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Zhang H, Yang Y, Cao Y, Guan J. Effects of chronic stress on cancer development and the therapeutic prospects of adrenergic signaling regulation. Biomed Pharmacother 2024; 175:116609. [PMID: 38678960 DOI: 10.1016/j.biopha.2024.116609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
Long-term chronic stress is an important factor in the poor prognosis of cancer patients. Chronic stress reduces the tissue infiltration of immune cells in the tumor microenvironment (TME) by continuously activating the adrenergic signaling, inhibits antitumor immune response and tumor cell apoptosis while also inducing epithelial-mesenchymal transition (EMT) and tumor angiogenesis, promoting tumor invasion and metastasis. This review first summarizes how adrenergic signaling activates intracellular signaling by binding different adrenergic receptor (AR) heterodimers. Then, we focused on reviewing adrenergic signaling to regulate multiple functions of immune cells, including cell differentiation, migration, and cytokine secretion. In addition, the article discusses the mechanisms by which adrenergic signaling exerts pro-tumorigenic effects by acting directly on the tumor itself. It also highlights the use of adrenergic receptor modulators in cancer therapy, with particular emphasis on their potential role in immunotherapy. Finally, the article reviews the beneficial effects of stress intervention measures on cancer treatment. We think that enhancing the body's antitumor response by adjusting adrenergic signaling can enhance the efficacy of cancer treatment.
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Affiliation(s)
- Hao Zhang
- Department of Oncology, The Eighth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100091, China; Department of Oncology, The Fifth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100071, China.
| | - Yuwei Yang
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing Key Laboratory of OTIR, Beijing, 100091, China.
| | - Yan Cao
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing Key Laboratory of OTIR, Beijing, 100091, China.
| | - Jingzhi Guan
- Department of Oncology, The Fifth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100071, China.
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2
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Packheiser J, Hartmann H, Fredriksen K, Gazzola V, Keysers C, Michon F. A systematic review and multivariate meta-analysis of the physical and mental health benefits of touch interventions. Nat Hum Behav 2024:10.1038/s41562-024-01841-8. [PMID: 38589702 DOI: 10.1038/s41562-024-01841-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/29/2024] [Indexed: 04/10/2024]
Abstract
Receiving touch is of critical importance, as many studies have shown that touch promotes mental and physical well-being. We conducted a pre-registered (PROSPERO: CRD42022304281) systematic review and multilevel meta-analysis encompassing 137 studies in the meta-analysis and 75 additional studies in the systematic review (n = 12,966 individuals, search via Google Scholar, PubMed and Web of Science until 1 October 2022) to identify critical factors moderating touch intervention efficacy. Included studies always featured a touch versus no touch control intervention with diverse health outcomes as dependent variables. Risk of bias was assessed via small study, randomization, sequencing, performance and attrition bias. Touch interventions were especially effective in regulating cortisol levels (Hedges' g = 0.78, 95% confidence interval (CI) 0.24 to 1.31) and increasing weight (0.65, 95% CI 0.37 to 0.94) in newborns as well as in reducing pain (0.69, 95% CI 0.48 to 0.89), feelings of depression (0.59, 95% CI 0.40 to 0.78) and state (0.64, 95% CI 0.44 to 0.84) or trait anxiety (0.59, 95% CI 0.40 to 0.77) for adults. Comparing touch interventions involving objects or robots resulted in similar physical (0.56, 95% CI 0.24 to 0.88 versus 0.51, 95% CI 0.38 to 0.64) but lower mental health benefits (0.34, 95% CI 0.19 to 0.49 versus 0.58, 95% CI 0.43 to 0.73). Adult clinical cohorts profited more strongly in mental health domains compared with healthy individuals (0.63, 95% CI 0.46 to 0.80 versus 0.37, 95% CI 0.20 to 0.55). We found no difference in health benefits in adults when comparing touch applied by a familiar person or a health care professional (0.51, 95% CI 0.29 to 0.73 versus 0.50, 95% CI 0.38 to 0.61), but parental touch was more beneficial in newborns (0.69, 95% CI 0.50 to 0.88 versus 0.39, 95% CI 0.18 to 0.61). Small but significant small study bias and the impossibility to blind experimental conditions need to be considered. Leveraging factors that influence touch intervention efficacy will help maximize the benefits of future interventions and focus research in this field.
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Affiliation(s)
- Julian Packheiser
- Social Neuroscience, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany.
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands.
| | - Helena Hartmann
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
- Center for Translational and Behavioral Neuroscience, University Hospital Essen, Essen, Germany
- Clinical Neurosciences, Department for Neurology, University Hospital Essen, Essen, Germany
| | - Kelly Fredriksen
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Valeria Gazzola
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Christian Keysers
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
| | - Frédéric Michon
- Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Art and Sciences, Amsterdam, the Netherlands
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3
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Chang A, Sloan EK, Antoni MH, Knight JM, Telles R, Lutgendorf SK. Biobehavioral Pathways and Cancer Progression: Insights for Improving Well-Being and Cancer Outcomes. Integr Cancer Ther 2022; 21:15347354221096081. [PMID: 35579197 PMCID: PMC9118395 DOI: 10.1177/15347354221096081] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The relationship between psychosocial factors and cancer has intrigued people for centuries. In the last several decades there has been an expansion of mechanistic research that has revealed insights regarding how stress activates neuroendocrine stress-response systems to impact cancer progression. Here, we review emerging mechanistic findings on key pathways implicated in the effect of stress on cancer progression, including the cellular immune response, inflammation, angiogenesis, and metastasis, with a primary focus on the mediating role of the sympathetic nervous system. We discuss converging findings from preclinical and clinical cancer research that describe these pathways and research that reveals how these stress pathways may be targeted via pharmacological and mind-body based interventions. While further research is required, the body of work reviewed here highlights the need for and feasibility of an integrated approach to target stress pathways in cancer patients to achieve comprehensive cancer treatment.
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Affiliation(s)
- Aeson Chang
- Monash Institute of Pharmaceutical Sciences, Drug Discovery Biology, Monash University, Parkville, VIC, Australia
| | - Erica K Sloan
- Monash Institute of Pharmaceutical Sciences, Drug Discovery Biology, Monash University, Parkville, VIC, Australia.,Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.,Peter MacCallum Cancer Centre, Division of Surgery, Melbourne, VIC, Australia
| | - Michael H Antoni
- Departments of Psychology, Psychiatry, and Behavioral Sciences, and Cancer Control Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Jennifer M Knight
- Department of Psychiatry and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rachel Telles
- Departments of Psychological and Brain Sciences, Obstetrics and Gynecology, and Urology, and Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Susan K Lutgendorf
- Departments of Psychological and Brain Sciences, Obstetrics and Gynecology, and Urology, and Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
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4
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Tague C, Seppelfrick D, MacKenzie A. Massage Therapy in the Time of COVID-19. J Altern Complement Med 2021; 27:467-472. [PMID: 33794106 DOI: 10.1089/acm.2021.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Carolyn Tague
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Dianne Seppelfrick
- Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA
| | - Adrien MacKenzie
- Osher Center for Integrative Medicine, Vanderbilt University, Nashville, TN, USA
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Borgi M, Collacchi B, Ortona E, Cirulli F. Stress and coping in women with breast cancer:unravelling the mechanisms to improve resilience. Neurosci Biobehav Rev 2020; 119:406-421. [PMID: 33086128 DOI: 10.1016/j.neubiorev.2020.10.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
Breast cancer diagnosis, surgery, adjuvant therapies and survivorship can all be extremely stressful. In women, concerns about body image are common as a result of the disease and can affect interpersonal relationships, possibly leading to social isolation, increasing the likelihood for mood disorders. This is particularly relevant as women are at greater risk to develop anxiety and depressive symptoms in response to highly stressful situations. Here we address the mechanisms and the pathways activated as a result of stress and contributing to changes in the pathophysiology of breast cancer, as well as the potential of stress management factors and interventions in buffering the deleterious effects of chronic stress in a gender perspective. An improved understanding of the biological mechanisms linking stress-management resources to health-relevant biological processes in breast cancer patients could reveal novel therapeutic targets and help clarifying which psychosocial interventions can improve cancer outcomes, ultimately offering a unique opportunity to improve contemporary cancer treatments.
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Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Barbara Collacchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elena Ortona
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Lopes-Júnior LC, Rosa GS, Pessanha RM, Schuab SIPDC, Nunes KZ, Amorim MHC. Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review. Rev Lat Am Enfermagem 2020; 28:e3377. [PMID: 33027406 PMCID: PMC7529450 DOI: 10.1590/1518-8345.4213.3377] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/24/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care. METHOD a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers. RESULTS eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%). CONCLUSION while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.
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7
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Manual Therapy as Treatment for Chronic Musculoskeletal Pain in Female Breast Cancer Survivors: A Systematic Review and Meta-Analysis. J Manipulative Physiol Ther 2020; 42:503-513. [PMID: 31864435 DOI: 10.1016/j.jmpt.2018.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to investigate the effectiveness of manual therapy (MT) for chronic musculoskeletal pain (CMP) in the upper limbs and thorax of female breast cancer survivors and to investigate the changes in the quality of life and function of these patients. METHODS Systematic searches were performed in the databases MEDLINE/PubMed, Cumulative Index of Nursing and Allied Health/EBSCO, Web of Science, and Physiotherapy Evidence Database, through March 2018, to identify randomized controlled trials investigating whether MT was effective to treat CMP pain in female breast cancer survivors (PROSPERO number CDR42017074175). RESULTS The database searches retrieved 1562 titles, and after screening, 5 papers were included for full analysis. The manual therapy techniques described in the included studies involved myofascial induction, myofascial release, classic massage, ischemic compression of trigger points, and myofascial therapy. A meta-analysis, using a fixed-effects model, found that MT decreased CMP intensity (standardized mean difference: 0.32; 95% CI 0.06-0.57), but no significant difference was observed in quality of life after the MT intervention in comparison with a control condition (standardized mean difference: 0.14; 95% CI 0.17-0.46). CONCLUSION Current evidence suggests that MT is considered effective for treating CMP in the upper limbs and thorax of female breast cancer survivors.
