Campeau, M.P., Gaboriault, R., Drapeau, M., Van Nguyen, T., Roy, I., Fortin, B., . . . Nguyen-Tan, P.F. (2007). Impact of massage therapy on anxiety levels in patients undergoing radiation therapy: Randomized controlled trial. Journal of the Society for Integrative Oncology, 5(4), 133–138.

To assess the impact of massage therapy on intermediate-term anxiety in patients undergoing radiation therapy

Patients were randomized to massage therapy and control groups. Patients in the massage therapy group rated anxiety before and after massage sessions, and control patients rated their anxiety 15 minutes before radiation treatment. All massage sessions took place before the radiation treatment over 10 consecutive days. Massage consisted of a 15-minute chair massage with a combination of effleurage and petrissage. Patients did not disrobe for the therapy, and no lotion was used. Massage therapists participated in a training course specifically targeting the care of patients with cancer. All therapy was standardized, but was adapted as necessary to avoid any massage to the treatment field. The massage therapist assessed anxiety in all patients using a visual analog scale (VAS) every day during the study.

• The sample included 100 participants.
• Mean age in the control group was 58 years; mean age in the massage group was 60 years (range = 35–85 years).
• The sample was 68% females and 32% male.
• Most participants had breast or head and neck cancers.

• Single site
• Outpatient setting
• Montreal, Quebec, Canada

Active treatment phase

A randomized controlled trial design was used.

• Visual Analog Scale (VAS): Ranges from 0 (not anxious at all) to 10 (the most anxious I have ever been), using a 10 cm ruler with a slide bar
• Spielberger State-Trait Anxiety Inventory (STAI)

The mean VAS score before massage was 4.0 and after massage was 2.2, which was a 45% decrease in anxiety (p < 0.001). Patients in the massage group showed a 15% decrease in anxiety scores from the first to the last session, and patients in the control group experienced a 19% decrease over the same time interval. Both groups had similar scores for state and trait anxiety at baseline. There were no differences in state anxiety between groups at the last session, indicating no intermediate effects on anxiety. VAS scores declined over time for both groups.

Massage therapy as used in this study was associated with a significant immediate reduction in anxiety, but appears to have little or no effect on intermediate-term anxiety. Anxiety over the course of radiation treatment declined for both groups.

• The study had no appropriate control group.
• The type of massage given was limited (only 15-minute chair massage), which could have influenced results.
• The control group met with the massage therapist for anxiety assessment, but it is not clear whether this provided an adequate attentional control.
• Bias may have been present since the massage therapist was the person who administered the VAS assessment to all patients.
• The study concluded after a 10-day period.
• The duration of therapy for participants was not described, so it is not clear how this reflected an intermediate point in therapy.
• The sample size was not sufficient to allow for subgroup analysis to determine potential differences in effect by diagnosis or other subject groups.
• Baseline VAS scores were relatively low on average in both study groups and was lower in the control group (3.2), which likely influenced effect sizes that could be seen.

Findings suggest that a brief chair massage can be effective for immediate reduction in anxiety, and this may be helpful for certain patients who are very anxious in beginning treatments. Because anxiety in all patients declined over time, and all subjects were seen by a massage therapist prior to each treatment, it may suggest that regular attention to anxiety in interaction with patients may be helpful for anxiety reduction over the course of treatment. This is an area that could be studied. The length and type of massage could influence findings, suggesting that further research in this area should incorporate evaluation of various types and duration of massage.