UNDERSTANDING THE POWER OF THOUGHT
Thoughts manifest biological and physiological responses…Your body responds to mental input as if it were a physical reality and belief system.
This knowledge should be a sobering reminder – to only allow the truest of thoughts to be part of your mental intake.
When you become aware that your conscious mind controls only 5% of your daily reality, and the subconscious mind (the mind that takes all thoughts, and the opinions of others, literally) has ultimate control over the remaining 95% of our day – you really need to ask – what life story are you telling yourself? Is it a negative or positively charge future?
A NEW WAY TO THINK ABOUT TREATING CANCER – Dr William Li at TED talk.
TED talks are always interesting, and Dr Li is worth listening to.
I love hearing what information others have to share with us, and whilst it is true that you may not gel with all that others are telling you are true for them, you will always hear something that makes you think a little deeper than you may have before, and from there…your truth and beliefs are borne and perfected.
IS THE MODERN DIET SETTING US UP TO FAIL?
Research has shown that some, not all, cancers are related to the foods that we eat every day of the week. If not the chemical content of processed and commercially produced foods, it is the lack of nutrients in our produce that sees our body suffering from the effects of malnutrition.
We can be socially acceptable in our thoughts and our opinions on whether “overpriced” quality natural foods are the best choice over packaged foods, for as long as the argument serves us, but when it comes down to it – how, and what we feed our body has nothing to do with social acceptability, and has everything to do with keeping us alive.
If we want the best possible chance of self healing, or supporting the body through – and after treatment, we need to counteract the modern diet.
The human body is perfectly designed…it is self healing, self renewing, and rejuvenation is automatic. However, if the body is suffering the effects of malnutrition or disease, the automatic function of the body is compromised, and no matter how many treatments or medications the body is subjected to, nutrition must be addressed and rectified.
Guilt over what we eat should not be a reason to change our dietary intake… the desire for health and wellbeing should be the reason every time.
Raw foods, in my opinion, are an underestimated health tool that many people are just now discovering the benefits of. Cooked foods (yes…this encompasses healthy cooked morsels, as well as processed cardboard!) increase the white blood cells, and your body may decide to see that increase as diseased cells – this causes the immune system to waste precious healing energy fighting the assumed disease.
When you are aware of how the modern diet impacts on your entire physical body, you are empowered to make healthy workable choices for yourself based on your desire for wellbeing – Change the Terrain, and you Alter the Outcome.
I know I did…. I lasted 1.5 days into a 3 day sugar detox in 2010, I wanted to rip heads off…destroy everything that was in my path…quite simply, I was peed off at everyone, and everything.
Whilst going through my withdrawals, I had no idea that the aggitation and anger I felt were actual proof of my sugar addiction – in my mind, everybody was being non supportive, and even listening to them speak drove me to distraction.
Literally, 5 seconds after giving in to my addiction on the second day, my mood improved, my attitude stabilised, and I decided that the other members of the household were to be spared because THEIR attitude improved!
It doesn’t need to be so tough – as long as you set yourself up with enough choices and support – it makes removal of this deadly dietary additive much more “doable”.
The lovely Cass Michelin from CHOOSE LIFE, LIVE IT, DO IT! wants to start a sugar free September revolution – so why not join the revolution? Check out her page, and see how positive support plus substituting instead of denying foods can make all the difference. Everybody needs a good challenge…
Starting From Today…
* Increased Energy
* Improved Health
* Reduction in Anxiety
* Rejuvenating Deep Sleep
If you are anything like everybody else….constant thoughts and reminders knock at your awareness every time you go shopping – those thoughts that compel you to at least consider what you are about to buy; look for healthier options; try harder to eat well. How often do we actually listen to, or act upon, that deep inner calling for some loving, healthy support? Each time…? Sometimes…? Next time……………..
So how difficult is it to bring some clear direction to your eating habits? Whether you are experiencing full health or a dis-ease such as cancer, it is only going to be as difficult as you wish to make it – which of course means that it will be easy…because we all want to simplify wherever possible, don’t we!
Sometimes just starting something new can be the stumbling block, but with planning, organisation, and support, changing to a healthier way of eating is quite simply…simple…
Cancer Support Therapies not only manage the physical and emotional effects of cancer, and the treatments that clients experience – the wellness aspect of our service includes overall health plans for people that wish to turn their health and wellbeing around. With the assistance of a personally tailored health plan that will support and provide results, it is all about working within what is achievable for each individual client, and about substituting instead of denying pleasure and enjoyment.
We work together with our clients so they succeed in their desire for better health, and increased energy – we do not set plans that are beyond our clients capabilities.