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Mühlenpfordt I, Stritter W, Bertram M, Ben-Arye E, Seifert G. The power of touch: external applications from whole medical systems in the care of cancer patients (literature review). Support Care Cancer 2020; 28:461-471. [PMID: 31781950 DOI: 10.1007/s00520-019-05172-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 11/05/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE In the context of whole medical systems (WMSs), external applications are manual treatments that stem from complementary medicine and are performed by practitioners, nurses and caregivers through the application of interpersonal touch. These applications work via physiological, psychological and social processes and are intended for holistic healing. In integrative oncology, these applications are used to improve patients' wellbeing. The purpose of the review is to collect and compare research results concerning external applications from WMSs applied to patients with cancer. METHODS We conducted a literature review to explore the effects of external applications on patients undergoing cancer treatment. Inclusion criteria were external applications from Anthroposophic Medicine, Traditional Chinese Medicine (TCM) and Ayurvedic Medicine, examined detached from the effect interdependencies of their respective WMSs. RESULTS Searches identified 111 publications. Final inclusions were four Shiatsu studies (from TCM), supplemented by two case reports exploring anthroposophic external applications. The literature review suggests that external applications may improve patients' wellbeing during cancer treatment and are associated with physical and psychological effects that potentially enhance supportive cancer care. The number and quality of published studies in the field is limited. CONCLUSIONS Future empirical investigations should assess the effectiveness and underlying effects in patients with cancer, adhere to a patient-tailored approach, and investigate the systemic complexity of touch-based applications from WMSs.
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Affiliation(s)
- Inga Mühlenpfordt
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Mathias Bertram
- Doerthe-Krause-Institute for Nursing Science and Education, Gemeinschaftskrankenhaus Herdecke gGmbH, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Eran Ben-Arye
- Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Lin and Carmel Medical Centers, Clalit Health Services, Tel Aviv-Yafo, Israel.,The Bruce Rappaport Faculty of Medicine, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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9
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Tarsha MS, Park S, Tortora S. Body-Centered Interventions for Psychopathological Conditions: A Review. Front Psychol 2020; 10:2907. [PMID: 32038351 PMCID: PMC6993757 DOI: 10.3389/fpsyg.2019.02907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 12/09/2019] [Indexed: 01/20/2023] Open
Abstract
World-wide, billions of dollars are spent each year on body-centered interventions to alleviate both physical and psychological pathologies. Given the high demand and increasing popularity of body-centered interventions, there is need for a systematic organization of empirical evidence associated with body-centered therapies. This article reviews the psychological effects of body-centered interventions on emotional well-being, including both self and other-administered (receptive) therapies. Theory behind body-centered interventions rely upon the bidirectional communication pathway between the brain and body. We investigated the bidirectional communication pathway between the brain and body by evaluating evidence across multiple body-centered therapies. The research reviewed includes studies that investigate effects of massage therapy, reflexology, acupuncture, functional relaxation, emotional freedom technique, Rolfing, yoga, tai-chi, and dance/movement therapy on psychological conditions across the lifespan. Results demonstrated that overall, massage therapy, tai-chi, dance/movement therapy, functional relaxation, reflexology, acupuncture and emotional freedom technique seem to alleviate stress, depression, anxiety, bipolar disorder and facilitate pain reduction. Of these, the most robust evidence available was for massage therapy, indicating it is an effective intervention for numerous age groups and populations. Rolfing and reflexology had the least amount of support, with few studies available that had small sample sizes. Although these conclusions are limited by scarcity of high-quality empirical data and contradictory findings, available evidence indicates that body-centered interventions can be effective in reducing psychopathology and supports the proposed mechanism of the bidirectional pathway between the brain and body: the body holds the potential to influence the mind. Integrating body-centered therapies in both clinical settings and as self-care could lead to better outcomes. Lastly, we propose the first taxonomy of body-centered interventions and empirical evidence of their effectiveness for clinicians and researchers.
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Affiliation(s)
- Mary S. Tarsha
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, United States
| | - Suzi Tortora
- Dancing Dialogue: Healing and Expressive Arts, New York, NY, United States
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10
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Karrasch S, Hitzler M, Gumpp A, Karabatsiakis A, Kolassa IT. Molekulartoxische Folgen von chronischem und traumatischem Stress und deren Reversibilität durch entspannungs- und achtsamkeitsbasierte Interventionen. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000505380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Behzadmehr R, Dastyar N, Moghadam MP, Abavisani M, Moradi M. Effect of complementary and alternative medicine interventions on cancer related pain among breast cancer patients: A systematic review. Complement Ther Med 2020; 49:102318. [PMID: 32147038 DOI: 10.1016/j.ctim.2020.102318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE This systematic review aimed to evaluate the efficacy of CAM interventions for cancer-related pain in breast cancer patients. METHODS Databases (PubMed, Scopus, Web of Science, and EMBASE) were searched from January 1, 2000, up to April 31, 2019, using the keywords: Complementary and alternative medicine therapies and cancer related pain. Standard tools were used to evaluate the quality of the studies included. RESULTS Of the 3742 articles found, 46 articles comprising 3685 participants entered the final phase. Our results indicate that interventions including acupuncture/acupressure, tai chi/qi gong, hypnosis, meditation, music therapy, yoga, massage, reflexology, and Reiki improve cancer-related pain in breast cancer patients. However, aromatherapy had no effect on the same. CONCLUSIONS Despite the positive effect of various CAM interventions in reducing cancer-related pain, necessary precautions should be adopted to use them alongside other treatments to control cancer pain in the clinical setting.
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Affiliation(s)
- Razieh Behzadmehr
- Department of Radiology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Neda Dastyar
- Department of Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Mahdieh Poodineh Moghadam
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahnaz Abavisani
- MSc of Medical Surgical Nursing, Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mandana Moradi
- Clinical Pharmacy Department, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran.
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12
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Eaton LH, Hulett JP, Langford DJ, Doorenbos AZ. How Theory Can Help Facilitate Implementing Relaxation as a Complementary Pain Management Approach. Pain Manag Nurs 2019; 20:207-213. [PMID: 31097374 DOI: 10.1016/j.pmn.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/29/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
Abstract
Complementary therapies provide cancer survivors and clinicians with options for managing chronic pain. Recent published clinical guidelines and research findings support the use of relaxation therapy for managing chronic pain in cancer survivors. However, translating research findings into clinical practice remains a challenge. Using theory to guide implementation of a new practice can increase the likelihood of successful adoption. This article uses relaxation therapy for cancer survivors to describe how clinicians could use Rogers' Diffusion of Innovation Theory and the related Collaborative Research Utilization Model to implement a complementary therapy and ensure that it becomes standard practice.
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Affiliation(s)
- Linda H Eaton
- School of Nursing & Health Studies, University of Washington Bothell, Bothell, Washington.
| | - Jennifer P Hulett
- College of Nursing, University of South Carolina, Columbia, South Carolina
| | - Dale J Langford
- School of Medicine, University of Washington, Seattle, Washington
| | - Ardith Z Doorenbos
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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13
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Antoni MH, Dhabhar FS. The impact of psychosocial stress and stress management on immune responses in patients with cancer. Cancer 2019; 125:1417-1431. [PMID: 30768779 PMCID: PMC6467795 DOI: 10.1002/cncr.31943] [Citation(s) in RCA: 142] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/22/2018] [Accepted: 08/16/2018] [Indexed: 12/20/2022]
Abstract
The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress-management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress-management interventions may provide important adjuncts to clinical cancer care going forward.
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Affiliation(s)
- Michael H. Antoni
- Department of Psychology, University of Miami and Sylvester Comprehensive Cancer Center, University of Miami School of Medicine
| | - Firdaus S. Dhabhar
- Department of Psychiatry and Behavioral Sciences, and Sylvester Comprehensive Cancer Center, University of Miami School of Medicine
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14
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Donoyama N, Satoh T, Hamano T, Ohkoshi N, Onuki M. Effects of Anma therapy (Japanese massage) on health-related quality of life in gynecologic cancer survivors: A randomized controlled trial. PLoS One 2018; 13:e0196638. [PMID: 29723235 PMCID: PMC5933696 DOI: 10.1371/journal.pone.0196638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/05/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives Anma therapy (Japanese massage therapy, AMT) significantly reduces the severity of physical complaints in survivors of gynecologic cancer. However, whether this reduction of severity is accompanied by improvement in health-related quality of life is unknown. Methods Forty survivors of gynecologic cancer were randomly allocated to either an AMT group that received one 40-min AMT session per week for 8 weeks or a no-AMT group. We prospectively measured quality of life by using the Japanese version of the European Organization for Research and Treatment of Cancer QLQ-C30 version 3.0 (EORTC QLQ-C30) at baseline and at 8-week follow-up. The QLQ-C30 response rate was 100%. Hospital Anxiety Depression Scale (HADS), Profile of Mood States (POMS), and Measure of Adjustment to Cancer were also prespecified and prospectively evaluated. Results The QLQ-C30 Global Health Status and Quality of Life showed significant improvement at 8 weeks (P = 0.042) in the AMT group compared with the no-AMT group, and the estimated mean difference reached a minimal clinically important difference of 10 points (10.4 points, 95% CI = 1.2 to 19.6). Scores on fatigue and insomnia showed significant improvement in the AMT group compared with the no-AMT group (P = 0.047 and 0.003, respectively). There were no significant between-group improvements in HADS anxiety and depression scales; however, POMS-assessed anger-hostility showed significant improvement in the AMT group compared with the no-AMT group (p = 0.028). Conclusions AMT improved health-related quality of life in gynecologic cancer survivors. AMT can be of potential benefit for applications in oncology.
