Pan, Y.Q., Yang, K.H., Wang, Y.L., Zhang, L.P., & Liang, H.Q. (2014). Massage interventions and treatment-related side effects of breast cancer: A systematic review and meta-analysis. International Journal of Clinical Oncology, 19, 829–841. 

• FINAL NUMBER STUDIES INCLUDED = 8
• TOTAL PATIENTS INCLUDED IN REVIEW = 950
• SAMPLE RANGE ACROSS STUDIES: 14–134 patients
• KEY SAMPLE CHARACTERISTICS: All received surgery; studies were done at various phases of care

PHASE OF CARE: Multiple phases of care

Studies included those with combined exercise and massage, support and massage for lymphedema, reflexology, foot massage, and aquatherapy. Eight randomized, controlled trials (RCTs) assessed effects on anxiety, and a meta-analysis showed no significant effect of massage on anxiety. Three RCTs looked at effects on fatigue, and a meta-analysis showed improvements in fatigue (SMD = -0.61, p = 0.01). Four RCTs looked at pain, and a meta-analysis showed improvement in pain (SMD = -0.33, p = 0.07, 95% CI -0.69,-0.03).

The evidence from this meta-analysis suggested that massage interventions may be beneficial in the management of fatigue and pain for women with breast cancer. The results did not suggest effectiveness for anxiety.

The specific effects of massage alone were difficult to identify because most studies included other interventions along with massage. The types of massages used were different, and there was no accommodation for the use of medications. There was high heterogeneity among the studies that examined effects on fatigue. The studies included had multiple methodologic flaws. Several studies were counted twice or more in the meta-analysis. Although different outcomes were reported, it was clear from the data that the study sample was the same in different publications.

Massage is a low-risk intervention that may be beneficial in combating fatigue among patients with cancer. This analysis provided evidence in support of massage; however, this was particularly strong given the study design flaws, the variability in types of massage, and the other interventions that were included in the analysis at various phases of cancer care. Additional well-designed research on massage would be helpful to clarify clinical applicability.