Phone Debbie at Cancer Support Therapies on 0414 632 668, or email email@example.com for further information.
And what follows Brrr…is generally Grrrr! We all hate colds and flu, and whilst the winter months do not hold exclusive rights to them, they are generally more prolific in the colder seasons.
In a body that is in a weakened state, a cold or flu can drag on for an extraordinary length of time, in fact a simple cold can cause complications that may weaken the body even further. Even more so with influenza – in the case where a cancer patient is undergoing chemotherapy. Chemotherapy produces profound immunosuppression in cancer patients, with an American study suggesting that 21%-33% of cancer patients may actually be infected with influenza when admitted to a hospital with respiratory symptoms during cold and flu season.
So what can you do to ensure that you have the best line of defense in place?
ELIMINATE sugar! Refined sugar is devoid of any nutritional value, and further suppresses the immune system.
EAT BEAUTIFULLY – fresh live foods prepared with love and dedication to wellness! Lollies, chips, cake, and processed nutritionally deficient foods, are not included in this list…
REMOVING processed and refined ingredients from your diet – even this act alone will assist in the improvement of the immune system and boost energy levels.
DRINK UP…stay hydrated to enable toxins and congestion to move through your body as quickly as possible. Lemon water, herbal teas, coconut water, and a clean and trusted source of spring water are all the fluids you will need.
ALKALINE the body to an efficient pH level. A urinary pH of around 7.0 will assist in maintaining bodily stability.
WARMING SPICES that are natural immune boosters and virus fighters – ginger, cinnamon, cumin, oregano and cayenne are but a few that may assist with constant use. However, if still within a chemotherapy treatment period, use of these spices could possibly affect the efficacy of treatment – it is imperative that medical advice be sought in an effort to evaluate their synergistic compatibility.
ZZZZZZ…..Sleep!! Give yourself the gift of deep restful sleep – time to recuperate and regenerate during the twilight hours.
Welcome to Cancer Support Therapies – it is my intention to offer information, techniques, and treatments, to clients that are diagnosed with cancer.
I have been working with people that are experiencing various forms of cancer for just over five years, and have tailored my continued learning, and additional qualifications, around this field.
Working in this field has made me so very aware of the need for a qualified therapist when working with clients that have cancer. There are many considerations to be taken into account, and treatment plan adaptations required – clients with suppressed immune systems; heavy levels of emotional and physical fatigue; range of movement decreasing due to radiation; even the removal of only one lymph node making a huge impact on the treatments to be undertaken.
I have a Diploma in remedial massage, and have ushered my career towards specialising in Oncology Massage; Lymphatic Drainage – for clients that suffer site specific lymphoedema as the result of cancer and/or its treatment; Hypnotherapy and Time Line Therapy® to address the emotional impact that a cancer diagnosis has on the entire mind and body; Meditation Facilitation – the body is in a place that is conducive to healing when in a meditative state.
So feel free to look around my site – scroll over the topics across the top of this page, and discover what it feels like to experience relaxation and calm in a time of emotional and physical upheaval.
Book an appointment with me, Debbie, at my clinic on the Sunshine Coast, and allow me to show you just how amazing your life with cancer can be….a release, and relief, at a time when you may need to find some reassurance, and friendly stability in your life.
Call me on 0414 632 668
Look for me on facebook “cancer support therapies” where I regularly post updates with information and health tips.
I work with my fair share of people that are nearing the end of their lives here on this earthly plane – and I love it…. I also work with a hell of a lot of people that are nowhere near finishing their time here – so don’t worry, being one of my clients is still a safe option!
But I have to share my enthusiasm for the work that I do with my palliative clients – I absolutely love the honesty and beauty of how real, and how accepting, people become when they have moved into just existing in this very moment. They have no regrets because they are no longer torturing themselves about things they need to get done, or should fix, and are just surrendering themselves to an amazing process that will take them to somewhere none of us have been before (depending on your beliefs). They usually have pain, so being medicated makes them more comfortable, they hate the dulling of the mind that the meds bring, but they know the feeling of physical pain – so a compromise is what it takes to get through each new day. We talk openly and honestly about fears, expectations, and…what they think happens to them after death – most people hope that there is continuation.