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Affiliation(s)
- Nozomi Donoyama
- Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | - Norio Ohkoshi
- Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Ibaraki, Japan
| | - Mamiko Onuki
- Department of Obstetrics and Gynecology, University of Tsukuba, Tsukuba, Ibaraki, Japan
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15
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Kinkead B, Schettler PJ, Larson ER, Carroll D, Sharenko M, Nettles J, Edwards SA, Miller AH, Torres MA, Dunlop BW, Rakofsky JJ, Rapaport MH. Massage therapy decreases cancer-related fatigue: Results from a randomized early phase trial. Cancer 2018; 124:546-554. [PMID: 29044466 PMCID: PMC5780237 DOI: 10.1002/cncr.31064] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/15/2017] [Accepted: 09/07/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by cancer survivors, yet treatment options for CRF are limited. In this study, we evaluated the efficacy of weekly Swedish massage therapy (SMT) versus an active control condition (light touch [LT]) and waitlist control (WLC) on persistent CRF in breast cancer survivors. METHODS This early phase, randomized, single-masked, 6-week investigation of SMT, LT, and WLC enrolled 66 female stage 0-III breast cancer survivors (age range, 32-72 years) who had received surgery plus radiation and/or chemotherapy/chemoprevention with CRF (Brief Fatigue Inventory > 25). The primary outcome was the Multidimensional Fatigue Inventory (MFI), with the National Institutes of Health PROMIS Fatigue scale secondary. RESULTS Mean baseline MFI scores for 57 evaluable subjects were 62.95 for SMT, 55.00 for LT, and 60.41 for WLC. SMT resulted in a mean (standard deviation) 6-week reduction in MFI total scores of -16.50 (6.37) (n = 20) versus -8.06 (6.50) for LT (n = 20) and an increase of 5.88 (6.48) points for WLC (n = 17) (treatment-by-time P < .0001). The mean baseline PROMIS Fatigue scores were SMT, 22.25; LT, 22.05; and WLC, 23.24. The mean (standard deviation) reduction in PROMIS Fatigue scores was -5.49 (2.53) points for SMT versus -3.24 (2.57) points for LT and -0.06 (1.88) points for WLC (treatment-by-time P = .0008). Higher credibility, expectancy, and preference for SMT than for LT did not account for these results. CONCLUSION SMT produced clinically significant relief of CRF. This finding suggests that 6 weeks of a safe, widely accepted manual intervention causes a significant reduction in fatigue, a debilitating sequela for cancer survivors. Cancer 2018;124:546-54. © 2017 American Cancer Society.
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Affiliation(s)
- Becky Kinkead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Pamela J. Schettler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | | | | | | | - James Nettles
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
- Atlanta School of Massage, Atlanta, GA USA
| | - Sherry A. Edwards
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Andrew H. Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
- Winship Cancer Institute, Atlanta, GA USA
| | - Mylin A. Torres
- Winship Cancer Institute, Atlanta, GA USA
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA USA
| | - Boadie W. Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Jeffrey J. Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
| | - Mark Hyman Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA USA
- Winship Cancer Institute, Atlanta, GA USA
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Glantz-Gashai Y, Meirson T, Reuveni E, Samson AO. Virtual screening for potential inhibitors of Mcl-1 conformations sampled by normal modes, molecular dynamics, and nuclear magnetic resonance. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:1803-1813. [PMID: 28684899 PMCID: PMC5484510 DOI: 10.2147/dddt.s133127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Myeloid cell leukemia-1 (Mcl-1) is often overexpressed in human cancer and is an important target for developing antineoplastic drugs. In this study, a data set containing 2.3 million lead-like molecules and a data set of all the US Food and Drug Administration (FDA)-approved drugs are virtually screened for potential Mcl-1 ligands using Protein Data Bank (PDB) ID 2MHS. The potential Mcl-1 ligands are evaluated and computationally docked on to three conformation ensembles generated by normal mode analysis (NMA), molecular dynamics (MD), and nuclear magnetic resonance (NMR), respectively. The evaluated potential Mcl-1 ligands are then compared with their clinical use. Remarkably, half of the top 30 potential drugs are used clinically to treat cancer, thus partially validating our virtual screen. The partial validation also favors the idea that the other half of the top 30 potential drugs could be used in the treatment of cancer. The normal mode-, MD-, and NMR-based conformation greatly expand the conformational sampling used herein for in silico identification of potential Mcl-1 inhibitors.
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Affiliation(s)
| | - Tomer Meirson
- Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Eli Reuveni
- Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
| | - Abraham O Samson
- Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel
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Darabpour S, Kheirkhah M, Ghasemi E. Effects of Swedish Massage on the Improvement of Mood Disorders in Women with Breast Cancer undergoing Radiotherapy. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017; 18:e25461. [PMID: 28191337 PMCID: PMC5292140 DOI: 10.5812/ircmj.25461] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/03/2015] [Accepted: 03/16/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Breast cancer is the most common cancer in women, and the second leading cause of cancer deaths. The detection and treatment of this cancer may create mental pressure and lower mood levels, causing anxiety, depression, stress, and pain for the patients. OBJECTIVES The aim of this study was to determine the effects of Swedish massage on mood disorders in breast cancer patients undergoing radiotherapy at the cancer institute of the Imam Khomeini hospital at the Tehran University of Medical Sciences. PATIENTS AND METHODS This study consisted of a clinical trial including 100 patients with breast cancer. The participants were chosen randomly, with their consent, by the use of polling, to be included in the intervention group (which received a Swedish massage three times a week, for 30 minutes, over five weeks) and control group (which received routine care). At the beginning of the intervention and after 5 weeks, the mood disorders of the patients, including anger, anxiety, depression, and any positive affect, were assessed using the affective control scale (ACS) questionnaire. RESULTS Before the intervention, there was no significant difference in the average of the overall scale between the intervention and control groups in the subscales of anger, anxiety, depression, and positive affect (P = 0.469). The average of the overall scale in the Swedish massage group decreased from 3.52 ± 0.65 to 2.42 ± 0.76 when compared to the pre-intervention conditions, and to (P < 0.001) after the intervention. Moreover, the values for the control group were 3.41 ± 0.94 for the pre-intervention and 3.38 ± 0.9 after the intervention (P = 0.620). CONCLUSIONS When compared to the control group, the Swedish massage showed an improvement in the mood disorders of women with breast cancer.
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Affiliation(s)
- Sara Darabpour
- Department of Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Masoomeh Kheirkhah
- PhD of Medical Education, Assistant Professor, Department of Midwifery, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Masoomeh Kheirkhah, PhD of Medical Education, Assistant Professor, Department of Midwifery, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9124137578, Fax: +98-2188201978, E-mail:
| | - Erfan Ghasemi
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Billhult A, Stener-Victorin E, Bergbom I. The Experience of Massage During Chemotherapy Treatment in Breast Cancer Patients. Clin Nurs Res 2016; 16:85-99; discussion 100-2. [PMID: 17452429 DOI: 10.1177/1054773806298488] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to describe the experience of massage for breast cancer patients during chemotherapy treatment. Ten patients received massage at five occasions. They were interviewed and analysis was conducted using Giorgi's ideas of phenomenological research. The essential meaning of getting massage during chemotherapy was described as a retreat from the feeling of uneasiness toward chemotherapy. Results revealed five themes: the patients experienced distraction from the frightening experience, a turn from negative to positive, a sense of relaxation, a confirmation of caring, and finally they just felt good. In conclusion, the findings of this study show that massage offered a retreat from uneasy, unwanted, negative feelings connected with chemotherapy treatment. It is a treatment that can be added to the arsenal of treatment choices available to the oncological staff.
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Affiliation(s)
- Annika Billhult
- Department of Physiotherapy, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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Molouki A, Hosseini SM, Rustaee M, Tabatabaee SM. The Immediate Effects of Manual Massage of Forearm on Power-Grip Strength and Endurance in Healthy Young Men. J Chiropr Med 2016; 15:112-20. [PMID: 27330513 DOI: 10.1016/j.jcm.2016.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the immediate effects of a single massage session on hand grip strength and endurance after isometric exercise in healthy young men under controlled conditions. METHODS A total of 44 healthy young men from a university population participated in the study. They were randomized to receive either massage or passive movement intervention. Hand grip endurance and hand grip strength in both groups were recorded using a Jamar hand grip dynamometer and a digital chronometer before and after the intervention. Statistical analysis was performed using the Wilcoxon, Mann-Whitney, and paired t test as well as independent t test. RESULTS Pre-and postmean hand grip endurance times for the massage group were 38.4 ± 12 and 46.5 ± 13 seconds (P < .001), and hand grip strength values were 43 ± 5.6 and 45.7 ± 5.3 kg (P = .077). Pre-and postmean hand grip endurance times for the passive movement group were 33 ± 12.3 and 31.9 ± 10.7 seconds (P = .513), and hand grip strength values were 42.8 ± 6 and 42.9 ± 5.6 kg (P = .854). CONCLUSION Immediately after 1 session of massage to the forearm and hand, the grip endurance improved in a group of healthy young men. However, passive movement of the upper limb for 1 session did not enhance grip performance.
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Affiliation(s)
- Ali Molouki
- Researcher, Physical Therapy MSc, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Majid Hosseini
- Assistant Professor, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammedmohsen Rustaee
- Assistant Professor, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehdi Tabatabaee
- Instructor, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Acupoint stimulation, massage therapy and expressive writing for breast cancer: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2016; 27:87-101. [PMID: 27515882 DOI: 10.1016/j.ctim.2016.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 03/23/2016] [Accepted: 06/10/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Researches have accumulated using non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing to manage breast cancer-related symptoms. Results from randomized controlled trials (RCTs) can get contradictory. OBJECTIVE A systematic review and meta-analysis were conducted to determine the effects on the quality of life, negative emotions and disease-related symptoms among women with breast cancer. METHODS Two independent researchers performed a structured search using data sources including MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed and PsychINFO from the beginning of time until the first week of January 2015. A total of 23 acupoint stimulation, massage therapy and expressive writing RCTs were included in the review. RESULTS The study showed that no single intervention could be put under the spotlight exhibiting an overall effective result on all measured outcomes; however, looking into each one in detail shows different results in specific outcomes. Among the three interventions, acupoint stimulation has a treatment effect for general pain (MD=-1.46, 95% CI=-2.38 to -0.53) and fatigue (MD=-2.22, 95% CI=-3.68 to -0.77), massage therapy has a treatment effect for anxiety (MD=-0.50, 95% CI=-0.77 to -0.24), and expressive writing has a treatment effect for quality of life (MD=7.18, 95% CI=0.38 to 13.98). The measurement other outcomes showed either ineffective or equivocal results. CONCLUSION Non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing have an effect on a middle-age woman with breast cancer. However, because of limitations, the seemingly promising results should be interpreted with caution.
