Massage is probably as old as mankind, and its used has been reported in many ancient civilisations. Massage therapy today is among the fastest growing complementary therapies used in the UK. And yet, unfortunately, it is very common for spas and massage establishment to refuse clients with a cancer history.
Basis for massage fears.
This situation has only one cause: fear of litigation based on ignorance. And yes, improper massage therapy on a person who live with cancer or even somebody who has had cancer at some point in their live can cause serious harm. Has the client had any lymph nodes removed? Have they had an history of lymphoedema (risk of recurrence)? Have they got any medical implants (risk of physical damage and interfering with chemo delivery)? Are they immunosuppressed (risk of client getting a serious infection)? Have they got low platelets (risk of bruising)? This is only a small selection of all the questions you need to ask before attempting any body work on a person with a cancer history.
There is also some concerns of spreading cancer cells when done inappropriately. But the risk of cancer spread from massage therapy has been debunked and thoroughly criticised as a myth (sources, sources, and more sources) as there is no physiological mechanism for this to happen. Massage therapy doesn’t move lymph any more than exercise does, doesn’t have meaningful effect on blood circulation and both the lymphatic system and blood are actually hostile environment to cancer cells.
That being said, massage therapy is an incredibly helpful intervention, which can benefit people living with cancer in many ways. Here are a few.
Cancer pain and massage.
Everybody associate muscular pain with massage therapy. However, massage can be useful beyond the day after that gym workout where you feel sore all over.
In fact, a 2004 large-scale american observational study involving 1,300 cancer patients over 3 years found a lasting near-50% improvement in pain perception. This has been confirmed in a 2015 meta-analysis from the College of Korean Medicine, which analysed twelve studies over 560 cancer patients. The causes of pain in those studies weren’t limited to muscular pain, and included pain from changes in skin, bone, nerve, and other tissues due to direct tumour involvement or metastases, and/or from treatment effects.
Massage for anxiety.
There has been a lot of erroneous information circulating on the internet about the benefits of massage – for instance massage doesn’t flush lactic acid, nor does it increase blood flow in any meaningful way. But one well-researched benefit of massage is on anxiety. Anxiety is a major issue in the cancer patient population for a variety of reasons.
It has been shown that a single sessions of massage therapy significantly reduce state anxiety (the momentary emotional experiences of apprehension, tension, and worry), and multiple sessions, performed over a period of days or weeks, significantly reduce trait anxiety, (the normally stable individual tendency to experience anxiety).
This effect has also been shown in people undergoing radiation therapy, with an immediate average reduction of 45% in anxiety symptoms.
Boost to metabolic therapy?
I have discussed in other articles how some of the latest research show the metabolic approach to cancer nutrition have great promise as a complementary therapy for cancer patients.
In the last couple of decades there has been a few studies indicating massage therapy has a possible lowering effect on blood sugar. Apparently the subject is not new as massage was already indicated for diabetes a hundred years ago (source). Casual observation in clinical practice also goes towards the weight of evidence (source).
For instance a 1989 study on eight volunteers injected with insulin showed a marked enhancement of insulin absorption induced by massage of the injection site. A couple of Iranian studies (here and here) showed a significant lower blood sugar markers in diabetic children after massage therapy. Another two studies off Sweden have also reported an improvement in blood sugar markers with gentle massage (study, study).
Although the studies are small, they should be a good indicator that the subject warrants further research. If confirmed, the combination of massage with dietary change could be a very significant help to people living with cancer.
Overall, an effect on blood sugar could be caused by the effect massage has on stress and anxiety. Indeed, there has been several studies showing a decrease in cortisol in people undergoing massage therapy (studies here, here, here and here) – although the evidence has been criticised elsewhere. But if further larger studies confirm that massage lower cortisol, it could be used as a complementary therapy to help control blood sugar spikes form glyconeognesis.
Boost to the immune system?
A growing body of research indicates massage therapy can benefit the immune system. There again, it is important to consider that the evidence is preliminary, small-scale, and somewhat controversial, before jumping to conclusions. That being said, the scientific literature reports the following:
- This randomised controlled study on 34 breast cancer patients reports an increase in blood counts of natural killer cells and lymphocytes after getting 30 minutes massages three times a week for five weeks.
- This controlled study also found a greater increase in circulating lymphocytes and a decrease in inflammation markers following 45 minutes of Swedish massage than following a light touch therapy.
- This 1996 study has also found an important increase in natural killer cell cytotoxicity in HIV patients after a month of daily massage – together with a decrease in urinary cortisol.
- Similar results have been noticed in pre-term infants, children with HIV, and in this other study on breast cancer patients.
Tissue stiffness and cancer spread.
In stark contract to the myth that massage may spread cancer (it doesn’t), recent evidence tend to suggest that there may be a link between tissue stiffness and cancer spread. In animal models and in vitro experiments, increased collagen deposition, alignment, and cross-linking were shown to promote tumor progression. However, the question of whether extracellular matrix stiffness can, by itself, promote cancer growth is not fully answered. See this white paper from the American Association for Cancer Research for more information).
It is interesting to notice that muscle cancers are almost non-existent, and in fact when injected into muscles, tumour cells are rapidly destroyed (study). There is also good evidence that increased extracellular matrix stiffness and increased collagen deposition may be protecting the tumour from the immune system and tumour-suppressing factors (source). It would be pure speculation to conclude that massage could have a positive effect on cancerous extracellular matrix, but it would be an interesting hypothesis to put to the test of a pilot study.
When will you get your next massage?
I offer oncology and standard Swedish massage in North-West London. Contact me for more details.