So where does some pizza & a few pies fit into this story? I recently had a cheeky client that passed away (a young guy that I will call “Cheeky” – because that is exactly what he is); he knew without a doubt that there was a new life for him on the other side, so he was totally at ease in the now. In this life, he had lived to the full – he instinctively knew that he wouldn’t live a long life, and decided to do exactly as he wanted; lived on the edge; burned the candle at both ends; ate COPIOUS amounts of junk food – especially pizza and pies…morning noon and night – even to the very end…pizza and pies. He wished that junk food didn’t react as badly as they did with the meds, but he just wanted to keep enjoying this part of his journey – he also didn’t know if they would be available in his next life – so he had to get his fill! He enthusiastically discussed what he believed constantly, he laughed, and made future plans, and knew he would be fine – I knew he would be too. I always left his house smiling, and seeing life a little more in tune after each visit. His beliefs were infectious.
And the psychic? Well, yesterday I went to see a psychic that speaks with those on the other side – and along with a few of my dearly departed relatives, guess who else popped in to see me whilst I was there…. Cheeky himself!…. without the pizza and pies apparently, but he just wanted to say he really enjoyed our time together, and that he was right…the other side does really exist, and it is brilliant – he is loving it. Then, being the cheeky bloke that he is, he gave me a kiss on the cheek, and left.
So fear not, experience tells me that we will all be fine…now…and later – I will not, however, recommend nor condone Cheeky’s pizza & pie diet, whether they are available at our next stop or not!
Look for me on Facebook https://www.facebook.com/CancerSupportTherapies where I regularly post updates with information and health tips.
The following Huffington Post article gives insight into the importance of early detection and actioning of Lymphoedema. Click on the post link for one persons experience with this sometimes crippling condition. Manual Lymphatic Drainage plays a vital part in restoring mobility and reducing pain and discomfort. Call my clinic on 0414 632 668 to discuss your treatment options.
What is “chemobrain”, and how will you know if you have it?
Some people will experience cognitive problems during their course of chemotherapy. It is a condition that is brought about by the introduction of a non organic systemic supply of chemicals to the body. Studies have established that the grey matter of the brain is predisposed to the absorption and storage of chemicals and toxins. Those that have experienced it; commonly refer to it as chemobrain. The most common display of this condition is described as having difficulty remembering words, difficulty concentrating, having trouble finding the right words and undertaking new learning, as well as finding it hard to manage daily activities.
Are you still trying to work a day job, or run a household whilst undergoing treatment? This can be a difficult state of mind to come to terms with. You are usually clear and concise, but now things are just slipping past you. What was once something simple, can now seem overwhelming when you keep forgetting the smallest of details.
Worries about being engulfed in the condition will only cause you greater fear, check with your doctor so that you can rule out contributing factors that will be adding to the memory loss such as low blood count, medications to treat side effects, anxiety, fatigue, sleep deprivation, or hormonal changes from some cancer therapies.
Duration time of chemobrain? General consensus is that within one year of treatment, many people see a huge improvement, or it may no longer exist. However, for some people, it can continue for years following completion of treatment.
Is there anything you can do to protect your grey matter, or help remove the chemotherapy any faster than it is naturally designed to do? If you have agreed to undertake a particular form of treatment, such as chemotherapy, it is vital that you are guided by the practitioner in determining the period of time that treatment needs to remain within the tissues of your body. There is a finite period where the body will attempt to naturally shed what is not of self, but to attempt to rush the process may see the full value of your chosen treatment to be diluted. However, when appropriate to do so, others have found plentiful amounts of water, juices, detox baths, additional fibre and exercising, a gentle and effective way to bring the body back to a state of “new normal”.
There is a high risk of developing Lymphoedema in (predominantly) women that have undergone treatment for breast cancer. Breast cancer surgery, including lumpectomy, and those who have had axillary lymph nodes removed or received radiation to this area are at an increased risk of the effects of Lymphoedema. Lymphoedema can occur weeks after surgery, within a few months, or several years after treatment.
The lymphatic system runs throughout the body, it is made up of ducts, nodes, and tissue. The lymphatic system carries fluid, cells and other waste material throughout the body to allow it to be filtered, collected and excreted. These materials are carried to the lymph nodes in a colourless fluid called lymph. Lymph nodes are groups of clustered immune cells that act as filters for the lymphatic system. It is also the job of lymph nodes to store white blood cells – white blood cells help fight infections. No credible studies on loss of white cells due to removal of lymph nodes has been undertaken. However, the correlation between node removal and a low immune system is overshadowed by the fact that most patients elect to undergo treatment via chemotherapy and/or radiation which automatically reduce the immune system. Difficult to study when there are additional factors determining the outcome.
There are several things that you can do that may reduce the risk of getting lymphoedema.
* Have blood taken, or injections to the unaffected arm.
* Reduce weight bearing duties for affected arm – change heavy hand bags to opposite
shoulder, reduce shopping bags weight or use other arm.