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Shin E, Seo K, Lee S, Jang J, Jung Y, Kim M, Yeon J. Massage with or without aromatherapy for symptom relief in people with cancer. Cochrane Database Syst Rev 2016; 2016:CD009873. [PMID: 27258432 PMCID: PMC10406396 DOI: 10.1002/14651858.cd009873.pub3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Massage and aromatherapy massage are used to relieve cancer-related symptoms. A number of claims have been made for these treatments including reduction of pain, anxiety, depression, and stress. Other studies have not shown these benefits. OBJECTIVES To evaluate the effects of massage with or without aromatherapy on pain and other symptoms associated with cancer. SEARCH METHODS We searched the following databases and trials registries up to August 2015: the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 7), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), PubMed Cancer Subset, SADCCT, and the World Health Organization (WHO) ICTRP. We also searched clinical trial registries for ongoing studies. SELECTION CRITERIA Randomised controlled studies (RCTs) reporting the effects of aromatherapy or massage therapy, or both, in people with cancer of any age. We applied no language restrictions. Comparators were massage (using carrier oil only) versus no massage, massage with aromatherapy (using carrier oil plus essential oils) versus no massage, and massage with aromatherapy (using carrier oil plus essential oils) versus massage without aromatherapy (using carrier oil only). DATA COLLECTION AND ANALYSIS At least two review authors selected studies, assessed the risk of bias, and extracted data relating to pain and other symptoms associated with cancer, using standardised forms. We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and created two 'Summary of findings' tables. MAIN RESULTS We included 19 studies (21 reports) of very low quality evidence with a total of 1274 participants. We included 14 studies (16 reports) in a qualitative synthesis and five studies in a quantitative synthesis (meta-analysis). Thirteen studies (14 reports, 596 participants) compared massage with no massage. Six studies (seven reports, 561 participants) compared aromatherapy massage with no massage. Two studies (117 participants) compared massage with aromatherapy and massage without aromatherapy. Fourteen studies had a high risk of bias related to sample size and 15 studies had a low risk of bias for blinding the outcome assessment. We judged the studies to be at unclear risk of bias overall. Our primary outcomes were pain and psychological symptoms. Two studies reported physical distress, rash, and general malaise as adverse events. The remaining 17 studies did not report adverse events. We downgraded the GRADE quality of evidence for all outcomes to very low because of observed imprecision, indirectness, imbalance between groups in many studies, and limitations of study design. Massage versus no-massage groupsWe analysed results for pain and anxiety but the quality of evidence was very low as most studies were small and considered at an unclear or high risk of bias due to poor reporting. Short-term pain (Present Pain Intensity-Visual Analogue Scale) was greater for the massage group compared with the no-massage group (one RCT, n = 72, mean difference (MD) -1.60, 95% confidence interval (CI) -2.67 to -0.53). Data for anxiety (State-Trait Anxiety Inventory-state) relief showed no significant difference in anxiety between the groups (three RCTs, n = 98, combined MD -5.36, 95% CI -16.06 to 5.34). The subgroup analysis for anxiety revealed that the anxiety relief for children was greater for the massage group compared with the no-massage group (one RCT, n = 30, MD -14.70, 95% CI -19.33 to -10.07), but the size of this effect was considered not clinically significant. Furthermore, this review demonstrated no differences in effects of massage on depression, mood disturbance, psychological distress, nausea, fatigue, physical symptom distress, or quality of life when compared with no massage. Massage with aromatherapy versus no-massage groupsWe analysed results for pain, anxiety, symptoms relating to the breast, and quality of life but the quality of evidence was very low as studies were generally at a high risk of bias. There was some indication of benefit in the aromatherapy-massage group but this benefit is unlikely to translate into clinical benefit. The relief of medium- and long-term pain (medium-term: one RCT, n = 86, MD 5.30, 95% CI 1.52 to 9.08; long-term: one RCT, n = 86, MD 3.80, 95% CI 0.19 to 7.41), anxiety (two RCTs, n = 253, combined MD -4.50, 95% CI -7.70 to -1.30), and long-term symptoms relating to the breast in people with breast cancer (one RCT, n = 86, MD -9.80, 95% CI -19.13 to -0.47) was greater for the aromatherapy-massage group, but the results were considered not clinically significant. The medium-term quality of life score was lower (better) for the aromatherapy-massage group compared with the no-massage group (one RCT, n = 30, MD -2.00, 95% CI -3.46 to -0.54). Massage with aromatherapy versus massage without aromatherapy groupsFrom the limited evidence available, we were unable to assess the effect of adding aromatherapy to massage on the relief of pain, psychological symptoms including anxiety and depression, physical symptom distress, or quality of life. AUTHORS' CONCLUSIONS There was a lack of evidence on the clinical effectiveness of massage for symptom relief in people with cancer. Most studies were too small to be reliable and key outcomes were not reported. Any further studies of aromatherapy and massage will need to address these concerns.
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Affiliation(s)
- Ein‐Soon Shin
- Korean Academy of Medical Sciences (KAMS)KAMS Research Center, Research Agency for Clinical Practice Guidelines44‐3 Hangang‐ro, 2(i)Yongsan‐guSeoulKorea, South140‐706
| | - Kyung‐Hwa Seo
- Research Institute for Healthcare Policy, Korean Medical AssociationDepartment of Research302‐75, Ichon 1‐dongSeoulKorea, South140 721
- Ewha Woman's UniversityDepartment of Medical SciencesSeoulKorea, South
| | - Sun‐Hee Lee
- EWHA Woman's University School of MedicineDepartment of Preventive Medicine911‐1 Mok‐6‐dongSuite A‐409SeoulSeoulKorea, South158 710
| | - Ji‐Eun Jang
- Korean Academy of Medical Sciences (KAMS)KAMS Research Center, Research Agency for Clinical Practice Guidelines44‐3 Hangang‐ro, 2(i)Yongsan‐guSeoulKorea, South140‐706
| | - Yu‐Min Jung
- EWHA Woman's University School of MedicineDepartment of Preventive Medicine911‐1 Mok‐6‐dongSuite A‐409SeoulSeoulKorea, South158 710
| | - Min‐Ji Kim
- EWHA Woman's University School of MedicineDepartment of Preventive Medicine911‐1 Mok‐6‐dongSuite A‐409SeoulSeoulKorea, South158 710
| | - Ji‐Yun Yeon
- Korean Academy of Medical Sciences (KAMS)KAMS Research Center, Research Agency for Clinical Practice Guidelines44‐3 Hangang‐ro, 2(i)Yongsan‐guSeoulKorea, South140‐706
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Jacobs S, Mowbray C, Cates LM, Baylor A, Gable C, Skora E, Estrada M, Cheng Y, Wang J, Lewin D, Hinds P. Pilot Study of Massage to Improve Sleep and Fatigue in Hospitalized Adolescents With Cancer. Pediatr Blood Cancer 2016; 63:880-6. [PMID: 26757318 DOI: 10.1002/pbc.25902] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/20/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adolescents with cancer experience many troubling symptoms, including sleep disruptions that can affect mood and quality of life. Massage is a safe and popular intervention that has demonstrated efficacy in pediatric and adult patients with cancer. This study aimed to assess the feasibility of conducting a massage intervention to help with sleep in hospitalized adolescent oncology patients. PROCEDURE Adolescents ages 12-21 with cancer who were expected to be hospitalized for at least four consecutive nights were recruited from the inpatient unit at Children's National Health System and randomized to either massage intervention or a waitlist control. Patients in the intervention group received one massage per night, for two or three nights. Sleep was measured with actigraphy and patient and proxy reported instruments were used to measure fatigue, mood, and anxiety. RESULTS The majority (78%) of patients approached for the study consented, and almost all patients in the intervention group (94%) received at least one massage, 69% received two, and rates of completion of instruments among adolescents were high demonstrating feasibility. There were trends toward increased night time and overall sleep in the intervention group compared with standard of care, but no differences between groups in the patient reported outcome measures. Participant and parent feedback on the intervention was positive and was the impetus for starting a clinical massage service at the hospital. CONCLUSIONS Massage for hospitalized adolescents with cancer is feasible, well received, and can potentially improve patients' sleep. A randomized multicenter efficacy study is warranted.
