Questions about massage appear frequently in online forums. Some massage therapists tell their clients that massage is contraindicated in lymphoma. Being a fan of massage, I decided to investigate the matter further. This is what I have found. (The following information applies to medium hard Swedish massage, but not to deep tissue body work such as Rolfing.)
Cancer Nursing (Ruth McCorkle, ed., 1996) has these good things to say about massage: "The benefits of massage include relaxation, reduced swelling, decreased stress, relief of fatigue, improved sleep, and decreased pain through the stimulation of endorphins. In addition, specific massage techniques may be helpful in reducing the myofascial trigger point pain by improving blood flow to the affected area. This increased blood flow reduces the collection of fluids, toxic metabolic waste products, and decreases ischemia." It cautions: "Massage is contraindicated in cases of inflammation, fever, heart conditions, or in cases of thrombosis or phlebitis."
My oncologist does not feel that massage is contraindicated in lymphoma. Other people online have reported the same -- their oncologist feels massage is ok. I have not run into anyone whose oncologist said otherwise.
I then undertook to query several massage therapists who were on America Online. Their responses varied from "donít do it" to "itís ok." Some said that they recalled being cautioned against massaging people with lymphoma in massage school because massage increases circulation and facilitates the activation of the lymph system. One person said that Pathology for Massage Therapists, by Don Newton, MA, DC (Simran Publications, second edition, year unknown) claims that massage is contraindicated for all white blood cell disorders, namely lymphoma, leukemia and multiple myeloma.
Another person sent this: "About 25 years ago it was thought that massage caused the cancer cell in a lymphoma to be circulated around the body, thus spreading the disease. It is now known that this is not the case at all."
The most helpful person was Dan, who wrote that he remembers being cautioned against it in school, but that he personally feels that it can only help by draining the lymph system, and possibly make chemotherapy more effective by moving the drugs into the tissues more effectively. He promised to find out more information from his medical contact. Some time later he sent the following note:
Vera. I now believe that massage is ok for people with lymphoma. Here is a letter from a doctor I know.
Dan, There is no medical reason why massage therapy is contraindicated for patients with lymphoma. Because lymphoma can sometimes go to the bones, many physicians prefer not to have their patients see chiropractors because there may be serious and permanent injury, but there is NO reason why a person should not get massage. There is one situation where massage may not be a good idea. Sometimes because of the lymphoma and sometimes because of the chemotherapy, the patient's platelet count may be decreased. When the platelet count is decreased, there is a tendency to have serious bruising and bleeding. If the platelet count is ok, the massage should be as well.
I am sorry for the delay in getting the info to you. I hope it is helpful to
you. Stay well, Dan
More recently, I contacted the AMTA (American Massage Therapy Association). They are at 847-864-0123 (Evanston, IL). I spoke with Christa Thomas, who did not have any literature regarding lymphoma and massage at all. She recommended that I contact the Massage Therapy Journal. They did have 5 articles on massage and cancer but nothing specific to lymphoma.
I also spoke with Kris at the Associated Bodywork and Massage Professionals (Evergreen. CO, 303-674-8478) who knew of no information specific to lymphoma but did send a page from their professional guidelines which advises massage professionals to avoid working on cancer patients unless they get a note from their oncologist that this is ok, because of fear of spreading metastases. She also mentioned a project at the University of Miami, the Touch Research Project, which has been investigating massage for the medical community. They have a web site which I have not seen. Apparently they have not done anything related to lymphoma but may in the future.
Other leads that could be investigated: massage therapists that specialize in working on cancer patients (they can be found through the various Wellness Communities and other cancer support centers); Office of Alternative Medicine, and the National Association of Nurse Massage Therapists.
I have concluded that some in the massage community have been spreading outdated information regarding lymphoma and massage, motivated perhaps by fears about professional liability in case the cancer does grow, and not understanding that lymphoma is usually widespread by definition. Such information does not agree with the information communicated by onconurses and oncologists.
I assume that massage is safe and beneficial for people with lymphoma, provided the above contraindications are observed. Based on what I know at present, I would probably skip it during chemotherapy treatment and any episodes of very low platelets (with the exception of some light touch massage), and if I had potentially curable NHL I would wait until after the treatment was completed and 6 months elapsed (as radiation and chemo keeps killing cells for several months after the treatment ends).
An interesting question for future researchers: Could massage be beneficial during treatment with monoclonal antibodies, helping to diffuse the antibodies throughout the body fluids and into all the tissues?
So, go and enjoy. Pleasure heals. :-)
Latest update: At the CFL miniconference on lymphoma in April 98, the first question from the audience was on massage. Dr Carol Portlock answered it, saying that she would not recommended it during treatment if the patient was experiencing low blood counts. She judged it fine otherwise, and recommended that the oil be washed off afterwards.
And one more thing: my spontaneous remission occurred at the tail end of a particularly massage-rich period of my life. For about a year and a half, I got a massage every two weeks or so. Then over a period of several months, all my nodes decreased about 80%.
Written by Vera Bradova © 1998-2001