* Avoid injury, including scratches, bruises, insect or animal bites to the at risk
* Wear a compression sleeve, and drink a lot of water, during long car or air flights.
Ensure garment remains on for a couple of hours after completion of air travel to
allow for your body to slowly return to balance.
* Avoid wearing tight clothing or jewellery on at risk arm.
Whilst Lymphoedema cannot be cured, there are many treatments that will restore movement, reduce pain and swelling, and make your daily life more comfortable. You may find that one, or a combination of treatments work for you.
* Elevating the arm, keeping your hand and arm higher than your heart and shoulder,
this can help increase the flow of lymphatic fluid.
* Being correctly fitted for a compression sleeve. The sleeves are an elastic garment
that applies gradual pressure in a cylindrical pattern to encourage Lymphatic fluid
* Lymphatic Drainage is a precise method of moving fluid from an effected limb or area
of the body through a gentle specific form of massage. It stimulates alternate
routes for fluid to drain away from.
See your doctor should any changes occur to your arm. The sooner Lymphoedema is diagnosed and treated, the better success you will see with control of the condition.
Call me on 0414 632 668 to book an appointment with me. I am able to assist you with reducing and managing the lymphatic fluid within the treated arm.
Any questions or comments? I am happy to assist.
Have FAITH in yourself…faith that you know your thoughts, emotions, and body better than anyone else.
LISTEN to what your body has to say…how often do you allow yourself the time to sit and go within? Not to give yourself extra time to worry – but to listen to your inner wisdom. If you do not offer listening time, your body does not have the permission to speak.
Find your room of DISCOVERY…and stay there! Stay there until you find the road, or the courage, you have been searching for. It may start off as an empty room of darkness, but that room will transform to light once you see that the space that it offers, contains inspiration and direction.
Book an appointment with me – allow me to show you just how amazing your life can be….a release, and relief, at a time when you may need to find some reassurance, and friendly stability in your life.
Call me on 0414 632 668
Oncology Massage for Cancer Patients.
The Need for a Less-Demanding Approach
By Gayle MacDonald
Originally published in Massage & Bodywork magazine, June/July 2005.
Copyright 2005. Associated Bodywork and Massage Professionals. All rights reserved.
Once on a flight to San Francisco, I sat next to a woman who revealed she had received chemotherapy for cancer. The clinic where she had received treatment had a massage therapist who rubbed patients’ feet as they received their IV medications. My seat mate raved about how glorious it was. I asked if she could describe why the foot massage was so wonderful. It was difficult for her to put into words except to say, “It restored my confidence in the goodness of humankind.”
This is by no means a unique story. I have heard variations of it many times over. Massage gently coaxed Paul back to life after months of treatment for tonsil cancer. For Christa, it was a ray of light in an otherwise dark world. “It made life worth living,” she once commented. Lois felt whole again despite never being cured of the disease.
I have also heard stories from cancer patients that disturbed or saddened me. Sue encountered a bodyworker who mistakenly thought a deep massage following four rounds of chemotherapy would help to eliminate the accumulation of toxins. Instead, it sent Sue to bed for three days with flu-like symptoms. It was six months before she dared try another massage. Following treatment for breast cancer, Sonia returned to her weekly massage sessions. After the first massage, she developed lymphoedema from the use of overly vigorous pressure on the quadrant of the body in which lymph nodes had been removed. Ralph sought out non-painful, comforting massage after undergoing surgery for prostate cancer. He knew his body had been traumatized by the medical procedure, and he wanted to resensitise it. Instead, the practitioner was overzealous. The first time she put her hands on him, the discomfort was so intense, Ralph almost punched her.
Many therapists, because of a lack of clinical training, are working with cancer clients using primarily their intuition for guidance and hoping for the best. As these examples show, sometimes the outcome is absolutely sublime and at other times massage causes highly unfavorable results. No longer is it necessary, however, to guess or just intuit how to work with this population. For 15 years, massage has been making slow but steady progress as a complementary therapy in hospitals, hospices, cancer wellness centers, and chemotherapy and radiation oncology clinics. Large, well-established institutions such as Memorial Sloan Kettering, Dartmouth Hitchcock Medical Center, Massachusetts General Hospital, and Stanford Hospital and Clinics provide a variety of bodywork services for their oncology patients. So, too, do small, lesser-known hospitals in cities such as Toledo, Ohio, The Dalles, Ore., Anchorage, Alaska, Mesa, Ariz., and Boulder, Colo. Thanks to these and many other pioneering programs, there is now a large body of collective experience and wisdom that can teach us how to administer massage in the oncology setting.
