Lopez, G., Liu, W., Milbury, K., Spelman, A., Wei, Q., Bruera, E., & Cohen, L. (2017). The effects of oncology massage on symptom self-report for cancer patients and their caregivers. Supportive Care in Cancer, 25, 3645–3650.

To examine the effect of a massage session on physical, psychological, and global distress among cancer patients and their caregivers

Conventional Swedish massage with unscented hypoallergenic lotion and adjusted for location and pressure based the caregivers feedback to the therapist. The session lasted either 30 or 60 minutes based on caregivers choice. A 60-minute session was recommended for the first session. Music and/or a bolstering pillow could be used based on preference. The majority of caregivers received a 60-minute massage (81.6%).

• N = 87 at baseline, 40 completed post
• AGE: 52.9 years (SD = 12.8)
• MALES: 25.3%  
• FEMALES: 74.7%
• KEY DISEASE CHARACTERISTICS: Patients had various cancers, but mostly with breast cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Patients and their caregivers were studied. Patient population disease and treatment characteristics not described in report.

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: MD Anderson Integrative Medicine Center

PHASE OF CARE: Not specified in the report

Pre-/post design. Patients and caregivers.

Edmonton Symptom Assessment Scale (ESAS)

Massage therapy significantly decreased caregivers symptoms of pain, fatigue, sleep, depression, anxiety, drowsiness, appetite, and spiritual pain. The reduction was considered clinically significant (reduction greater than 1) for pain, fatigue, anxiety, well-being, and sleep and for all ESAS subscales (global distress, physical distress, and psychological distress). The duration of massage did not make a significant difference (30 versus 60 minutes) on reduction in symptom burden.

Massage offers as much benefit to caregivers as to patients. The largest improvement for caregivers was in their anxiety, pain, and fatigue. A 30-minute massage seems to be as effective as a 60-minute massage.

• Small sample (< 100)
• Baseline sample/group differences of import        
• Risk of bias (no control group)
• Risk of bias (no random assignment)
• Risk of bias (sample characteristics)
• Key sample group differences that could influence results
• Findings not generalizable
• Intervention expensive, impractical, or training needs
• Subject withdrawals ≥ 10%  
• Other limitations/explanation: Massage was available only to those who could pay for it. Significant difference existed between caregivers who completed the post ESAS and those who did not (higher anxiety and psychological distress). 87 caregivers filled the baseline data and only 40 filled the post data. Study was conducted in a comprehensive cancer center.

Offer massage to patients and their caregivers. Massage seems to improve symptom control (immediate effect). Additional study the accumulative effects of massage on caregivers and identify the "right" frequency and dose. Larger randomized controlled trials would provide additional assessment of the intervention.