Oncology Massage (3) – Adjustments

This is what it all comes down to: the adjustments needed to make massage possible (and comfortable, safe, and effective) for cancer patients and survivors. But let’s back up for a second and take a look at the larger picture. What are these adjustments for, exactly?

To state the obvious, cancer treatment puts the body through a lot of stress. The lymph system spends extra energy filtering out dead cells and cellular debris left over from chemotherapy and radiation. Drugs and medication can increase pain and nausea. Surgery leaves painful scars; radiation can leave the skin raw and tender. Lots of treatments, little time to recover in between. The body is overwhelmed from invasive procedures and needs to heal as best it can.

It’s easy to see how an overeager massage might add to the troubles. If the therapist enters the massage session with the mindset that she will be fixing the client, she may wind up introducing new stressors to the client’s already overtaxed body. Instead of healing itself from the cancer treatment, the body will need to spend extra time and effort repairing the tissue damage brought on by a deep massage.

In this setting, the therapist needs to have a new goal: not to heal, but to help. I’ve already talked about the benefits of massage, the ways that a massage session can truly help the oncology client – less pain and nausea, increased relaxation and a better sense of wellness. Some of these goals are a little vague, but perhaps that’s the point. The massage is creating an environment in which the patient’s body can properly heal itself.

There are a lot of potential adjustments, but most of them fall under just a few categories. Site adjustments: where on the body you’ll be massaging. Avoid scars from recent surgery and don’t massage near medical devices (e.g. chemo ports). Positioning adjustments: Does the client have trouble breathing when laying down? You can easily prop him up with some pillows. If the client is most comfortable when sitting, a chair massage might be the best option.

Pressure adjustments: As I explained above, a massage that’s too strong could interfere with healing when someone’s body is already under a lot of stress. Of course, different bodies have different thresholds, so what’s too much pressure for one client might be perfect for another. Pressure adjustment is often a source of contention: The client might feel that he or she can tolerate a deep, strong massage, but the therapist may not be comfortable working at that level. The best option is to start with soft, light pressure and build up over several sessions. This way, the client can see how his or her body responds to the increase. As long as both the client and therapist remain in communication, they should be able to find the appropriate balance.

The final adjustment category is the level of demand. Beyond just pressure level, there are a wide number of factors that determine the intensity of the massage. What parts of the body will the massage focus on? A full-body massage has a higher level of demand than a hands-and-feet massage. Will the client remain clothed or be draped? Clients undergoing invasive treatment might be extra protective of their body and not be comfortable with having certain areas touched or exposed. How long will the massage session be? It hardly needs to be said that an hour-long session has a different level of demand than a 10 minute one.

While some of the goals of massage in this setting are pretty general, it’s still possible for the client and therapist to develop a set of goals specific to the client’s needs. This is especially true when working with cancer survivors. For example, let’s say a client wants to regain range of motion in her shoulder after a mastectomy and subsequent reconstruction. It’s a very common goal, but the steps taken to reach it are different depending on the client’s history. How long ago was the mastectomy? Did the client have lymph nodes removed in that area? How active is the client in her daily life? All of these details will determine the details of the massage session.

Massage is always possible in an oncology setting; it might just take a little refining. The best thing is to be flexible, and to view the massage as a learning opportunity. The client and therapist have to forget what they know about “normal” massages and open themselves up to new techniques and approaches. Working together, they can tailor the session to meet the client’s needs and easily create the best possible massage.

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Part One: Introduction
Part Two: Benefits
Part Three: Adjustments
Part Four: Hospice

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