In a room packed full of massage therapists at the 2010 AMTA National Convention in Minneapolis, Minnesota, Susan Salvo, massage therapist and owner of Bodyworks Massage Therapy in Lake Charles, Louisiana, asked a simple, straightforward question: “How many in this room have been affected by cancer, whether personally or someone you know?” Nearly every hand in the room went up. “Take a look around,” Salvo encouraged. “Isn’t that amazing?”
A humbling display, perhaps, but a good reminder for everyone present: you will probably, if you haven’t already or don’t now cater to cancer patients, massage someone who is dealing with this disease. And Salvo helped attendees understand how to best serve these clients if—or, more probably when—the time comes.
The More You Know
Salvo encouraged attendees to arm themselves with information, both about their client as well as the disease. “The more information you have,” she explained, “the better able you are to serve your client.” This process starts at the intake. You need to ask your client what goals they have for the session, as well as the specifics about their disease and treatment. Has the client had any surgical procedures that would affect the session? Are they receiving chemotherapy or other treatments for their illness? What medication are they taking? Do they have any current symptoms, including any side effects from their treatment, you need to know about? Knowing the answers to these questions, and understanding the outcome your client is hoping for, goes a long way in designing a treatment plan.
You are also going to have to be in touch with the client’s physician and be willing to collaborate with other health care professionals involved in the client’s care. “You need to ask about any restrictions their physician has placed on them,” Salvo explained, “and apply those same restrictions to your massage session.”
Salvo also suggested that massage therapists keep up with the latest in cancer research, explaining that the advancements in knowledge and technology are constantly changing.
During the Massage Session
There are going to be things that are necessarily different about your massage therapy sessions with clients who have cancer, but the overall goal is the same as you have with many of your other clients: comfort. “Your focus is not to fix anything,” Salvo began. “Your focus is on providing comfort.”
Many times, clients with cancer don’t need full sessions and instead appreciate a massage lasting 30 minutes or less. “Sometimes,” Salvo said, “five minutes might be what is needed by the client.” Salvo also encouraged attendees to use lighter touch with these clients, and avoid certain areas like tumor sites, enlarged lymph nodes and areas affected by radiation. “If the client has a port that’s used to administer chemotherapy,” Salvo added, “you need to leave a 4-inch radius around the port where you don’t touch the client.”
Massage therapists also need to be able to read some of the signs their clients with cancer might be sending. For example, pay attention for signs of discomfort. Does the client grimace or fl inch during the massage session? Are they holding their breath or tightening muscles? “Be honest with your clients about what you’re noticing,” Salvo explained. “Then, ask them open and close-ended questions.” If you ask how they’re doing and they simply answer “fine,” be more specific: Can you take more pressure? Would you like less pressure?
Remember, too, that chemotherapy often makes patients more prone to infection, so you need to consider not only the health of your client, but also your own well-being, when scheduling massage therapy sessions. For clients who have an infection, massage shouldn’t be performed until they’ve been fever-free for 48 hours. Additionally, if you have a cold or fever, you should reschedule any appointments you have with clients who have cancer. This rule also extends to your immediate family members because you can be a carrier of infection without having any symptoms yourself. “If someone in your household is sick,” Salvo warned, “postpone your massage therapy session.”
Some other general guidelines suggested by Salvo include: Postpone massage after chemotherapy for at least one day, as this treatment often leaves people feeling especially tired. “I wouldn’t massage the day before or the day after a chemotherapy treatment,” Salvo said. Clients undergoing chemotherapy might also experience cold intolerance, so Salvo suggested having a blanket on-hand during all massage sessions. If chemotherapy results in mouth sores, avoiding the prone position is absolutely necessary.
Document the Results
You do this activity for every client, but for the client with cancer, documenting the session is extremely important and gives you a reference point for future and past appointments. So, after the session, spend some time recording what you observed during the session and how well your client received massage therapy.
Here, you can detail the signs and symptoms you noticed, as well as both the areas you worked and the areas you avoided. You should also record what techniques you used during the session, and perhaps briefly describe how well each technique seemed to work for the client. Was light touch good or did the client want you to go a little deeper? Did the client experience any pain or discomfort? How well did the client tolerate massage therapy?
Having a record of the sessions can give you a clearer understanding of what works for your client and what doesn’t. Massage therapists have a lot to offer clients who have been diagnosed with or are battling cancer. From decreasing pain to reducing muscle tension to improving sleep, the positive effects massage therapy can have for clients dealing with diseases such as cancer is encouraging. “Don’t be afraid to touch these clients,” Salvo reminded attendees. “You provide them a little space to be who they are.”
Whether a new client or someone who you’ve been working with for years, a cancer diagnosis brings about a wide range of emotions. “Getting the diagnosis brings about a lot of changes,” Susan Salvo, massage therapist and owner of Bodyworks Massage Therapy in Lake Charles, Louisiana, told attendees of the 2010 AMTA National Convention in Minneapolis, Minnesota. “They might feel fear, anxiety, anger or depression.”
As a massage therapist, there are some things you can do to help clients dealing with cancer feel better, the primary one being offering them a space where they can be wholly and completely themselves. “Let them run the show,” Salvo encouraged. “Respect when they want to talk and when they don’t want to talk.” Salvo also suggested that just as with other clients, massage therapy can be an emotional outlet for people with cancer. So, don’t be surprised if your client starts crying, and remember to respect the boundaries they establish in terms of how much they want—or don’t want—to talk.
“Take your clients where they’re at,” Salvo continued. As an example, Salvo offered up the story of a client with cancer she had who really just enjoyed having her scalp massaged. “Just because you avoid or don’t massage certain areas,” Salvo reminded attendees, “doesn’t mean your clients with cancer are going to feel like they didn’t get a complete session.”