In order to massage cancer patients, advanced training is often thought to be needed. I believe the opposite to be true — the ability to work with this population should be part of a basic curriculum and should be taught to all therapists who use manual interventions. The rate of occurrence is so high, approximately 40 percent in the United States, that all bodyworkers will eventually come into contact with people who are in treatment for cancer or who have a history of it. Therefore, it seems logical that all touch therapists should have a fundamental understanding of how to administer bodywork to cancer patients.
The Real Issues
The fear that touch modalities will cause metastasis is no longer an issue in the oncology community, even if the bodywork has a circulatory or mechanical aspect. Science now understands this disease spreads due to genetic mutation, not because of mechanical forces such as massage or exercise. This does not mean there are no cautions to be observed when working with those in or recovering from cancer treatment. Therapists must be alert to the many side effects caused by chemotherapy, radiation, and surgery. When performing body-centered therapies with an oncology client, practitioners must make adjustments in three main categories:
- The level of demand (both physical and psychological) on the client.
- Avoidance of certain sites on the body.
The last two categories — site restrictions and positioning — can, with common sense, usually be figured out by the practitioner. However, bodyworkers often need guidance when learning to create treatment plans that are less demanding on the client. Hence, this is my focus here: Decreasing the level of physical and psychological demand on the person who has a history of cancer treatment.
The general principles I will present are applicable to the work of touch practitioners, movement specialists, and conditioning experts. The guidelines are the same whether the modality is Swedish massage, yoga, or weight lifting. Obviously, because my own focus is massage, the examples given throughout are a reflection of my experience.
Why Be Less Demanding?
First, it is important to clearly define what is meant by the term “massage.” Often, it is thought of as soft tissue manipulation. But, when this is the reference point, the list of contraindications can become lengthy for those with cancer or other medical conditions. For our purposes, massage is defined as any form of systematic touch, which opens the possibilities greatly. Within this definition, nearly all clients, despite their infirmity, qualify for touch therapies of some sort.*
During cancer treatment and the recovery period, which may be a year or more, the body needs all its resources to heal, instead of coping with unnecessary stressors, such as vigorous exercise or deep massage. In most cases, it is not the disease that saps or damages the body, it is the side effects of chemotherapy, radiation, and/or surgery. Blood counts, immune function, lymphatic drainage, digestion, and organ vitality are all affected and take time to improve. Forceful massage is not helpful during healing because it stimulates the sympathetic nervous system, causing the heart rate to accelerate, blood vessels to constrict, blood pressure to elevate, and the gastrointestinal system to become depressed. These physiological activities, which are associated with the “fight or flight” response, are also a reaction to constant anxiety like that which accompanies the cancer experience. The person affected by cancer treatment, therefore, needs the restorative action of the parasympathetic response, which slows heart rate, dilates blood vessels, and increases intestinal peristalsis and gland activity. Long, slow, undemanding strokes such as effleurage initiate these rejuvenating, parasympathetic reactions.
There is no physiological evidence as to the demand massage places on the body of someone who has undergone cancer treatment. We must, therefore, rely on anecdotal evidence. Having worked with well over a thousand cancer patients and another thousand massage students and practitioners, I have a wealth of examples that offer proof for the need to be undemanding when working with this population.
For example, one of my hospital massage students once massaged a 31-year-old man who was being prepared for a bone marrow transplant. Willie was very fit and his blood counts were all good, his nurse gave the green light for whatever the patient wanted in terms of pressure or length of session. Even though the massage student tempered the pressure and despite the fact that the massage strokes felt comfortable to Willie at the time, he woke later that night in significant pain, which he attributed to the massage. From that point on, Willie was wary of massage and never again accepted our offer of a session during his hospital stay.
Another client who came for massage during chemotherapy always felt flu-like symptoms following his sessions. It wasn’t until he had received several massages that he and the therapist realized the nauseous sensations were a direct side effect of the bodywork session. A third patient, someone who had recently been admitted to hospice, requested deep bodywork from the massage therapist. The practitioner sensed this woman was not a candidate for vigorous bodywork and was, with some effort, able to convince the patient that light acupressure would be more appropriate. As in the first example, the bodywork felt good to the patient in the moment, but later the woman admitted it was too much and had caused her discomfort.
These occurrences are not isolated examples, and they usually happen despite therapists’ best efforts to not tax the client. In the above examples, each of the practitioners are people I personally know and highly capable, caring persons. Each of them was distraught to later discover the bodywork session had caused their client discomfort. I know each was operating from a place of high intention. But, despite those best intentions, the massage caused some physical suffering. The experiences of these clients and therapists, however, are extremely helpful to the rest of us, we learn through their mistakes. It is this 15-year accumulation of successes and failures that instructs us all in how to more safely perform massage for cancer patients.