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Affiliation(s)
- Shana Jacobs
- Divison of Oncology, Center for Cancer and Blood Disorders, Children's National Health System, Washington, District of Columbia
| | - Catriona Mowbray
- Divison of Oncology, Center for Cancer and Blood Disorders, Children's National Health System, Washington, District of Columbia
| | | | - Allison Baylor
- Clinical Psychology Doctoral Program, Virginia Commonwealth University, Richmond, Virginia
| | - Christopher Gable
- Philadelphia College of Osteopathic Medicine and Children's Hospital of Philadelphia, Philadelpha, Pennsylvania
| | - Elizabeth Skora
- Division of Pulmonary and Sleep Medicine, Children's National Health System, Washington, District of Columbia
| | - Monica Estrada
- Divison of Oncology, Center for Cancer and Blood Disorders, Children's National Health System, Washington, District of Columbia
| | - Yao Cheng
- Center for Translational Science, Children's National Health System, Washington, District of Columbia
| | - Jichuan Wang
- Center for Translational Science, Children's National Health System, Washington, District of Columbia
| | - Daniel Lewin
- Division of Pulmonary and Sleep Medicine, Children's National Health System, Washington, District of Columbia
| | - Pamela Hinds
- Department of Nursing Research and Quality Outcomes, Center for Translational Science, Children's National Health System, Washington, DC
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Lopes-Júnior LC, Bomfim EO, Nascimento LC, Nunes MDR, Pereira-da-Silva G, Lima RAG. Non-pharmacological interventions to manage fatigue and psychological stress in children and adolescents with cancer: an integrative review. Eur J Cancer Care (Engl) 2015; 25:921-935. [PMID: 26374619 DOI: 10.1111/ecc.12381] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2015] [Indexed: 11/28/2022]
Abstract
Cancer-related fatigue (CRF) is the most stressful and prevalent symptom in paediatric oncology patients. This integrative review aimed to identify, analyse and synthesise the evidence of non-pharmacological intervention studies to manage fatigue and psychological stress in a paediatric population with cancer. Eight electronic databases were used for the search: PubMed, Web of Science, CINAHL, LILACS, EMBASE, SCOPUS, PsycINFO and the Cochrane Library. Initially, 273 articles were found; after the exclusion of repeated articles, reading of the titles, abstracts and the full articles, a final sample of nine articles was obtained. The articles were grouped into five categories: physical exercise, healing touch, music therapy, therapeutic massage, nursing interventions and health education. Among the nine studies, six showed statistical significance regarding the fatigue and/or stress levels, showing that the use of the interventions led to symptoms decrease. The most frequently tested intervention was programmed physical exercises. It is suggested that these interventions are complementary to conventional treatment and that their use can indicate an improvement in CRF and psychological stress.
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Affiliation(s)
- L C Lopes-Júnior
- University of São Paulo at Ribeirão Preto College of Nursing - USP, WHO Collaborating Centre for the Development of Nursing Research, Ribeirão Preto, SP, Brazil.
| | - E O Bomfim
- University of Saskatchewan at College of Medicine - UOfS, Saskatoon, SK, Canada
| | - L C Nascimento
- Department Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing - USP, Ribeirão Preto, SP, Brazil
| | - M D R Nunes
- Rio de Janeiro State University, College of Nursing - UERJ, Rio de Janeiro, RJ, Brazil
| | - G Pereira-da-Silva
- Department Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing - USP, Ribeirão Preto, SP, Brazil
| | - R A G Lima
- Department Maternal-Infant Nursing and Public Health, University of São Paulo at Ribeirão Preto College of Nursing - USP, Ribeirão Preto, SP, Brazil
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Smith PR, Cope D, Sherner TL, Walker DK. Update on research-based interventions for anxiety in patients with cancer. Clin J Oncol Nurs 2015; 18 Suppl:5-16. [PMID: 25427605 DOI: 10.1188/14.cjon.s3.5-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anxiety may begin at the moment a person is diagnosed with cancer and may fluctuate throughout the cancer trajectory as physical illness improves or declines. The purpose of this article is to present current evidence for nurses to implement interventions to reduce anxiety in patients who have cancer. The PubMed and CINAHL® databases were searched to identify relevant citations addressing interventions that treat or prevent anxiety symptoms in patients with cancer. Based on available evidence, the interventions addressed herein are categorized according to the Putting Evidence Into Practice (PEP®) rating schema. Interventions include pharmacologic and nonpharmacologic approaches to care, and meet criteria for three PEP categories: likely to be effective, effectiveness not established (the largest category of results), or effectiveness unlikely.
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Affiliation(s)
- Patsy R Smith
- College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City
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Rapaport MH, Schettler P, Breese C. A preliminary study of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals. J Altern Complement Med 2015; 16:1079-88. [PMID: 20809811 DOI: 10.1089/acm.2009.0634] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Massage therapy is a multi-billion dollar industry in the United States with 8.7% of adults receiving at least one massage within the last year; yet, little is known about the physiologic effects of a single session of massage in healthy individuals. The purpose of this study was to determine effects of a single session of Swedish massage on neuroendocrine and immune function. It was hypothesized that Swedish Massage Therapy would increase oxytocin (OT) levels, which would lead to a decrease in hypothalamic-pituitary-adrenal (HPA) activity and enhanced immune function. DESIGN The study design was a head-to-head, single-session comparison of Swedish Massage Therapy with a light touch control condition. Serial measurements were performed to determine OT, arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocytes markers, and mitogen-stimulated cytokine production. SETTING This research was conducted in an outpatient research unit in an academic medical center. SUBJECTS Medically and psychiatrically healthy adults, 18-45 years old, participated in this study. INTERVENTION The intervention tested was 45 minutes of Swedish Massage Therapy versus a light touch control condition, using highly specified and identical protocols. OUTCOME MEASURES The standardized mean difference was calculated between Swedish Massage Therapy versus light touch on pre- to postintervention change in levels of OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels. RESULTS Compared to light touch, Swedish Massage Therapy caused a large effect size decrease in AVP, and a small effect size decrease in CORT, but these findings were not mediated by OT. Massage increased the number of circulating lymphocytes, CD 25+ lymphocytes, CD 56+ lymphocytes, CD4 + lymphocytes, and CD8+ lymphocytes (effect sizes from 0.14 to 0.43). Mitogen-stimulated levels of interleukin (IL)-1ß, IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, and IFN-γ decreased for subjects receiving Swedish Massage Therapy versus light touch (effect sizes from -0.22 to -0.63). Swedish Massage Therapy decreased IL-4, IL-5, IL-10, and IL-13 levels relative to baseline measures. CONCLUSIONS Preliminary data suggest that a single session of Swedish Massage Therapy produces measurable biologic effects. If replicated, these findings may have implications for managing inflammatory and autoimmune conditions.
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Affiliation(s)
- Mark Hyman Rapaport
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center , Los Angeles, CA
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Abstract
Moderate pressure massage has contributed to many positive effects including increased weight gain in preterm infants, reduced pain in different syndromes including fibromyalgia and rheumatoid arthritis, enhanced attentiveness, reduced depression and enhanced immune function (increased natural killer cells and natural killer cell activity).Surprisingly, these recent studies have not been reviewed, highlighting the need for the current review. When moderate and light pressure massage have been compared in laboratory studies, moderate pressure massage reduced depression, anxiety and heart rate, and it altered EEG patterns, as in a relaxation response. Moderate pressure massage has also led to increased vagal activity and decreased cortisol levels. Functional magnetic resonance imaging data have suggested that moderate pressure massage was represented in several brain regions including the amygdala, the hypothalamus and the anterior cingulate cortex, all areas involved in stress and emotion regulation. Further research is needed to identify underlying neurophysiological and biochemical mechanisms associated with moderate pressure massage.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami Medical School, USA; Fielding Graduate University, USA.
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Bao Y, Kong X, Yang L, Liu R, Shi Z, Li W, Hua B, Hou W. Complementary and alternative medicine for cancer pain: an overview of systematic reviews. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2014; 2014:170396. [PMID: 24817897 PMCID: PMC4003746 DOI: 10.1155/2014/170396] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 02/25/2014] [Accepted: 03/07/2014] [Indexed: 12/22/2022]
Abstract
Background and Objective. Now with more and more published systematic reviews of Complementary and Alternative Medicine (CAM) on adult cancer pain, it is necessary to use the methods of overview of systematic review to summarize available evidence, appraise the evidence level, and give suggestions to future research and practice. Methods. A comprehensive search (the Cochrane Library, PubMed, Embase, and ISI Web of Knowledge) was conducted to identify all systematic reviews or meta-analyses of CAM on adult cancer pain. And the evidence levels were evaluated using GRADE approach. Results. 27 systematic reviews were included. Based on available evidence, we could find that psychoeducational interventions, music interventions, acupuncture plus drug therapy, Chinese herbal medicine plus cancer therapy, compound kushen injection, reflexology, lycopene, TENS, qigong, cupping, cannabis, Reiki, homeopathy (Traumeel), and creative arts therapies might have beneficial effects on adult cancer pain. No benefits were found for acupuncture (versus drug therapy or shame acupuncture), and the results were inconsistent for massage therapy, transcutaneous electric nerve stimulation (TENS), and Viscum album L plus cancer treatment. However, the evidence levels for these interventions were low or moderate due to high risk of bias and/or small sample size of primary studies. Conclusion. CAM may be beneficial for alleviating cancer pain, but the evidence levels were found to be low or moderate. Future large and rigor randomized controlled studies are needed to confirm the benefits of CAM on adult cancer pain.
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Affiliation(s)
- Yanju Bao
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Xiangying Kong
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Nanxiaojie, Dongzhimennei Avenue, Beijing 100700, China
| | - Liping Yang
- Department of Nephrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Rui Liu
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Zhan Shi
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Weidong Li
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Baojin Hua
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
| | - Wei Hou
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beixiange 5, Xicheng District, Beijing 100053, China
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Çelebioğlu A, Gürol A, Yildirim ZK, Büyükavci M. Effects of massage therapy on pain and anxiety arising from intrathecal therapy or bone marrow aspiration in children with cancer. Int J Nurs Pract 2014; 21:797-804. [PMID: 24689780 DOI: 10.1111/ijn.12298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cancer and its treatment are stressful and reduce the quality of life in children. The aim of this study was to investigate the effect of massage therapy on pain and anxiety arising from intrathecal therapy or bone marrow aspiration in children with cancer. We conducted a controlled pretest/posttest quasi-experimental study at a paediatric oncology unit in Turkey. Twenty-five children were enrolled in this study. Their pain and anxiety were determined using a visual analogue scale. When the pretest and posttest pain and anxiety levels of the groups were compared, no statistically significant difference was found (P > 0.05). It was determined that pain and anxiety levels in the experimental group decreased significantly. This study provides preliminary evidence for the effectiveness in children of massage in reducing pain and anxiety arising from intrathecal therapy or bone marrow aspiration.
