Cancer is a leading cause of death in Australia, accounting for around 3 in 10 deaths. Increasingly patients are finding that palliative care, in the form of dedicated oncology massage, is an invaluable form of support while they fight the disease and recover from treatment. Many patients report improved well-being and relief from symptoms.
ntpages caught up with Sarah Trangmar, a dedicated oncology massage therapist, who specialises in working with people with cancer and other life threatening illness – to learn more.
Tell us a bit about yourself and how you got into massage?
"I was originally a photographer but always had an interest in health and found the body fascinating. My husband – who is a "fitness freak" was running marathons and I wanted to be able to help him and his friends prepare for and recover from their events. I was also looking for a "Sea Change" that was flexible around children - so I studied massage.
I found that the more I learned about the body and mind the more fascinating I found it – and the more I wanted to help people so I went on to train in Bowen therapy and kinesiology as well.
When my mother was diagnosed with advanced ovarian cancer I used various techniques while she was in intensive care after a major operation and was able to witness the positive effects of gentle touch techniques on the monitors such as stabilising of blood pressure, heart rate and O2 levels – to the extent that the nurses would actually ask me to continue doing what I was doing.
I continued to work with my mother through the duration of her numerous chemotherapy treatments which helped her to cope with many of the side effects. This instilled in me the desire to be able to do the same for other people undergoing similar journeys. So I became a volunteer therapist at the Cancer Care Centre at Unley and have been there ever since. I have also completed the Oncology Massage training to the highest available level in Australia."
Where/how did oncology massage evolve?
"Generally, I suspect that oncology massage has been used for centuries the world over, by people wanting to give nurturing and comfort to those suffering the disease. However, the more formally integrated with medical acceptance form of oncology massage has been evolving since the early 1990's. People like Gayle Macdonald (author of Medicine Hands) have been at the forefront of this evolution. In Australia, Oncology Massage Training is the brainchild of Eleanor Oyston who began training people 10 years ago after spending time and training with Gayle Macdonald in the US. With her medical background in cancer research laboratories and a degree in Cytology plus her massage training she was uniquely qualified to develop her program whilst facilitating the Quest for Life program for Petrea King. Her Oncology Massage Training program is now internationally accredited.
There is also wealth of information about oncology massage on the website for the Society for Oncology Massage."
What are the primary benefits of massage for cancer patients?
"International research shows reports a 47% improvement in pain levels, 42% improvement in fatigue, 59% improvement in anxiety levels, 51% improvement in nausea and 48% improvement in depression. Other problems such as insomnia, brain fog, dry mouth and shortness of breath showed overall improvement of 48% (ref: Memorial Sloan Kettering Cancer Center NY 2004). These results have been replicated in numerous smaller studies. Many side effects of treatment can be alleviated such as constipation, muscle tension, peripheral neuropathy, scar tissue adhesions and lymphoedema.
However I believe that one of the main benefits is that a massage allows a patient a period of time to just "be", to have space away from the roller coaster ride of appointments, treatments, and the anxiety of their loved ones. It gives then back a degree of "control" over their own destiny. Also, many clients comment on how lovely it is to receive nurturing touch over a body that is traumatised by needles, operations and treatments."
How does oncology massage differ from other forms of massage?
"Oncology massage is by no way habitual. Every client requires a massage tailor made to their unique physical experience at that present moment. Oncology Massage Training teaches the therapist to be able to deal with the many and varied situations that arise during the illness and its treatment and to adapt literally moment by moment to what they observe as they work with a patient. Safety of the patient is paramount and things such as lowered blood counts, lymphoedema, wounds sites, surgical devices all need to be adapted for appropriately."
Are there some types of cancer where massage is not appropriate?
"It may not be appropriate to massage over certain areas of the body and certainly not over a tumour but there is usually somewhere that can be massaged – even if it is just a hand, foot or the head!"
When is massage not appropriate for a cancer patient?
"There are times when treatments and / or the course of the disease cause situations where extreme caution and care needs to be used - such as low blood counts. However it is rare that there is no form of gentle touch that may be used. If that was the case the person would be under intensive medical supervision anyway.
There may be times when the patient does not wish to be touched or can only tolerate a very short time. Establishing a relationship with the patient that allows them to be comfortable to give feedback and feel that it is ok to say "stop now" is of great importance and should be put in place from the very start. There are times when the patient requests deeper touch or more from their massage, however it is the therapist's responsibility to stay safe and "do no harm". It is better to inch forward at each massage session than to over tax an already stressed body system."
How do you determine when massage is appropriate for a client/patient – do you take direction/advice from doctors/specialists?
"It is a pre-requisite that my cancer patients have permission from their primary specialist to have a massage. If a massage therapist has completed Oncology Massage Training some insurance companies do not require the therapists to get the doctor's permission however I have found it invaluable to have a strong working relationship with me client's primary medical care givers.
On occasion a doctor will give written instructions or specific direction, but generally once their permission is sought and given (assuming the patient is not in hospital) they require little input."
How closely do you work with doctors/oncology specialists?
"That varies depending on the status of the patient, generally if they are home and mobile there is little contact with the doctors apart from the initial permission and general direction. Occasionally, there will be contact if there is a change in the patient which is relevant. However, if they are at home and under palliative care, there may be more regular contact and instruction. Also if they are hospitalised and massage is allowed /requested by both the patient and the doctor you would be expected to be able to work with the medical team."
Is there resistance to oncology massage from the medical community?
"As there is more and more evidence based research showing the benefits of massage it is becoming more accepted. There are a number of hospitals in the USA and the UK which encourage and incorporate massage as part of their treatment plan.
In Australia the Austin hospital in Melbourne is the first public hospital to build a "Wellness Centre" and to have a massage therapist on the staff. Some private hospitals are now offering massage in their day treatment units and massage is often made available in a hospice setting.
While some specialists are embracing it there are others who are at best ambivalent!"
Do you have a particular story to share, re: the power of massage?
"It would be difficult to pick one - the people I encounter each have a unique story and are each an inspiration in their own way. I am honoured at the trust shown and the intimacy allowed during the time I spend with them, it is a time where they can safely "unload" or "go somewhere else". I have patients that continue to see me long after their treatment is done and those who only see me at the time of greatest need, one of the greatest honours is to have been requested to give a treatment to those in their final hours of life.
Specific, unique moments of relief are always special – such as a bowel that went into paralytic shock after an operation and would not work for 10 weeks but resumed peristaltic action after several daily abdominal massage treatments. Abdominal massage is an advanced technique taught to oncology massage therapists who have been invited to study Oncology Massage Training Level 2. Or the chemo that left severe dizziness in its wake which could be controlled by regular head and neck massages. Or the patient who had not been able to sleep for three days due to the steroid medication finally getting a good sleep."
Originally published on Jul 29, 2013