- Bone fragility (either due to osteoporosis or bone metastases)
- Easy bruising
- Implications of pain medication
- IV catheter sites
- Sensitive or fragile skin
When we study the lengthy list of side effects caused by cancer treatments, it becomes very clear why bodywork, or other physical interventions, should be done in a gentle and measured way. Chemo-therapy, for instance, commonly results in a litany of consequences, (see “Chemotherapy Side Effects”), each of which requires the therapist to be more tender in her approach and less demanding.
Radiation invariably brings about fatigue and damage to the skin in the field of treatment. It can also cause many long-term side effects, such as constriction of soft tissues in the area that was treated. Bones in the field of treatment can lose their integrity, becoming fragile. When major organs, such as the heart and lungs, are part of the treated area, scarring can diminish their functioning. And, if the neck, axilla, or groin are part of the irradiated area, lymphatic functioning can be severely damaged due to scarring and adhesions in the nodal clusters. Each of these symptoms calls for the therapist to be less demanding.
Surgery, the third main type of cancer treatment, also requires the touch practitioner to be more cautious. Patients who have had surgery that involves a large amount of blood, such as an abdominal or thoracic surgery, are at some risk for blood clots. Cancer patients often have lymph nodes removed either to excise the cancer or as part of the diagnostic process. Lymph node removal, particularly from the neck, axilla, or groin, puts the person at risk for lympheodema for the remainder of her life. Fatigue is also a side effect of surgery that requires the therapist use a gentle approach. And, during this time, the patient needs to be “pieced back together” rather than enduring another invasive intervention.
Many of the consequences of cancer treatment, such as fatigue, nausea, easy bruising, incisions, or hair loss, are visible to both the patient and practitioner. Underlying these visible side effects, however, are assaults to the body that cannot be seen. Chief among these are the demands chemotherapy and radiation place on the body’s major organs, especially the heart, lungs, kidneys, liver, and gastrointestinal system, thereby decreasing the body’s ability to function at peak efficiency. Permanent damage can even occur. Lois, for instance, underwent radiation for Hodgkins disease. Included in the field of treatment were her heart, lungs, and spine. As a result, Lois was left with congestive heart failure, scarred lungs, and kyphosis, all of which required adjustments to her massage sessions.
The organs of detoxification, including the lymphatic system, become overextended as the body metabolizes not only the drugs but the debris from dying cancer cells and other cells affected by the treatments. This cellular debris overloads lymph nodes that are part of the body’s filtration system. Additionally, during treatment, patients are more sedentary. Muscular action is one of the prime movers of the lymphatic system, and the lack of it causes lymph to stagnate, much like sediment in a pond. A demanding massage can then stir up this sediment, overwhelming the lymphatic system’s filtration capability. Readers may have had the experience of feeling unwell following practice sessions when taking a lymphatic massage class. Imagine then the response of a body that has undergone cancer treatment. It, therefore, makes sense to spare the body from stirring up the waste products, which then spares the client from experiencing flu-like symptoms for days following the massage. A focus on being supportive and nurturing creates many beneficial outcomes — physical energy increases, people feel whole and lovable, and pain and anxiety lessen, just to name a few.
Chemotherapy Side Effects
- Bone fragility (either due to osteoporosis or bone metastases)
– Easy bruising
– Implications of pain medication
– IV catheter sites
– Sensitive or fragile skin
Equally important as the physical side effects are the psychological repercussions. Perhaps more than any other group of practitioners, touch therapists understand the connection between psyche and soma — that which assaults the body, also assaults the emotions.
In case you are not familiar with what cancer patients go through, let me help you imagine some of their treatments. Imagine being left alone in a lead-lined room, lying on a stainless steel table while the technicians operate the machinery positioned over your head with remote controls because it is too dangerous for them to be in the room. Imagine repeating this every day for 35 days. Try to envision IVs being placed in your arm each time you are given chemotherapy. See yourself having radioactive dye injected into your veins or your neck being awkwardly positioned for 40 minutes while a diagnostic scan is performed. Imagine your head is locked in a mask that ensures there will be no movement while radiation is beamed into your brain, or that your jaw was removed because of tongue cancer, or that your bowels empty into a bag attached to the outside of your body, or that your hair has fallen out. It is no wonder people with cancer sometimes develop post traumatic stress disorder because of the invasiveness of the treatments.
