Many moons ago, when I attended massage school, the prevailing doctrine was that one should not massage someone with cancer. The belief was that, by increasing circulation, we might set off tumor cells to other parts of the body, and therefore “spread cancer”.
Fortunately, that teaching has been laid to rest, and people challenged with cancer can now receive the many benefits that massage and reflexology have to offer.
I love that I am able to provide comfort and symptom relief to people who are regularly poked and prodded while fighting cancer. It’s been a sizable part of my clinical practice over the years, and even more significantly, something I was able to offer my own father in his last days of battling lung cancer.
How cancer spreads
The spreading of cancer within the body is not a by-product of increased circulation.
Metastasis (the development of secondary malignant growths at a distance from a primary site of cancer) is a very complex process. In simple terms, metastasis develops from a convergence of:
- Genetic mutations, both inherited and acquired, that cause uncontrolled cell proliferation
- A lack of cell surface adhesiveness
- Secretion of degradative enzymes
- New capillary growth
Avoiding comfort-oriented bodywork will not stop malignant cells from slipping away from the original tumor. It will, however, deny people with cancer the many benefits we have to offer.
Contraindications
Reflexology poses fewer contraindications for working with cancer patients than does massage therapy. Reflexology contraindications for someone with cancer are the presence of fever, a severely reduced platelet count (<50,000 u/l) and recently radiated tissue. Beyond that, I rely on the person to inform me of whether or not they want to receive therapeutic touch that day, for how long and with what pressure.
The intent of my sessions is deep relaxation of the entire body and sometimes a focus on helping to manage troublesome side effects of chemotherapy treatment like nausea, lack of appetite, low energy, peripheral neuropathy symptoms and hand and foot syndrome.
For me, working with people fighting for their lives is a privilege. What has been your experience working with people with cancer?
Hi Karen.
Can you just clarify why you can’t do reflexology with a reduced platelet count (<50,000 u/l) and recently radiated tissue?
Thanks
Vicki Scott
Vicki – Thanks for asking, and I must admit straight off, that I am conservative and cautious when it comes to working with cancer patients when they are in the midst of radiation treatment.
Radiation inflames and heats the body – all of it; not just where the radiation is directed. Histamines released during the inflammatory response can result in the accumulation of water in the interstitial spaces anywhere in the body. This increases the stress on the body, both the heart and the organs of elimination (skin, kidneys, lymphatic system). I don’t want to overload and overwhelm an already traumatized body.
Another common effect of radiation is reduced blood cell counts, both red and white.
A reduced white blood cell count, known as neutropenia, causes serious changes in the body. These include:
1. Depressed immune system, leaving the individual very vulnerable to any communicable pathogens. It is prudent for all bodyworkers to practice “protective isolation precautions” when working with immune-suppressed clients. The protocols are to protect the patient from any communicable pathogens that may be introduced by the practitioner and/or the environment in which the session is being offered.
Protective isolation precautions include proper 30-second hand washing before the session; postponing the appointment if the practitioner has even the slightest fever, flu, cold or is in constant contact with others who are ill, re-washing the hands during the session if the practitioner sneezes or coughs into their hands, and conducting the session in the client’s home so s/he doesn’t have to muster up the energy to travel.
2. Easing bruising. This can arise anywhere, not just where touch is offered. If bodywork is given, it is recommended that touch be applied to the entire body, not just to one area, and very, very lightly,
Reduced red blood cell count, also a common effect of radiation, can result in severe anemia, leaving the individual very fatigued. Increasing circulation, as reflexology does, can stir up more waste products for the heart and organs of elimination to have to deal with than the person can handle.
So, as I said at the beginning of this lengthy response (-: I am very conservative with these situations. There is limited research on the effects of bodywork on people undergoing cancer treatment. I choose to be very cautious. There is a lot that I can offer between radiation treatments to help support the person battling cancer. Not all therapists adhere to the same boundaries.
Karen’s answer is correct. The patient is immune suppressed, therefore vulnerable to infection. The skin bruises extremely easily. Gentle touch is so comforting and even gently holding the feet can bring great comfort.
I can relate to your experience of feeling privileged to providing a deep relaxing relief. I volunteered for a hospice and gave reflexology to people with terminal conditions, many of whom had cancer. I also had a client who developed terminal Cancer and found reflexology treatments, even a short hand treatment, deeply relaxing. Thank you for the reminder of why reflexology does not ‘spread cancer’.
