Lymphovenous Canada: Discussion point

Can providing massage therapy to individuals who have active cancer or who are terminally ill promote the spread of cancer?

There appears to be no concrete scientific evidence, however, which suggests massage therapy promotes the spread of cancer. Many studies seem to indicate that massage therapy can potentially enhance the health, sense of well-being and quality of life of individuals with cancer.

Two recent studies have found no ill effects from the use of manual lymph drainage on cancer patients:

• Can manual lymph drainage of lymphedema promote metastasis? by Godette K., et al, Soc., Integr Oncol 2006: 4(1);8-12.
  
• Manipulative therapy of secondary lymphedema in the presence of locoregional tumors. Pinell XA, et al. Cancer 2008; 112(4):950-4.

A 2010 U.S. National Institute of Cancer PDQ on lymphedema, notes that massage if done correctly should not cause any medical problems, however cautions that it should not be undertaken under the following circumstances:

• Where there are open wounds, bruises, or areas of broken skin.
  
• Tumors that can be seen on the skin surface.
  
• Areas with deep vein thrombosis (blood clot in a vein).
  
• Sensitive soft tissue where the skin was treated with radiation therapy.

In Diagnosis and therapy of malignant lymphedema, Fortschr Med 1998 Apr 30; 116(12):28-30, 32, 34 K. Ruger of the Fachklinik fur Lymphologie und Odemkrankheiten, St. Blasien, reports,

"With the standard physical treatment of edema...successful clinical management of malignant lymphedema is also possible. The sole contraindication of manual lymph drainage, we believe, locoregional tumor reoccurance, which can be completely eliminated by the immediate initiation of radical tumor treatment. The tumor reoccurance is the result not of falsely indicated manual lymph drainage, but of inadequate primary treatment that leaves behind residual tumor tissue, the early detection of which still remains an unresolved problem. Manual lymph drainage is indispensable for improving the quality of life of tumor patients with lymphedema."

In a retrospective study of 191 patients treated for head and neck cancer on the occurrence of lymphedema and therapy with manual lymph drainage, Preisler VK, Hage R, and Hoppe F report in Indications and risks of manual lymph drainage in head-neck tumors, Laryngorhinootologie, 1998 Apr; 77(4):207-12:

• "100 patients had received lymphatic drainage, whereas 91 patients belonged to the group without lymphatic drainage therapy. In 37 cases a tumor reoccurance or local metastases were reported, 18 of whom had received lymphatic drainage and 19 belonged to the control group. Among these 37 patients neither the group with lymphatic drainage nor the control group differed significantly concerning stage of cancer, histopathological grading, the in sano/non in sano resection of the primary tumor and a lymphangiosis carcinomatosa.

• Conclusion: A lymphatic drainage therapy for patients presenting with lymphedema after the oncological therapy does not increase the rate of local recurrencies. Moreover it improves the quality of life after the cancer therapy. As only few data are available for cases with non in sano surgery and tumors with lymphangiosis carcinomatosa, these cases should be excluded from lymphatic drainage therapy. A spreading of occult tumor cells in these patients might be possible."

Relief of anxiety and other physical symptoms associated with cancer or HIV/AIDS-related illnesses is well-documented:

• A four-year study at the James Cancer Hospital in Columbus, Ohio, researchers found that the immune system was actually stimulated during the massage, blood pressures dropped and circulation improved. In many cases researchers saw a dramatic drop in pain. (Source: Cancer Massage, December 27, 1999 Eyewitness News, KlS-TV, Salt Lake City; results were published in Psychology Today and in the Massage Therapy Journal.)
• In a study initiated by the Touch Research Institute, University of Miami School of Medicine, Florida, U.S.A. 29 gay men with and without HIV received daily massages for one month. 11 of the 20 HIV positive men experienced a significant incarease in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluable CD8, and the cytotoxic subset of CD8 cells. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. (Source: Int. J. Neurosci 1996 Feb;84(1-4): 205-17)

Health care professionals have also reported to us that therapeutic ultrasound over a site of possible metastasis is contra-indicated because it's been shown to enhance tumour growth in lab mice.

• Sicard-Rosenbaum L, Lord D, Danoff JV, et al. Effects of continuous therapeutic ultrasound on growth and metastasis of subcutaneous murine tumors. Physical Therapy 1995;75:3-10
• Sicard-Rosenbaum L, Danoff J, Guthrie J, Eckhaus M. Effects of energy-matched pulsed and continuous ultrasound on tumor growth in mice. Physical Therapy 1998;78:271-277.