.4) 0.7 (1.6) 0.7 (1.6) 21.2% (38.3)
Depression 1254 2.4 (2.8) 1.2 (2 ) 1.2 (1.9) 30.6% (41.0)
Other 105 6.5 (2.5) 3.4 (2.8) 3.1 (2.8) 46.6% (36.9)
Figures are given as mean (standard deviation) “Defined as the symptom with the highest score at baseline”
Irish Cancer Society Website Information On Complementary Therapies www.cancer.ie http://www.cancer.ie/cancerInfo/complementary.php#Complementary
“The majority of patients receive conventional treatment for their illness, and it is rare for patients to abandon conventional treatment in favour of alternative treatments. However, many patients feel that complimentary or alternative therapies may be able to help them in some way that conventional medicine cannot. This is because when diagnosed with cancer, patients have to come to terms with a serious illness that not only affects their physical but also their mental and emotional health.”
Dawn Nolan Tel: 087-6327560 045-981629 E: dawn.nolan@upcmail.ie
19 Old Town Rise, Sallins Road, Naas, Co. Kildare, Ireland
Outcome Study a Major Cancer Center
Barrie R. Cassileth, PhD and Andrew J. Vickers, PhD
Intergrative Medicine Service (B.R.C., A.J.V.) and Bioslatistics Service (.AJ.V.), Memorial
Sloan-Kettering Cancer Center, New York, New York, USA
Abstract
Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and “other”. Changes in symptom scores and the modifying effects of patient status (in – or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48 hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients’ symptom scores.J Pain Symptom Manage2004;28:244-249. © 2004
Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Table 1
Types Of Massage Therapy Received
Inpatients Outpatients Total
Therapy n (%) n (%) n (%)
Massage 316 (33) 244 (74) 560 (43)
Light Touch Massage 69 ( 7) 21 ( 6) 90 ( 7)
Foot Massage 536 (56) 49 (15) 585 (45)
Results
Cards were returned for 3,609 episodes of care; post therapy data were available for 3,359 (93%). Of these, 2,465 (74%) involved care of an MSKCC patient, with smaller numbers for cancer patients from other hospitals (94.3%), family members (78.2%), staff (345, 10%) and members of the public (377, 11%). Data reported below reflect the initial episode of care for the 1,290 different MSKCC patients who provided post-treatment data.
As indicated in Table 1, the most commonly administered touch therapies were standard (Swedish) massage or foot massage, with far fewer patients receiving light touch massage. Fifty five patients received more than one type of touch therapy during the same session, i.e., some foot massage and some Swedish massage during a single session. Foot massage was predominantly used for inpatients; standard and light touch massage was more equally balanced between in-and outpatients. The most common presenting symptom was anxiety (397, 31%), followed by pain (366, 28%) and fatigue (312, 24%) Fewer than 10% of patients reported greatest distress from depression, nausea or another symptom.
The immediate effects of massage therapy on symptoms are shown in Table 2. Although major improvements in symptom scores are apparent – severity of the presenting symptom was reduced by a mean of 54% (95% G.I. 52%, 56%) – Table 2 may actually underestimate massage effects. Patients did not necessarily experience high levels of all symptoms. Therefore, the data for each symptom includes a significant number of zero or near zero scores. A patient presenting with depression, for example, may have reported no pain or nausea. For such a patient, no improvement in pain and nausea would be possible, thus diluting the apparent effects of treatment on these symptoms at the group level.
Table 2
Improvements in Symptom Scores Following Massage Therapy
Symptom * Baseline Post-Treatment Change Improvement
Presenting* 1290 6.6 (2.5) 3.2 (2.7) 3.4 (2.6) 54.1% (43.1)
Pain 1284 3.6 (2.9) 1.9 (2.2) 1.7 (2 ) 40.1% (40.9)
Fatigue 1263 4.7 (2.9) 2.7 (2.7) 2.1 (2.2) 40.7% (39.1)
Anxiety 1273 4.6 (3.1) 1.8 (2.2) 2.8 (2.5) 52.2% (39.5)
Nausea 1255 1.4 (2.4) 0.7 (1.6) 0.7 (1.6) 21.2% (38.3)
Depression 1254 2.4 (2.8) 1.2 (2 ) 1.2 (1.9) 30.6% (41.0)
Other 105 6.5 (2.5) 3.4 (2.8) 3.1 (2.8) 46.6% (36.9)
Figures are given as mean (standard deviation) “Defined as the symptom with the highest score at baseline”
Irish Cancer Society Website Information On Complementary Therapies www.cancer.ie http://www.cancer.ie/cancerInfo/complementary.php#Complementary
“The majority of patients receive conventional treatment for their illness, and it is rare for patients to abandon conventional treatment in favour of alternative treatments. However, many patients feel that complimentary or alternative therapies may be able to help them in some way that conventional medicine cannot. This is because when diagnosed with cancer, patients have to come to terms with a serious illness that not only affects their physical but also their mental and emotional health.”
Dawn Nolan Tel: 087-6327560 045-981629 E: dawn.nolan@upcmail.ie
19 Old Town Rise, Sallins Road, Naas, Co. Kildare, Ireland
