neuromuscular therapy, myotherapy and myofascial release, may be beneficial. The authors of “Massage for Supportive Cancer Care” [www.cancersupportivecare.com/massage.html], describe the application of four basic massage strokes for treatment of individuals with cancer: ● Effleurage : The very slow stroking that should begin and end every massage. Light stroking is used to relax the client, while deep stroking empties the blood and lymphatic vessels. The massage therapist should begin effleurage by placing the hands very lightly on the area to be massaged, running hands slowly over the area, with the lightest possible pressure, making full contact with both hands. Continuous motion should be used, with the hands maintaining contact with the client’s body throughout the stroke. ● After five minutes of light stroking : The therapist can begin to deepen the strokes towards the heart, and lighten the strokes going away from the heart. The massage should never hurt; communicating with the client is key to inducing the relaxation response and to avoid causing pain. Deep effleurage can be used to decrease edema, but only with a physician’s approval. ● Petrisage or kneading : Performed with either the palms, heels of the hands, or the fingertips. In this stroke, the therapist picks up the muscle tissue, moving it away from the bone with the goal of minimizing muscle spasms. Again, Chemotherapy and radiation In most cases, massage can safely be given to the nearly 60 percent of clients who receive either chemotherapy or radiation in the course of cancer treatment. Radiation, which is used to shrink tumors or to kill cancer cells and keep them from growing and dividing, can be given internally or externally, though the usual delivery method is external. With external radiation, the body does not become radioactive, and touching clients who have received that type of treatment is completely safe for the practitioner. Internal radiation, on the other hand, causes the individual to become radioactive at the site of the implant. The radioactivity runs its course within a year of implantation, and consultation with the medical staff at the radiation oncology clinic can help define what limits, if any, should apply in treating that individual. Side effects of radiation are generally specific to the area that was treated, and can include diarrhea, hair loss, damage to the reproductive system, difficulty swallowing, cough or hoarseness, bladder irritations and depressed blood counts. Additionally, the inflammation caused by high doses of radiation can cause tissues in the treated area to become fibrotic, which can lead to lymphedema. Lymphedema occurs when normal flow of lymphatic fluid cannot be accommodated by damaged lymph nodes, and blockage by scar tissue or swelling of the lymphatic vessels causes an accumulation of excess fluid and protein in tissues. Radiation can also cause adhesions in muscle tissues, requiring attention and possible adjustments in treatment for clients experiencing this condition. Hard, thickened skin, soreness and a feeling of being “overstretched” are common side effects of radiation. Scar tissue can, in fact, develop as long as six months after treatments have ended. In the past, doctors told patients experiencing these side effects that there was little that could be done to relieve these symptoms. Increasingly, doctors are referring clients to massage therapists for careful massage therapy to release tightened fascia and return more normal circulation to the area. Be aware that clients undergoing chemotherapy or radiation may have low blood platelet counts and will bruise easily; so gentle touch is crucial to their health and comfort. If the cancer has spread to bone tissue, heavy pressure is contraindicated, due to the increased fragility of the bones, which can break more easily. Tumors and radiation burns should be avoided, but other areas of the body can be worked.
communication with the client is important to confirm the appropriate amount of pressure is applied. ● Tapotement : A “hacking” or “slapping,” performed with the sides of the hands, or by cupping the hands to sharply tap an area. This stroke is generally not appropriate for clients with cancer or other serious illnesses, and should be used only with a physician’s approval. ● Friction: Applying pressure, with one or two fingertips, in a circular motion over bony areas like the knees, pelvic bones, shoulders and knees. Focusing on one area for a prolonged time, then moving to the next location, is most effective. This stroke is helpful in reducing the incidence of decubitus ulcers (pressure sores) for individuals who cannot get out of bed, use wheelchairs for most of the day, or cannot change position to relieve pressure. The following techniques may be effective for women with breast cancer: ● Myofascial softening and spreading, acupressure and trigger point, manual lymph drainage, and cross fiber fractioning and skin rolling to release scar tissue are all good adjunctive therapies to the other treatments a client with breast cancer is receiving. ● The client with breast cancer can be positioned with a small pillow under the forearm and elbow on the side of the surgery. Radiation affects the skin like a severe sunburn; it can be itchy, painful and swollen. For clients with these symptoms, the affected area should be avoided until touch can be comfortably tolerated in that area. Herbal ointments (such as combinations of calendula, St. John’s wort, and comfrey) administered before and during this phase of treatment may prevent or reduce some of the burning effect. Do not use deep pressure, extreme heat, or extreme cold. Nausea, vomiting, and diarrhea are common chemotherapy side effects, although many improvements in recent years have lessened the severity of some of these symptoms. Depressed blood counts, particularly a drop in the white blood cell count, leave the client vulnerable to communicable diseases. Studies have shown that massage therapy reduces the prevalence of these side effects, and can help clients maintain their appetite and constant body weight during chemotherapy treatments. Bodywork need not necessarily be delayed until chemotherapy or radiation treatments are complete. In fact, bodywork can be very beneficial during the time the individual is undergoing treatment. Massage treatments can help the client associate his or her body with positive feelings at a time when negative feelings about the body are overwhelming, providing psychological support to help the individual get through the treatments. Cancer treatments may feel invasive and dehumanizing. Skilled, attentive touch can help the client with cancer feel emotionally whole again. The massage therapist should consult with the client’s oncologist in cases where a potential client is currently undergoing or has just finished chemotherapy or radiation treatments. Because these treatments increase inflammation, the focus of the massage in this phase should be cooling and soothing body processes. Individuals with no experience treating clients with cancer may prefer to assist the potential client in obtaining a referral to someone who has the necessary experience. Never refuse to treat an individual with cancer without referring him or her to someone who can attend to their needs effectively.
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Book Code: MTX1323
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