Bradt, J., Dileo, C., Grocke, D., & Magill, L. (2011). Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database of Systematic Reviews, 8, CD006911.

To examine the effects of music therapy and \"medical music\" on patients with cancer.

• Databases searched were MEDLINE, EMBASE, LILACS, CINAHL, Computer-Assisted Information Retrieval Service System (CAIRSS), and Cochrane Collaboration. The investigators also evaluated for inclusion studies listed on web sites about clinical trials or on the web sites of relevant professional organizations, those cited in journals dealing with music and music therapy, and those included in the reference lists of relevant articles.
• The investigators provided an extensive list of search terms in the report.
• Studies were included if patients, of any age, had cancer and if the studies compared music interventions to standard care, alternative interventions plus standard care, or placebo. Studies were included if they were randomized, controlled trials or incorporated quasiexperimental designs.
• Studies were excluded if they involved patients who were undergoing diagnostic procedures.

• The investigators retrieved a total of 773 studies.
• The investigators evaluated the quality of the studies according to the criteria in the Cochrane Handbook for Systematic Reviews of Interventions.

• The final number of studies analyzed was 30.
• The studies analyzed included a total of 1,891 patients.
• The range of mean patients per study was 8 to 86.
• The analyzed studies comprised multiple cancer types and age groups.

• Patients were undergoing multiple phases of care.
• The study has clinical applicability for pediatrics and palliative care.

• Findings from seven trials, regarding effect on anxiety, showed positive effects for reducing anxiety (standardized mean difference [SMD] = –0.61; 95% confidence interval [CI] [–0.97, –0.26]; p = 0.0007).
• Findings from six trials, regarding effect on pain, showed positive effects on perceived pain (SMD = –0.59; 95% CI [–0.92, –0.27]; p = 0.0003).
• The investigators noted no significant effects on depression or fatigue.
• Several studies showed that music listening and music interventions affected physical findings—for example, the studies reduced pulse rate.
• Many studies had high risks of bias, and the type, duration, and timing of the interventions varied greatly.

Music interventions appear to have beneficial effects regarding pain reduction and short-term reduction of anxiety.

• The investigators found a relatively small number of studies that examined a specific symptom or outcome.
• The interventions were very different in terms of sample types, timing, and duration; therefore, synthesizing the findings was difficult. 
• Most studies had small sample sizes and high risks of bias.

Music therapy and listening to music may be helpful means of reducing anxiety and perceived pain, and these interventions can have an effect of moderate size. The effects may be relatively short-lived, and the evidence is somewhat weak in terms of study design. However, listening to music has no risks for patients, can be easy to implement, and is an intervention that patients can do themselves. Nurses can suggest that patients use this approach to help manage pain and anxiety.