The health care providers who must deliver these treatments do their best to be sensitive, but there is an inherent intrusiveness that affects most patients. Touch therapy is one of the best ways to heal the insults to the body, mind, and spirit. In order to accomplish this, practitioners must be willing to set aside their agenda, to move slower and more gently into the relationship with an emphasis on building trust. Like someone who has suffered a physical trauma, cancer patients may be disconnected from their body or the part of the body that has been treated. They may be unaware of how their body feels, including pain levels or areas of holding and therefore unable to give the massage therapist accurate feedback. And so, the patient’s body must be touched with hands of peace, whispered to instead of shouted at, reverently anointed, or handled as if it is a delicate flower.
How to Be Less Demanding
When receiving touch therapy, cancer patients require individual adjustments, with modifications that might change from week to week. For instance, when I worked with Alan during his radiation treatment, he was fatigued and depressed. The two adjustments I consistently made were a decrease in pressure and slowing the speed of the strokes. One week near the end of his radiation, Alan was so deeply distraught, he could barely relax enough to lie down. That session ended abruptly as Alan bolted off the table, unable to lie still for a moment longer.
There are many types of adjustments that can be made so the bodywork session is less demanding on the client. Generally, not all of the following variables need to be changed for each client.
- Changing modalities.
- Decreasing the duration of the sessions.
- Decreasing the pressure.
- Giving the sessions at the client’s home.
- Handling the body with great mindfulness.
- Letting go of the intention to “fix” the client in favor of just “being.”
- Slowing the speed of the strokes.
The majority of oncology patients who are in treatment always require less pressure and slower speed of strokes. By doing this, it is possible to administer nearly any touch technique, even those normally thought of as vigorous, such as Thai massage or trigger point therapies. Most people also need us to handle the body with exquisite mindfulness. And even then, cancer clients are brought to tears as the trauma dissipates from their bodies. Lois always cried at the beginning as my hands lightly cradled her face. With Betsy, who had finished treatment for breast cancer a month earlier, just placing my hands mindfully onto the treated arm brought a big breath. When I asked her about it, she quietly started to cry and said, “When you touch me, I’m afraid. I’ve been handled so roughly throughout my treatment.”
One of the best ways for therapists to lessen the demand is to let go of any intention to fix the person beneath their hands. When practitioners want to “fix,” that expectation places a demand on the client, a goal that implies success or failure. And, as author Rachel Naomi Remen points out, “There is distance between ourselves and whatever or whomever we are fixing. Fixing is a form of judgment.”
To be present with people is enough — to embrace their bodies and psyches just as they are. People change when they are received in this way.
Gauging the Level of Demand
Gauging the level of demand of massage on a cancer client’s body is difficult for both the client and the therapist. Patients who have received massage prior to being diagnosed with and treated for cancer mistakenly believe they can tolerate the same type of bodywork sessions as before. In my experience, that is never the case — ever. Even the most robust of clients find they must modify their activities as they are going through treatment and recovery. The most common adjustment to the massage session will be the use of a soothing, nurturing pressure rather than a deep or vigorous one.
I teach therapists to “inch forward” with the level of demand. Begin the first session with the idea of creating a baseline. Engage in superficial contact focusing on no more than the surface layer of muscles. If the person is fragile, use a level of touch that focuses only on the skin. For the first session after the start of treatment, even if you have worked with this client for years, perform the entire massage at an undemanding level, resisting the client’s urging for deeper pressure or your own need to do more. Concentrate on restfulness, tranquility, and ease. There should be no attempt to dig deep or fix musculoskeletal problems. Interestingly, even when the massage is gentle, with no specific agenda, amazing clinical outcomes occur. The research is fairly clear about the effect of massage on pain, anxiety, and nausea. Each of those three variables shows significant improvement immediately following touch sessions. Anecdotal evidence also suggests that systematic touch can help some people sleep better, temporarily decrease fevers, improve bowel function, and decrease fatigue. Deep, effortful bodywork is not necessary to achieve profound results.
Massage schools train therapists to ask clients if the pressure they are using is comfortable. While this is a necessary question, it is not an adequate measurement for the therapist working with cancer patients.
The feedback a cancer client gives in the moment is not always an indication of what is appropriate. Time and again I have listened to clients’ stories of how wonderful a massage felt while they were receiving it, only to be in pain or have flu-like symptoms that evening or the next morning. Granted, this discomfort is temporary and causes no long-term damage, but it can create an aversion to massage, such as occurred with Willie, mentioned earlier. Lympheodema, however, is the exception to this rule of “it’s only temporary.” When lympheodema is triggered, which can happen because of massage, it can cause long-term side effects. (For more detailed information on the adjustments needed for those at risk for lympheodema, see “Cancer, Radiation, and Massage,” August/September 2001, page 16, and “Edema
and Lympheodema,” December/January 2005, page 46, or visit the archives at www.massageandbody work.com.)
