The Clinical and Biochemical Effects of Massage Therapy During Radiation Treatment for Breast Cancer

Purpose:
Aim - Investigate the clinical and biochemical effects of massage therapy on fatigue, insomnia and cytokines among women undergoing radiation treatment for breast cancer

Background/Significance:
Most women with breast cancer receive radiation therapy and many experience debilitating fatigue and sleep disturbance with limited treatment options. Cancer related fatigue (CRF) and sleep disturbance have been associated with inflammation. It is theorized that massage therapy through vagus nerve stimulation may reduce the inflammatory response triggered by radiation therapy and thus reduce fatigue and insomnia.

Methods:
A two-armed, controlled, partially blinded pilot study. N= 23 females with breast cancer and undergoing radiation therapy in a Midwest Community Hospital Cancer Center. Randomly assigned to two groups; massage therapy group (MG; n=17) and standard care group (SCG; n=6). Groups stratified by radiation alone or radiation following chemotherapy. The MTG had a weekly study visit with a 60 minute massage for duration of radiation therapy. SCG had weekly study visits only. The main variables (fatigue, insomnia, inflammation) were compared between groups at 3 points using Insomnia Severity Index and Pittsburgh Sleep Quality Index, Fatigue Symptom Inventory, Plasma IL-6 and CRP cytokine levels.

Results:
Of 24 women enrolled 23 completed the study with no adverse events. As hypothesized fatigue, insomnia and cytokine (IL-6 and CRP) levels declined from baseline to end of study in MG. Between group differences on the Insomnia Index scores were statistically significant. Women with combined therapy (Chemo and Radiation) had significantly higher levels of insomnia at baseline.

Conclusions and Implications for Practice:
Findings support previous studies showing efficacy and acceptability of massage therapy for symptom management during cancer treatment. Preliminary data supports theoretical model linking massage to reduced inflammation and fatigue but needs further investigation with larger, multi-site trial.