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Affiliation(s)
- Ayda Çelebioğlu
- Department of Pediatric Nursing, Faculty of Health Science, Atatürk University, Erzurum, Turkey
| | - Ayşe Gürol
- Health Services Vocational School, Atatürk University, Erzurum, Turkey
| | - Zuhal Keskin Yildirim
- Division of Pediatric Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Mustafa Büyükavci
- Division of Pediatric Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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Pan YQ, Yang KH, Wang YL, Zhang LP, Liang HQ. Massage interventions and treatment-related side effects of breast cancer: a systematic review and meta-analysis. Int J Clin Oncol 2013; 19:829-41. [PMID: 24275985 DOI: 10.1007/s10147-013-0635-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Massage as a complementary and alternative therapy has been associated with enhancing health and coping with treatment-related side effects in patients with breast cancer worldwide. This systematic review examined whether massage interventions provide any measurable benefit in breast cancer-related symptoms. METHODS Randomized controlled trials (RCTs) were searched for in PubMed, EMBASE.com and the Cochrane Library through June 2013. We evaluated the quality of the studies included by the Cochrane Handbook 5.2 standards and analyzed the data using the Cochrane Collaboration's RevMan 5.2 software. RESULTS Eighteen RCTs with a total of 950 participants were included. Compared with the control group, our meta-analysis showed that patients receiving regular use of massage had significantly greater reductions in anger and fatigue symptoms. However, there were no significant differences in depression, anxiety, pain, upper limb lymphedema, cortisol and health-related quality of life. CONCLUSIONS The current evidence demonstrates that there was mild evidence that massage may be a useful intervention in alleviating negative emotions and fatigue in patients with breast cancer. More trials with longer follow-up are needed to determine the exact long-term efficacy of this class of complementary and alternative medicine on breast cancer-related symptoms and quality of life.
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Affiliation(s)
- Yuan Q Pan
- Department of Medical Psychology, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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Waters-Banker C, Butterfield TA, Dupont-Versteegden EE. Immunomodulatory effects of massage on nonperturbed skeletal muscle in rats. J Appl Physiol (1985) 2013; 116:164-75. [PMID: 24201707 DOI: 10.1152/japplphysiol.00573.2013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Massage is an ancient manual therapy widely utilized by individuals seeking relief from various musculoskeletal maladies. Despite its popularity, the majority of evidence associated with massage benefits is anecdotal. Recent investigations have uncovered physiological evidence supporting its beneficial use following muscle injury; however, the effects of massage on healthy, unperturbed skeletal muscle are unknown. Utilizing a custom-fabricated massage mimetic device, the purpose of this investigation was to elucidate the effects of various loading magnitudes on healthy skeletal muscle with particular interest in the gene expression profile and modulation of key immune cells involved in the inflammatory response. Twenty-four male Wistar rats (200 g) were subjected to cyclic compressive loading (CCL) over the right tibialis anterior muscle for 30 min, once a day, for 4 consecutive days using four loading conditions: control (0N), low load (1.4N), moderate load (4.5N), and high load (11N). Microarray analysis showed that genes involved with the immune response were the most significantly affected by application of CCL. Load-dependent changes in cellular abundance were seen in the CCL limb for CD68(+) cells, CD163(+) cells, and CD43(+)cells. Surprisingly, load-independent changes were also discovered in the non-CCL contralateral limb, suggesting a systemic response. These results show that massage in the form of CCL exerts an immunomodulatory response to uninjured skeletal muscle, which is dependent upon the applied load.
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Khiewkhern S, Promthet S, Sukprasert A, Eunhpinitpong W, Bradshaw P. Effectiveness of aromatherapy with light thai massage for cellular immunity improvement in colorectal cancer patients receiving chemotherapy. Asian Pac J Cancer Prev 2013; 14:3903-7. [PMID: 23886205 DOI: 10.7314/apjcp.2013.14.6.3903] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with colorectal cancer are usually treated with chemotherapy, which reduces the number of blood cells, especially white blood cells, and consequently increases the risk of infections. Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by, for example, increasing the numbers of natural killer cells and peripheral blood lymphocytes. However, there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer. The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer, who have received chemotherapy, can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects. MATERIALS AND METHODS Sixty-six patients with colorectal cancer in Phichit Hospital, Thailand, were enrolled in a single-blind, randomised-controlled trial. The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period. The control group received standard supportive care only. Assessments were conducted at pre-assessment and at the end of one week of massage or standard care. Changes from pre-assessment to the end of treatment were measured in terms of white blood cells, neutrophils, lymphocytes, CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores. RESULTS The main finding was that after adjusting for pre-assessment values the mean lymphocyte count at the post-assessment was significantly higher (P=0.04) in the treatment group than in the controls. The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11%. The secondary outcomes were that at the post assessment the symptom severity scores for fatigue, presenting symptom, pain and stress were significantly lower in the massage group than in the standard care controls. CONCLUSIONS Aromatherapy with light Thai massage can be beneficial for the immune systems of cancer patients who are undergoing chemotherapy by increasing the number of lymphocytes and can help to reduce the severity of common symptoms.
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Affiliation(s)
- Santisith Khiewkhern
- Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
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Ang JY, Lua JL, Mathur A, Thomas R, Asmar BI, Savasan S, Buck S, Long M, Shankaran S. A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants. Pediatrics 2012; 130:e1549-58. [PMID: 23147978 PMCID: PMC3507248 DOI: 10.1542/peds.2012-0196] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the effects of massage therapy (MT) on the immune system of preterm infants. The primary hypothesis was that MT compared with sham therapy (control) will enhance the immune system of stable premature infants by increasing the proportion of their natural killer (NK) cell numbers. METHODS A randomized placebo-controlled trial of MT versus sham therapy (control) was conducted among stable premature infants in the NICU. Study intervention was provided 5 days per week until hospital discharge for a maximum of 4 weeks. Immunologic evaluations (absolute NK cells, T and B cells, T cell subsets, and NK cytotoxicity), weight, number of infections, and length of hospital stay were also evaluated. RESULTS The study enrolled 120 infants (58 massage; 62 control). At the end of the study, absolute NK cells were not different between the 2 groups; however, NK cytotoxicity was higher in the massage group, particularly among those who received ≥5 consecutive days of study intervention compared with control (13.79 vs 10 lytic units, respectively; P = .04). Infants in the massage group were heavier at end of study and had greater daily weight gain compared with those in the control group; other immunologic parameters, number of infections, and length of stay were not different between the 2 groups. CONCLUSIONS In this study, MT administered to stable preterm infants was associated with higher NK cytotoxicity and more daily weight gain. MT may improve the overall outcome of these infants. Larger studies are needed.
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Affiliation(s)
- Jocelyn Y. Ang
- Divisions of Infectious Diseases,,Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Jorge L. Lua
- Neonatal and Perinatal Medicine, and,Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Ambika Mathur
- Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Ronald Thomas
- Children’s Research Center of Michigan, Detroit, Michigan
| | - Basim I. Asmar
- Divisions of Infectious Diseases,,Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Sureyya Savasan
- Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan;,Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
| | - Steven Buck
- Hematology and Oncology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan
| | - Michael Long
- Department of Pathology/Immunology Section, Wayne State University/Detroit Medical Center, Detroit, Michigan; and
| | - Seetha Shankaran
- Neonatal and Perinatal Medicine, and,Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan
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Abstract
The purpose of this report was to provide an in-depth review of responses from older adults residing in long-term care facilities receiving Healing Touch (HT) for pain management. Persistent pain is common in this population and, while the mainstay for pain management is analgesics, HT may provide supportive therapy. Twenty older adults from 5 facilities in the southwestern United States participated in the study, with 12 receiving the active intervention of HT and 8 receiving the control of presence care. A convergent mixed-methods approach was used in this secondary report, using the providers' descriptions of 84 HT sessions and quantitative findings to provide an in-depth within-case analysis. Outcome measures included quantitative measures of pain, daily living, and quality of life, as well as qualitative descriptors of the HT sessions. The findings suggest that the experience is highly varied and on a continuum from no perceived or noticeable benefit to a decrease in pain and improvement in other physiological and psychosocial symptoms. Therefore, HT may be beneficial for some older adults within long-term care facilities as an adjunct for chronic pain.
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Rapaport MH, Schettler P, Bresee C. A preliminary study of the effects of repeated massage on hypothalamic-pituitary-adrenal and immune function in healthy individuals: a study of mechanisms of action and dosage. J Altern Complement Med 2012; 18:789-97. [PMID: 22775448 DOI: 10.1089/acm.2011.0071] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study gathers preliminary data about the biologic effects of repeated Swedish massage therapy compared to a light-touch control condition. DESIGN The study design was a 5-week comparison of repeated Swedish massage and light touch on oxytocin (OT), arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocyte markers, and mitogen-stimulated cytokine function. SETTING The setting was an outpatient research unit in an academic medical center. PARTICIPANTS The study subjects were medically and psychiatrically healthy young adults. INTERVENTION The study comprised 45 minutes of Swedish massage or light touch, using highly specified and identical protocols, either weekly or twice weekly for 5 weeks. OUTCOME MEASURES The outcome measures were mean differences between massage and light touch on OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels. RESULTS Compared to the touch control condition, weekly Swedish massage stimulated a sustained pattern of increased circulating phenotypic lymphocyte markers and decreased mitogen-stimulated cytokine production, similar to what was previously reported for a single massage session, while having minimal effect on hypothalamic-pituitary-adrenal function. Twice-weekly massage produced a different response pattern with increased OT levels, decreased AVP, and decreased CORT but little effect on circulating lymphocyte phenotypic markers and a slight increase in mitogen-stimulated interferon-γ, tumor necrosis factor-α, interleukin (IL)-1b and IL-2 levels, suggesting increased production of pro-inflammatory cytokines. CONCLUSIONS There are sustained cumulative biologic actions for the massage and touch interventions that persist for several days or a week, and these differ profoundly depending on the dosage (frequency) of sessions. Confirmatory studies in larger samples are needed.
