What Research Tells Us About Massage for Cancer Related Fatigue

During treatment, it is common for cancer patients to experience cancer-related fatigue or lack of energy. This fatigue may be the result of their disease or the side effects of treatment and/or a broad range of physical and psychological comorbidities. Cancer-related fatigue affects 80 to 100 percent of people with cancer. [1]

 

In 2000, researchers conducted a survey of 379 cancer patients having a prior history of chemotherapy and concluded that cancer-related fatigue is multidimensional, described in terms of perceived energy, mental capacity, and psychological state. Such fatigue can impair day-to-day functioning, leading to negative impact on quality of life, self-care capabilities and even desire to continue treatment., Cancer-related fatigue even can become the most significant barrier to functional recovery in cancer patients with stable disease who are undergoing chemotherapy. [2]

 

How do patients describe cancer-related fatigue?

 

Cance-related fatigue can interfere with managing day-to-day tasks. The level of fatigue can range from feeling tired to feeling completely drained of energy. Resting or getting a good night’s sleep does not help.

 

When the fatigue starts also varies. Sometimes it can start even before a cancer diagnosis. In other cases, symptoms start after a diagnosis. And in others, the fatigue does not start until patients begin chemotherapy or radiation treatment. For some patients, even after treatment ends, the cancer-related fatigue continues. [3]

 

Underlying causes of cancer fatigue

 

Factors contributing to cancer fatigue include the immune system working hard to fight the disease. When this happens, the immune system is drawing energy. Other factors or changes that happen that can bring fatigue:[4]

 

·         Trying to keep up with normal day-to-day activities. Using energy when there is not much to spare because fighting the disease can cause fatigue.

 

·         Depression and anxiety that comes with cancer can cause fatigue and dampen a patient’s spirit.

 

·         Chronic, severe pain increases fatigue.

 

·         Stress from having the disease and worries about the future can exacerbate fatigue.

 

·         Tumor cells compete for nutrients, often at the expense of normal cells’ growth and metabolism. Common results are weight loss, decrease in appetite and fatigue.

 

Someone also may experience cancer-related fatigue from cancer treatments including:[5]

 

·         Chemotherapy: A chemotherapy drug can cause fatigue, which can last throughout treatment and even after completing treatment.

 

·         Radiation treatment: Radiation therapy can cause cumulative fatigue, which means it increases over time. Cancer-related fatigue from radiation usually lasts from three to four weeks after treatment stops but can continue for up to two to three months.

 

·         Immunotherapy: Immunotherapy stimulates the immune system to fight cancer. Cancer fatigue from immunotherapy may last from a few months to a year after treatment.

 

·         Stem cell (bone marrow) transplant: It can cause cancer fatigue lasting up to one year.

 

Role of massage therapy in cancer-fatigue treatment

 

There is no single medication available to treat cancer-related fatigue though some medications can help treat underlying causes. Several research studies have explored the effectiveness of massage therapy as part of cancer-fatigue treatment.

 

A 2018 study[6] by Emory University School of Medicine evaluated the efficacy of weekly Swedish Massage Therapy (SMT) versus an active control condition (light touch, LT) and waitlist control (WLC) on persistent cancer-related fatigue in breast cancer survivors. The early phase randomized, single-masked, six-week investigation of SMT, LT and WLC enrolled sixty-six female Stage 0-III breast cancer survivors age 32–72 who had received surgery plus radiation and/or chemotherapy/chemoprevention with cancer-related fatigue.

 

The study concluded SMT produced clinically significant relief of CRF. This suggests that six weeks of safe, widely accepted manual intervention causes a significant reduction in fatigue, a debilitating after effect for cancer survivors.

 

Another study[7] published in 2023 investigated the effectiveness of cancer-related fatigue with positive results. The research included the review of eight databases from inception to May 2022 for randomized controlled trials. The review included eleven qualified studies that included 789 patients (massage therapy group: 389; control group: 400) in the meta-analysis.

 

The conclusion of the review was that massage therapy can be effective in relieving cancer-related fatigue in cancer patients. The review suggested that reflexology is the most effective approach, especially in breast cancer patients. The optimal intervention frequency and cycle for massage therapy is twice a week for three to five weeks, and the optimal duration is 20-40 min.

 

And another quasi-experimental study[8], randomly assigned eighty-eight gastrointestinal cancer patients to either an intervention or control group to examine the effect foot massage had on fatigue when compared to standard care. Participants in the intervention group received four sessions of foot massage with an interval of 40 minutes during chemotherapy. The massage duration was seven minutes per foot. Fatigue was directly after intervention and 24 hours after chemotherapy. 

 

The results showed a significant difference in the mean score of fatigue between the two groups immediately after chemotherapy. In the intervention group, fatigue scores decreased gradually; fatigue scores in the control group increased. Researchers said the study demonstrated that foot massage could be a simple method to reduce chemotherapy-induced fatigue.

 

These research studies show there are benefits of massage for those needing help managing