What clients report in the moment may not be an indication of how they will feel in six hours. The therapist must use other guideposts in order to gauge the appropriate level of demand, such as:
- Other demands on the body. The body may already be overtaxed from other interventions and activities. For instance, perhaps the client is zealously trying to regain her health and has increased her level of exercise, is receiving acupuncture, and is taking supplements prescribed by a naturopath to cleanse the liver. Heavy, or even moderate, massage would be ill-advised during this time.
- Exercise level. This can tell a practitioner a great deal about how much the body can tolerate. However, do not assume that if the client is able to walk several miles or that she is back in the gym, it means the massage does not need to be moderated. It still needs to be given in a restrained manner. Remember, inch forward.
- Length of time in treatment. The person who has had cancer treatment for years will be less able to tolerate a robust massage.
- Looks can be deceiving. The practitioner must bear in mind the treatments that affect unseen parts of the body. Appearance cannot be used as a guideline because often patients appear amazingly healthy.
Therapists often ask, “What if clients request or even demand deep massage?” This can almost always be avoided by explaining to clients prior to the first massage that their body has a “new normal” and that there is no way for them or the practitioner to know what that “new normal” is. Together, you must slowly and cautiously discover what the body and psyche can tolerate. I explain to the client that we are going to gradually work up to deeper pressure. I tell them that within 48 hours of each session I will call to see how they felt after the massage. And, if there was no deleterious outcomes, we will inch forward the next time. When clients know that they eventually will be able to have pressure that is firmer, they are very agreeable to this systematic plan.
Practitioners must take a stronger leadership role in guiding the massage sessions. Clients, and even their health care providers, don’t usually understand the effect of massage on the body. Rather than caving into what the client wants in the moment, the bodyworker must educate the patient before the session begins and explain the principle of inching forward.
Patients who have leanings toward complementary modalities may request the massage therapist assist them in detoxification of the body. Helping a client detoxify following cancer treatment is an appropriate goal, but it should come after other things have been accomplished. Confidence in the body must be regained, the trauma of undergoing medical treatment dissipated, and wholeness reestablished. The “new normal” must be discovered. All of this may take months or more. Detoxification regimens place demand on the entire body, a body that is still processing the consequences of chemotherapy, radiation, or surgery. Wait until the client is well-recovered from the obvious side effects of treatment, such as fatigue and immunosuppression, and is no longer on a long list of medications.
In massage school, I often left pathology classes more afraid than before I went in. I hope that’s not how I’ve left you here. Awareness, precaution, and care are the things I hope you can take away from this — not fear.
Even after I was a licensed massage therapist, I nearly gave up the profession after hearing a petrifying lecture on deep vein thrombosis. It is not my intention to be frightening here. So, in case I have recounted too many stories that were focused on the potential for injury or suffering, let me end by reiterating that nearly all cancer patients can safely receive massage if certain adjustments are made, such as decreasing the level of demand on the client.
Massage, given with care, has the capacity to open hearts, create wholeness, and change lives. Erna is an example of this. I never tire of hearing her story of how doctors cured the cancer, but massage helped her “connect with healing.” That’s important work.
Gayle MacDonald is the author of Medicine Hands: Massage Therapy for People with Cancer (Findhorn Press, 1999) and Massage for the Hospital Patient and Medically Frail Client (Lippincott Williams & Wilkins, 2005). Readers can reach her at firstname.lastname@example.org. MacDonald’s teaching schedule can be found at www.medicinehands.com.
Your Doctor has given you news that you were not wanting to hear, and you absolutely never thought this would happen to you. What do you do now? After a very short period of time to process these words, your Doctor will start giving you the options that they have for your particular situation, a discussion on an initial treatment plan will ensue, and given the condition that you present them with, they will indicate what time frame they will need to work within.
In one way or another, people generally experience their own unique version of a crisis at this point, either right there in the office whilst they are hearing the news, or after processing the information and understanding the effects of what the treatments will mean for them. This crisis point does not have to be as negative as it sounds, you will have in this period, so many questions; why; how; what now….the list will be endless. But what you do with those questions, how you decide to seek out that information, will determine what quality of answer your receive.
A manual that gives us all the information we need for our body, would sell like hotcakes! However, as at today’s date, that issue is yet to be released to the public…so, we are left with the job to find out what we need to do to effect change. If we change nothing…nothing changes… What might surprise you is that we are all capable of working out what our body requires, and what will work for us. For some, it will be conventional treatments, and for others it will be alternative methods.