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Affiliation(s)
- Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
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Papathanassoglou EDE, Mpouzika MDA. Interpersonal touch: physiological effects in critical care. Biol Res Nurs 2012; 14:431-43. [PMID: 22773451 DOI: 10.1177/1099800412451312] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Nurses use several forms of touch in patient encounters. Interpersonal touch elicits specific physiological and psychological responses, including neuroendocrine effects and reduction of stress. Critical illness is a state of excessive physiological and psychological stress. AIMS To critically review evidence on the effect of touch on physiological outcomes in critically ill individuals. Results of intervention studies in adult critical care settings were reviewed along with supportive evidence from studies in other populations. METHODS Critical literature review based on studies published in MEDLINE, PubMed, Cinahl, Embase, and Cochrane databases. RESULTS Eleven studies were reviewed. Significant effects of interpersonal touch included lower systolic and diastolic blood pressure and respiratory rate, improved sleep, and decreased pain. Almost no results were replicated owing to discrepancies among studies. Although the effect of touch on cardiovascular autonomic status appears considerable, several confounders must be considered. In noncritically ill populations, replicable findings included increased urinary dopamine and serotonin, natural killer cytotoxic activity, and salivary chromogranin. Effects on plasma cortisol and immune cells were variable. Effects appear to vary according to amount of pressure, body site, duration, and timing: Moderate pressure touch may elicit a parasympathetic response in contrast to light touch, which may elicit a sympathetic response. Moreover, touch effects may be mediated by the density of autonomic innervation received by the body areas involved and repetition of sessions. CONCLUSION The physiological pathway mediating the effects of touch is unclear. Although no concrete conclusions can be drawn, research evidence suggests that touch interventions may benefit critically ill individuals.
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Shin ES, Lee SH, Seo KH, Park YH, Nguyen TT. Aromatherapy and massage for symptom relief in patients with cancer. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Grossman M, Agulnik J, Batist G. The Peter Brojde lung cancer centre: a model of integrative practice. ACTA ACUST UNITED AC 2012; 19:e145-59. [PMID: 22670104 DOI: 10.3747/co.19.929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The generally poor prognosis and poor quality of life for lung cancer patients have highlighted the need for a conceptual model of integrative practice. Although the philosophy of integrative oncology is well described, conceptual models that could guide the implementation and scientific evaluation of integrative practice are lacking. PURPOSE The present paper describes a conceptual model of integrative practice in which the philosophical underpinnings derive mainly from integrative oncology, with important contributions from Traditional Chinese Medicine (TCM) and the discipline of nursing. The conceptual model is described in terms of its purpose, values, concepts, dynamic components, scientific evidence, clinical approach, and theoretical underpinnings. The model argues that these components delineate the initial scope and orientation of integrative practice. They serve as the needed context for evaluating and interpreting the effectiveness of clinical interventions in enhancing patient outcomes in lung cancer at various phases of the illness. Furthermore, the development of relevant and effective integrative clinical interventions requires new research methods based on whole-systems research. An initial focus would be the identification of interrelationship patterns among variables that influence clinical interventions and their targeted patient outcomes.
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Affiliation(s)
- M Grossman
- McGill School of Nursing, McGill University, Montreal, QC.
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Baker BS, Harrington JE, Choi BS, Kropf P, Muller I, Hoffman CJ. A randomised controlled pilot feasibility study of the physical and psychological effects of an integrated support programme in breast cancer. Complement Ther Clin Pract 2012; 18:182-9. [PMID: 22789796 DOI: 10.1016/j.ctcp.2012.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 03/16/2012] [Indexed: 12/31/2022]
Abstract
A pilot study was conducted to assess recruitment and effectiveness of an integrated support programme in women with breast cancer. Twelve participants were randomised to receive medical care with or without the support programme. Psychosocial questionnaires and immune/hormonal assays were completed at baseline, three and six months. Recruitment was problematic. In the intervention group, mental fatigue was significantly improved (p = 0.016) compared to controls; increased NK cell activity suggested an improvement in immune function. Total stress (p = 0.009), anxiety (p = 0.032) and endocrine-specific (p = 0.032) symptoms were significantly improved in the controls. A large-scale randomisation trial appears warranted, dependent upon effective recruitment.
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Maruyama K, Shimoju R, Ohkubo M, Maruyama H, Kurosawa M. Tactile skin stimulation increases dopamine release in the nucleus accumbens in rats. J Physiol Sci 2012; 62:259-66. [PMID: 22411566 PMCID: PMC10717409 DOI: 10.1007/s12576-012-0205-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 02/28/2012] [Indexed: 12/17/2022]
Abstract
We investigated the effect of mild (non-noxious) tactile stimulation (stroking) of skin on dopamine (DA) release in the nucleus accumbens (NAc) of rats. A coaxial microdialysis probe was stereotaxically implanted in the NAc and perfused with modified Ringer's solution. Dialysate output from consecutive 5-min periods was injected into a high-performance liquid chromatograph and DA was measured using an electrochemical detector. Bilateral tactile stimulation of the back for 5 min significantly increased DA release in conscious and anesthetized animals. Increased DA release was observed by stimulation of the contralateral, but not ipsilateral, back. DA secretion was also increased with stimulation of the forelimb, hindlimb, and abdomen. These effects were abolished after lesioning the ventral tegmental area (VTA). In contrast, noxious stimulation (pinching) of these areas had no effect on DA secretion. In conclusion, innocuous mechanical stimulation of the skin increases DA release in the contralateral NAc via the VTA.
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Affiliation(s)
- Kimiko Maruyama
- Center for Medical Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501 Japan
- Present Address: Department of Rehabilitation, International University of Health and Welfare Hospital, Nasushiobara, Tochigi 329-2763 Japan
| | - Rie Shimoju
- Center for Medical Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501 Japan
- Department of Physical Therapy, International University of Health and Welfare, Otawara, Tochigi 324-8501 Japan
| | - Masato Ohkubo
- Center for Medical Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501 Japan
- Department of Tokyo Judo Therapy, Teikyo University of Science, Tokyo, 120-0045 Japan
| | - Hitoshi Maruyama
- Department of Physical Therapy, International University of Health and Welfare, Otawara, Tochigi 324-8501 Japan
| | - Mieko Kurosawa
- Center for Medical Science, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501 Japan
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Otawara, Tochigi 324-8501 Japan
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López-Sendín N, Alburquerque-Sendín F, Cleland JA, Fernández-de-las-Peñas C. Effects of physical therapy on pain and mood in patients with terminal cancer: a pilot randomized clinical trial. J Altern Complement Med 2012; 18:480-6. [PMID: 22540970 DOI: 10.1089/acm.2011.0277] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine the effects of physical therapy, including massage and exercise, on pain and mood in patients with advanced terminal cancer. DESIGN The design was a randomized controlled pilot study. SUBJECTS Twenty-four (24) patients with terminal cancer were randomly assigned to one of two treatment groups. INTERVENTIONS Group A received a physiotherapy intervention consisting of several massage techniques, mobilizations, and local and global exercises. Group B received a simple hand contact/touch to areas of pain (cervical area, shoulder, interscapular area, heels, and gastrocnemius), which was maintained for the same period of time as the intervention group. All patients received six sessions of 30-35 minutes in duration over a 2-week period. OUTCOMES Outcomes were collected at baseline, at 1 week, and at a 2-week follow-up (after treatment completion) by an assessor blinded to the treatment allocation of the participants. Outcomes included the Brief Pain Inventory (BPI, 0-10 scale), Memorial Pain Assessment Card (0-10 scale), and Memorial Symptom Assessment Scale (MSAS Physical, Psychological, 0-4 scale). Baseline between-group differences were assessed with an independent t-test. A two-way repeated-measures analysis of variance was used to examine the effects of the intervention. RESULTS There were no significant between-group baseline differences (p>0.2). A significant group × time interaction with greater improvements in group A was found for BPI worst pain (F=3.5, p=0.036), BPI pain right now (F=3.94, p=0.027), and BPI index (F=13.2, p<0.001), for MSAS Psychological (F=8.480, p=0.001). CONCLUSIONS The combination of massage and exercises can reduce pain and improve mood in patients with terminal cancer. A sustained effect on pain and psychologic distress existed; however, parameters such as physical distress and the least pain were no greater in the intervention group as compared to the sham.
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Fernández-Lao C, Cantarero-Villanueva I, Díaz-Rodríguez L, Fernández-de-las-Peñas C, Sánchez-Salado C, Arroyo-Morales M. The influence of patient attitude toward massage on pressure pain sensitivity and immune system after application of myofascial release in breast cancer survivors: a randomized, controlled crossover study. J Manipulative Physiol Ther 2011; 35:94-100. [PMID: 22018755 DOI: 10.1016/j.jmpt.2011.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 07/07/2011] [Accepted: 07/13/2011] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the influence of patient's attitudes toward massage on pressure pain sensitivity and the immune effects of myofascial release in breast cancer survivors (BCS). METHODS Twenty BCS participated. They presented to the laboratory at the same time of the day on 2 occasions separated by 2 weeks. At each session, they received either a myofascial release technique or control (special attention) intervention. Salivary flow rate, cortisol and immunoglobulin A (IgA) concentrations, and α-amylase activity were obtained before and immediately after intervention from saliva samples. Pressure pain thresholds (PPT) over the cervical spine and temporalis muscle were assessed bilaterally. The attitude toward massage (ATOM) scale was collected before the first session in all BCS. RESULTS The analysis of covariance revealed a significant intervention × time interaction for salivary flow rate (P = .010), but not α-amylase (P = .111), IgA (P = .655), and cortisol (P = .363) in favor of the experimental group: BCS exhibited an increase of salivary flow rate after myofascial release intervention. When the ATOM scale was included in the analysis, significant influence on IgA (P = .001) was found: BCS with positive attitude had a significant increase in IgA (P > .05). The analysis of covariance did not find a significant intervention × time interaction for PPT over the cervical spine or temporalis muscle, with no effect of ATOM scales for PPT (P > .05). CONCLUSION The current study suggests that myofascial release may lead to an immediate increase in salivary flow rate in BCS with cancer-related fatigue. We also found that the effect of myofascial release on immune function was modulated by a positive patient's attitude toward massage.