I think that working with people in painful situations, largely outside their control, is one of the most rewarding pieces of being a reflexologist.
I am a new graduate and this is my heart’s desire, to give comfort and relief from treatment symptoms. I just don’t know enough. Do you have recommendations?
Cheri
Hi Cheri! I would suggest you read all you can find about the effects of professional touch on people living with cancer: reflexology and massage. If you can find someone who teaches a course on working with cancer patients utilizing reflexology, but all means do so.
Please read this article on CURRENT RESEARCH about Cancer and Massage Therapy
https://www.scienceofmassage.com/2017/05/science-of-oncology-massage-part-1/
Thank you for sharing this.
Wonderful reading, thank you.
Thanks, Kim, for taking the time to comment.
Thank you Karen. I’ll share to my Facebook page
Thanks Caroline.
Thank you for sharing this. I have work with people suffering from cancer and it has been the biggest gift in this profession. Pure love experience in both side. Thank you!
You’re welcome, Ana. Keep up the good work.
Thank you Karen I shall share to my page xx
Thank you, Helen.
If you are looking for additional information here is a link for specialized training in this area of our practices. When treating such conditions it is necessary to have all the answers.
http://www.beaumont.edu/education/schools-of-allied-health/clinical-oncology-massage/
Thanks, Michelle. This could be useful for anyone doing massage instead of reflexology. http://www.tracywalton.com is another good training center for people wanting to do massage with oncology patients.
Dear Karen,
I have prostate cancer and on the 7th cycle of chemotherapy treatment. Can I apply reflexology treatment to vital organs like the heart, liver, lungs and kidneys?
It might be a good idea to check with the physician to see if he or she sees any reason why reflexology would be contraindicated. Generally, reflexology does help with relaxing people and supporting the various organs under attack.
I have out of breath experience due to Aberaeron acetate treatment I received previously and chemotherapy treatment now.. I seems to reduce the symptoms after massage to the accue point of the chest, diaphragms, lungs and heart.
I’m more energetic breath easily.
Sounds like it’s been helpful.
A reflexologist in Spain who is a medical doctor lists cancer with metastasis as a contraindication. Now I’m unsure. Can you clarify and offer your viewpoint?
Thank you!
Michelle
Hi Michelle!
Is it Dr. Jesus Manzanares that you are referring to? I guess I would need to read his reasons for making that statement before I could really respond.
I work with many cancer patients, some with cancer metastasized to many areas of their body and on chemo drugs for the rest of their lives. Reflexology makes their time on drugs easier, reduces the side effects, and improves the quality of their lives so much they would never consider stopping. We are able to maintain relatively safe liver enzyme levels and improve their immune function.
Hi Karen,
It is Dr. Manzanares and despite buying his research study where the contraindication is listed, he does not support his statement with any theory. I am teaching a reflexology certification class and want to be careful about alarming my students about working on clients with cancer. My only thought on Dr. Manzanares contraindication is that he perhaps believes that working the reflex of an organ with cancer could increase blood supply to the cancer cells and promote growth. It is helpful just to know that you have not found an adverse reaction to working on individuals who have had mastatasis. I appreciate your time and reply!
My understanding of metastasis is that cancer cells must establish their own blood supply (angiogenesis) in order to grow into a tumor. You’re wonderful questions, Michelle, are prompting me to publish something I wrote for students on cancer, based on research published by the American Massage Therapy Association. Stay tuned!
Thanks, Karen. I look forward to reading that information. Again, I appreciate your sharing your thoughts and your time. 🙂
Can a child with near haploid acute lymphoblastic leukemia have reflexology? Especially when neutropenic?
Hello Annette – I wish there was a way for me to give you some definitive answer to your question. The condition you refer to is rare; the situation would require much more information and collaboration with the child’s doctor to determine what, if anything, a reflexologist could provide.
Thank you Karen for your very interesting blog post and extra comments. I’ve been practicing for 2 years but today is the first time i’ve been asked to treat with Reflexology someone currently undergoing chemotherapy. My training said I should ask the client to get their consultant approval, which they have. What’s your view on the need for me to wear gloves whilst treating someone having chemo? Thank you
Hi Jane! Thanks for writing with your question. Although I have never worn gloves when working with people undergoing chemotherapy, I know that many bodyworkers do. If there is a risk, I wonder if it would be more so if the person was receiving as a ‘drip’ as opposed to taking oral meds? Of course, no matter what, if I had an open cut on my own hands I would make sure to cover.