Dialogue Through Touch

Massage throughout cancer treatment becomes a dialogue through touch. Cancer treatments include surgery, chemotherapy, and radiation treatment, biological and hormonal treatment. Cancer treatment is not always a definite period with an ending and beginning, many times it can be treated as a chronic ailment for many years. A Massage Therapist, trained on massage modifications for cancer treatments, soon realizes that being present will include compassion, training and learning to listen to the patient's journey, as well as offer the many tools from their tool box that can help with their quality of care.

The request for massage from a patient changes throughout the treatment. A newly diagnosed patient is consumed with anxiety from the unusual rash that lasted too long, a lump recently discovered, or fever they can't shake and are now sitting in the physician's office waiting for the diagnostic tests to reveal the results and discuss the treatment options. A phone call comes with the request for massage, "please when can I get a massage, I am so upset, I have cancer." Listening to the fear over the phone, their Massage Therapist quickly realizes the intent of the massage will be to calm their client down and help them prepare mentally to fight the battle of their life. Arriving at their home, the story unfolds and listening is an important part of the appointment time and usually includes lots of "relax, everything will be fine, you have confidence in your doctors, now let's learn some relaxation coping techniques to help you during this massage." Usually half way through the massage when the patient has been positioned face down the talking subsides. The newly diagnosed client finally is now completely at peace. The goal now is to help the patient/client find their strength. The relationship between the client and Massage Therapist will be a source of comfort for the patient throughout their treatment. This is usually the time the Massage Therapist is thrilled about the oncology massage class they took a few months ago, wondering if they would ever need to use the training.

Immediately after surgery, there is a period that massage must be modified; surgical site avoided, awareness of drains in place, pain medicines, positional consideration for comfort and pressure restrictions to avoid trauma to recent surgery. Even with all those restrictions a massage mood can be achieved with a mind-full touch approach; gentle hands and feet, time spent on the face, scalp and shoulders. No need to turn a patient over, keep them comfortable in the position they prefer, shorten the session, normally there are lots of "thank you's" and "I am so grateful for your gentle touch."

Working in an outpatient cancer center, the opportunity comes more often to be with patients during their treatment. This is usually the time that the conversations are about the aches and pains of inactivity. The pain or discomfort can come from the side effects of chemotherapy, or just the inactivity brought on by chemotherapy induced fatigue, another side effect of chemotherapy. When chemotherapy induced peripheral neuropathy is diagnosed, now comes the talks about simple stretches, gentle self massage, and movement therapies that might help decrease the neuropathy or hopefully decrease the amount of time the neuropathy lingers after chemotherapy is over. A side benefit to movement is that it might actually help the fatigue. Even within the treatment center it is possible to achieve a truly relaxing environment and within 10 minutes of a head, neck and shoulder massage you hear, "you have put me on a beach somewhere, I promise to continue the stretches at home."

Usually after chemotherapy, the next phase of the journey is radiation treatment. A patient's body barely has time to regroup and now comes the regime of 36 treatments for 6 weeks. Combine that with being back to work, family responsibilities and you can imagine the fatigue factor during radiation treatment. "I'm hanging in there," is a usual response as they follow you to the massage room. Short massages at the radiation center are helpful, tips to help with the muscle tension are offered, and encouraging conversations that cheers the patient on to the finish line. Since the relationship between the Massage Therapist and patient has been going on for almost a year, the conversation often turn to, "how was your vacation, congrats on your new grandchild or when is the family reunion." Conversations about the triggers of lymph edema are discussed, because they will be returning to the life that includes spa experiences, exercise, activities that increase the risk of lymph edema. Many times this education might not have come from the surgeon's office, chemotherapy or radiation experience.

The spa massage therapist, who has cancer and massage training, becomes part of the survivor's community that can help a patient cope with the side effects of treatment during and after treatment. A "new normal massage" away from the cancer center during this time is definitely a reward. Patients are always requesting information about safe massage during and after treatment and with the appropriate education about safe massage they can plan that spa trip, even while in cancer treatment. Massage away from the cancer center allows a massage therapist to help connect the patient's whole body through safe touch. A time to feel good touches without all the medical procedures that can be so invasive and debilitating. Breathing techniques, visualization and guided imagery can also be taught to help calm the patient in treatment, along with the massage. The mind-body connections is never more noticed than when through your hands you feel their body relax, the full breath taken, a sigh released and always the comment, "it feels good to feel good once again, I want to thrive and survive."

Often times, a Massage Therapist will meet a survivor that has been cancer free for many years. They show up at your spa and request a deep tissue massage or other body treatment, "I have always received a deep massage from my other therapist, I have been cancer free for 5 years." Once again the oncology massage training enables you to explain that up to now they have been lucky, but your training allows you to speak with confidence and explain fully why deep tissue is not appropriate for nodal dissection or when bones have been radiated. You might lose a new client, but many times they are grateful for your knowledge and you gain their respect and their business.

Working with oncology patients, there will be times that you find yourself doing palliative care. Treatment is over, the patient has chosen no new treatments and the goal is to offer comfort, compassionate touch, an ear to hear their stories, hugs from families that appreciate your understanding and loving care, so many "God Blesses," you realize you made a difference. It might seem that you are not doing much, but with your presence, your touch is priceless.

The dialogue of touch is a dance that weaves through the life and experiences of your clients. You will be forever changed by oncology massage training and opportunity to be part of their care.