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Judson PL, Dickson EL, Argenta PA, Xiong Y, Geller MA, Carson LF, Ghebre R, Jonson AL, Downs LS. A prospective, randomized trial of integrative medicine for women with ovarian cancer. Gynecol Oncol 2011; 123:346-50. [PMID: 21864886 DOI: 10.1016/j.ygyno.2011.07.099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Despite increased use of integrative medicine in cancer therapy, little data exist on its efficacy. This prospective, randomized, pilot trial sought to evaluate the feasibility of combined modality integrative medicine (CM-IM) in women with ovarian cancer (OvCA) and evaluate its effects on quality of life (QoL), chemotherapy toxicity and immunologic profiles. METHODS Women with newly diagnosed OvCA requiring chemotherapy were offered enrollment. Those randomized to the experimental arm received hypnosis, therapeutic massage and healing touch with each cycle of chemotherapy. The control arm received chemotherapy without CM-IM. All patients completed QoL questionnaires prior to cycles 1, 3 and 6, and 6-months after chemotherapy. Immunologic profiles were measured. Statistical analysis was based on intent-to-treat. Student's t-test and Fischer's exact-test were used to determine differences. RESULTS Forty-three women enrolled. All women randomized to CM-IM were successfully treated. There were no statistical differences between the groups in age, stage, grade, histologic cell type, CA125 levels, or surgical cytoreductive status. There was no difference in overall QoL measurements. Re-hospitalization rates, treatment delays, anti-emetic use, and infection rates were similar. Immunologic profiles revealed no difference between arms for WBC or salivary IgA levels. Women receiving CM-IM had consistently higher levels of CD4, CD8 and NK cells, although this did not reach statistical significance. CONCLUSIONS Prospective clinical evaluation of integrative medicine for women with gynecologic malignancy is feasible. This first, pilot study of CM-IM in gynecologic oncology demonstrated no improvement in QoL or chemotherapy toxicity. Integrative medicine-associated improvements in immunologic profiles warrant further investigation.
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Affiliation(s)
- Patricia L Judson
- H. Lee Moffitt Cancer Center & Research Institute, Department of Women's Oncology, USA.
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Munk N, Kruger T, Zanjani F. Massage Therapy Usage and Reported Health in Older Adults Experiencing Persistent Pain. J Altern Complement Med 2011; 17:609-16. [DOI: 10.1089/acm.2010.0151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Niki Munk
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY
| | - Tina Kruger
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY
| | - Faika Zanjani
- Graduate Center for Gerontology, University of Kentucky, Lexington, KY
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Contribución al estudio de los efectos sistémicos neurovegetativos del masaje terapéutico mediante el análisis espectral de la variabilidad de la frecuencia cardiaca. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.rifk.2012.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lutgendorf SK, Mullen-Houser E, Russell D, Degeest K, Jacobson G, Hart L, Bender D, Anderson B, Buekers TE, Goodheart MJ, Antoni MH, Sood AK, Lubaroff DM. Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach. Brain Behav Immun 2010; 24:1231-40. [PMID: 20600809 PMCID: PMC3010350 DOI: 10.1016/j.bbi.2010.06.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Revised: 06/23/2010] [Accepted: 06/23/2010] [Indexed: 11/19/2022] Open
Abstract
Patients receiving chemoradiation for cervical cancer are at risk for distress, chemoradiation-related side-effects, and immunosuppression. This prospective randomized clinical trial examined effects of a complementary therapy, Healing Touch (HT), versus relaxation training (RT) and usual care (UC) for (1) supporting cellular immunity, (2) improving mood and quality of life (QOL), and (3) reducing treatment-associated toxicities and treatment delay in cervical cancer patients receiving chemoradiation. Sixty women with stages IB1 to IVA cervical cancer were randomly assigned to receive UC or 4 ×/weekly individual sessions of either HT or RT immediately following radiation during their 6-week chemoradiation treatment. Patients completed psychosocial assessments and blood sampling before chemoradiation at baseline, weeks 4 and 6. Multilevel regression analyses using orthogonal contrasts tested for differences between treatment conditions over time. HT patients had a minimal decrease in natural killer cell cytotoxicity (NKCC) over the course of treatment whereas NKCC of RT and UC patients declined sharply during chemoradiation (group by time interaction: p = 0.018). HT patients showed greater decreases in two different indicators of depressed mood (CES-D depressed mood subscale and POMS depression scale) compared to RT and UC (group by time interactions: p<0.05). No between group differences were observed in QOL, treatment delay, or clinically-rated toxicities. HT may benefit cervical cancer patients by moderating effects of chemoradiation on depressed mood and cellular immunity. Effects of HT on toxicities, treatment delay, QOL, and fatigue were not observed. Long-term clinical implications of findings are not known.
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Abstract
In this paper recent research is reviewed on the effects of yoga poses on psychological conditions including anxiety and depression, on pain syndromes, cardiovascular, autoimmune and immune conditions and on pregnancy. Further, the physiological effects of yoga including decreased heartrate and blood pressure and the physical effects including weight loss and increased muscle strength are reviewed. Finally, potential underlying mechanisms are proposed including the stimulation of pressure receptors leading to enhanced vagal activity and reduced cortisol. The reduction in cortisol, in turn, may contribute to positive effects such as enhanced immune function and a lower prematurity rate.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami School of Medicine, Miami, FL, USA.
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Krohn M, Listing M, Tjahjono G, Reisshauer A, Peters E, Klapp BF, Rauchfuss M. Depression, mood, stress, and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy. Support Care Cancer 2010; 19:1303-11. [PMID: 20644965 DOI: 10.1007/s00520-010-0946-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2009] [Accepted: 07/01/2010] [Indexed: 01/27/2023]
Abstract
PURPOSE Cancer patients frequently suffer from psychological comorbidities such as depression and elevated stress. Previous studies could demonstrate that cancer patients benefit from massage therapy on the physical and psychological level. This pilot study investigates the effects of massage on depression, mood, perceived stress, and the Th1/Th2 ratio in breast cancer patients. METHODS Thirty-four breast cancer patients were randomly assigned to a massage group (n=17) and a control group (n=17). Patients of the massage group received two 30-min classical massages per week for 5 weeks. At baseline, at the end of the intervention period, and 6 weeks after the end of intervention, patients of both groups completed the Perceived Stress Questionnaire (PSQ), the Patient Health Questionnaire (PHQ), and the Berlin Mood Questionnaire (BFS) and blood was withdrawn for determining cytokine concentrations and the Th1/Th2 ratio. RESULTS Twenty-nine patients were included in the statistical analysis. Depression (PHQ) and anxious depression (BSF) were significantly reduced immediately after massage compared to the control group. Stress (PSQ) and elevated mood (BSF) did not show significant alterations after massage therapy. Changes of cytokine concentrations and Th1/Th2 ratio were insignificant as well, although there was a slight shift towards Th1 in the massage group over time. CONCLUSIONS Massage therapy is an efficient treatment for reducing depression in breast cancer patients. Insignificant results concerning immunological parameters, stress, and mood indicate that further research is needed to determine psychological and immunological changes under massage therapy.
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Affiliation(s)
- Michaela Krohn
- Department of Psychosomatics and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany.
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The efficacy of classical massage on stress perception and cortisol following primary treatment of breast cancer. Arch Womens Ment Health 2010; 13:165-73. [PMID: 20169378 DOI: 10.1007/s00737-009-0143-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 12/28/2009] [Indexed: 10/19/2022]
Abstract
To investigate the efficacy of classical massage on stress perception and mood disturbances, 34 women diagnosed with primary breast cancer were randomized into an intervention or control group. For a period of 5 weeks, the intervention group (n = 17) received biweekly 30-min classical massages. The control group (n = 17) received no additional treatment to their routine health care. The Perceived Stress Questionnaire (PSQ) and the Berlin Mood Questionnaire (BSF) were used and the patients' blood was collected at baseline (T1), at the end of the intervention period (T2), and 6 weeks after T2 (T3). Compared with control group, women in the intervention group reported significantly lower mood disturbances, especially for anger (p = 0.048), anxious depression (p = 0.03) at T2, and tiredness at T3 (p = 0.01). No group differences were found in PSQ scales, cortisol and serotonin concentrations at T2 and T3. However, perceived stress and cortisol serum levels (p = 0.03) were significantly reduced after massage therapy (T2) compared with baseline in the intervention group. Further research is needed to validate our findings.
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Listing M, Reisshauer A, Krohn M, Voigt B, Tjahono G, Becker J, Klapp BF, Rauchfuss M. Massage therapy reduces physical discomfort and improves mood disturbances in women with breast cancer. Psychooncology 2010; 18:1290-9. [PMID: 19189275 DOI: 10.1002/pon.1508] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND. A randomized controlled trial was conducted to investigate the efficacy of classical massage treatment in reducing breast cancer-related symptoms and in improving mood disturbances. METHODS. Women diagnosed with primary breast cancer were randomized into an intervention group and a control group. For a period of 5 weeks, the intervention group received bi-weekly 30-min classical massages in the back and head-neck areas. The control group received no additional treatment to their routine healthcare. To evaluate treatment efficacy, the following validated questionnaires were administrated at baseline (T1), at the end of the intervention (T2), and at a followup at 11 weeks (T3): the Short Form-8 Health Survey, the European Organization of Research and Treatment of Cancer quality of life questionnaire breast module (EORTC QLQ-BR23), the Giessen Complaints Inventory (GBB), and the Berlin Mood Questionnaire (BSF). RESULTS. Eighty-six eligible women (mean age: 59 years) were enrolled in the study. A significantly higher reduction of physical discomfort was found in the intervention group compared with the control group at T2 (p=0.001) and at T3 (p=0.038). A decrease in fatigue was also observed. Women in the intervention group reported significantly lower mood disturbances at T2 (p<0.01) but not at T3. The effect of treatment on mood disturbances was significantly higher if a patient was treated continuously by the same masseur. CONCLUSION. Classical massage seems to be an effective adjuvant treatment for reducing physical discomfort and fatigue, and improving mood disturbances in women with early stage breast cancer.
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Affiliation(s)
- Miriam Listing
- Department of Psychosomatics and Psychotherapy, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany.
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