Massaging someone with cancer was once a contra indication for massage therapists because it was believed that it might spread cancer cells. We now know that this is not the case. In fact Oncology Massage has become part of managing symptoms experienced during cancer treatments in cancer centres and hospitals all over the world, due to its effect of reducing pain, fatigue, anxiety, nausea and depression.

  • Nausea improved by 47%
  • Fatigue improved by 42%
  • Anxiety improved by 51%
  • Depression improved by 48% (1)

Oncology Massage can help with symptoms experienced during conventional cancer treatments and can be very helpful at any time after diagnosis, bearing in mind that this type of massage is very different to the Deep Tissue and even Swedish (Relaxation) Massage techniques generally used in the industry.

It is a specific, light touch massage, which can improve general well being at a time when the body’s resources are depleted.  Oncology Massage can be done during treatments ie during chemo therapy to reduce nausea and anxiety or after to ease fatigue and depression.

‘It reduces the side effects experienced from conventional treatments of cancer and the symptoms of the disease process itself.’ (1)

Lymphoedema - Accumulation of protein rich fluid in the tissue

Lymphoedema is a progressive condition and ‘when the flow rate of lymph fails there can be compromised immunity, a tendency to deposit fat, fibrotic induration, and a vicious cycle of worsening of cellular, tissue and organ health often associated with recurrent infection.’ (2)

When the lymphatic system is working well there will be no long term accumulation of fluid in the tissue. Lymphoedema is a complex medical condition which needs to be managed by various health providers and early detection is important.

"the prevalence of lymphoedema after cancer treatments are 3% to 60%"

According to Professor Neil Piller from Flinders University and an authority in Lymphology and Lymphoedema, it is estimated that the prevalence of lymphoedema after cancer treatments are 3% to 60% depending on the treatments the person was exposed to. This mostly depends on how many Lymphnodes were removed and how much the lymphatic vessels and Lymph nodes were affected by surgery and radiotherapy.

As the risk of getting lymphoedema is fairly high it is incredibly important to be aware of the risk factors. The most important being any factors which will increase the lymphatic load. An intact lymph system (all vessels and lymph nodes are present and functioning) only has to work to about 10-20 % of its full capacity. So there is a huge reserve capacity which is needed for instance when there is an infection. It just has to work so much harder. This is why lymphoedema generally does not happen for years after cancer treatments.

So what can we do to prevent Secondary Lymphoedema?

At the moment there are real and relative risk groups. Research is being done in this area although some are not substantiated by large trials and therefore are not being considered.  My point here is why risk even a relative risk when the outlook of having lymphoedema is that of managing a condition for the rest of ones life?

And this is where we are getting back to massage. It is not my intention to discredit any therapist or instilling fear about massage as more and more research is being done on the benefits of this therapy, but the medical field is becoming more and more specialized and so it is happening in the massage industry, although unfortunately it is not a very regulated modality.

It is not my intention to discredit any therapist or instilling fear about massage as more and more research is being done on the benefits of this therapy

‘Normal massage techniques’ and I am speaking generally because even the pressure of a relaxation massage will increase lymph load. Meaning that for an intact lymph system this ‘tissue bath’ can be wonderful but for a compromised system to push more fluid into the tissue spaces which then has to be ‘mopped up’ by the lymphatic system, which is already struggling is an increase in lymph load.

Furthermore if for instance there has been a full axillary clearance (removal of lymph nodes in armpit) and the arm and/or back is being massaged as usual (strokes going towards and into the armpit) it puts an increased load on an area which is extremely compromised as there are no lymph nodes to take the lymph being pushed up from the back and the arm. Even if there is even the slightest risk of overloading this area why risk it?

We know that Trigger Point Therapy and deep massage can induce inflammation. A person with Lymphoedema is already exposed to the danger of inflammation in the tissue. Why add more?

It is not to be confused with lymphatic massage.

Lymphatic Drainage is a therapy which is much more beneficial in these instances and will actually decrease the lymphatic load overall thus aiding the whole of the lymphatic system. It is not to be confused with lymphatic massage. Lymphatic drainage is a specialized field and can only be done by a trained therapist. It is very gentle as our superficial lymphatic vessels are just under the skin. A trained therapist will move the lymph from one area where there are no lymph nodes available to the next available lymph nodes and therefore ‘off load the compromised area’.

This article is about information. Health conditions are so varied, that it easy to fall behind with the information and updated research.

It is important to keep your therapist updated with your medical history, especially if you are seeing a massage therapist and you have had treatments for cancer. If your therapist does not update your medical history before a massage and you have a compromised lymph system, be sure that you are seeing a massage therapist who understands the relative risks involved, as the treatment should be adjusted according to your individual condition.

Written by Manuela King Dip Rem Massage, Oncology Massage, Lymphoedema and Scenar Therapist

References

1. Cassileth and Vickers 2004, Sloan Kettering Cancer centre, USA
2. A brief summary about Lymhoedema: Causes, assessment, prevention and management. Professor Neil Piller