Through Each Other’s Eyes
A Journey to Boston, Caring for Cancer Clients with Oncology Massage
By : Chandrika P. Choo
A case of “Serendipity!” Is it chance, fate, destiny, karma, luck, fortune or coincidence? What a wonderful way to describing my debut into palliative care and journey these past 3 years. Losing the love of my life to cancer paved me an unlimited path to render my service in caring for clients with cancer through Oncology Massage. At Perak Palliative Care Society, we call it Palliative Massage, a therapy that addresses body and mind reciprocation through therapeutic touch.
There used to be a time when massage was deemed to be contraindicated to people with cancer. This contraindication persisted for decades until research studies proved that massage when delivered by skilled therapists was safe to be administered to these population. My thirst to excel further in the area of Palliative Massage led me to Boston to be further trained in this area. I am eternally indebted to PPCS for sponsoring me this educational opportunity and I am honoured to mention that I was thought by the USA recognised educator for Oncology Massage, Ms Tracy Walton.
Palliative Massage Therapy is a pilot project and PPCS is the first to incorporate this service to its home care clients. I have been working in isolation where cancer massage was concerned. My CE’s basically were dependent on learning via internet and connecting with Oncology Massage Therapists online for advice. I have had the privilege of befriending many great therapists who have been ever willing to assist me in areas of need. Nevertheless, greater was the reality when I actually met a whole lot of wonderful Oncology Massage Therapists and facilitators when I went to Boston.
My journey led me to meet my host Judy Dyer, a Nurse Practitioner with whom I spent many learning moments throughout my stay with regards to palliative care. Besides the course that I attended with Tracy Walton and Associates at the Elizabeth Grady School of Esthetics and Massage Therapy Boston, I also had the chance to shadow/attachment opportunities with Karen Ingwersen, Erika Slocum, Cortiva Institute, Boston Medical Centre & Massachusetts General Hospital. I also met with many great therapists who besides being Oncology Massage Therapist were also experts in Lymphedema and Paediatric Massage.
I was awed by the use of massage in cancer care by the major hospitals in Boston and the way they had integrated touch in the various stages of caring for clients with cancer.
Another unforgettable learning experience was attending The Anatomical Exhibition of real human bodies which featured authentic human bodies. It was almost like going through a crash course in Anatomy & Physiology.
It is my hope and dream that massage be integrated into palliative care to relieve common problems faced by oncology patients including emotional and physical pain, anxiety, insomnia, depression, stress, chemotherapy related nausea and fatigue. Oncology Massage is Medical Massage and it makes a holistic difference in patients as it addresses the physiological and psychological needs of patients in their various cancer stages. Greater awareness is needed together with formal educational program to establish a career pathway in Oncology /Palliative Massage Therapy.
With Tracy Walton
Wendy Stone & Saskia Cote
INTRODUCING PALLIATIVE MASSAGE THERAPY (PMT) TO HOSPICE AND PALLIATIVE SERVICES IN MALAYSIA BY
PERAK PALLIATIVE CARE SOCIETY
By Chandrika P. Choo
In recent years (approximately the past 15 years or so), there has been a great evolution in cancer care for supportive intervention to those in need of hospice and palliative attention. This integrated intervention has proven to be most useful with patients presenting with pain, anxiety, loss of sleep, depression, mood disorders, stress, nausea and fatigue. These are criteria set by AMTA (American Massage Therapy Association) and S4OM (Society 4 Oncology Massage) where Massage adaptations are required for fatigue, peripheral neuropathy, low blood cell counts, blood clots, bone pain, bone metastases, radiation or surgery, removal of lymph nodes, lymphedema, medications, medical devices and late effects of treatment.
Those under Hospice or Palliative care have immensely benefited from this integrated intervention which is evidence based on numerous studies conducted by leading oncology research bodies.
Perak Palliative Care Society has introduced Palliative Massage Therapy to its clients since late 2010, a Pilot Project in a Supportive Allied Health Care provision to its palliative clients.
This intervention is also knows as Oncology Massage or Cancer Massage which aims to deliver comfort and relaxation through touch and largely aims at pressure scales to connect the body and mind in a reciprocate manner in order to improve local musculoskeletal symptoms, mood state and pain threshold. Here, displacement of pressure includes skin, fascia, muscle, blood vessel, nerves, joint and bone. However the above pressure scale is not an absolute quantification of massage pressure; because pressure is subjective, it is delivered differently by different therapists according the client condition. This is further elaborated by Dr S M Sagar in his article, Massage therapy for cancer patients: a reciprocal relationship between body and mind
Massage in general is a generic term for a variety of techniques that involve touching, pressing, kneading and manipulation of the soft tissues of the body for therapeutic purposes (Calvert 1992; Jackson 1993). There are many types of massage, (Russell 1994) available which aims at client choice to choose which technique is most suited and comfortable which involves Physiological and Psychological Effects. The history of massage dates back to as long as human beings have existed with multitudes of methods from almost all culture, religion and ethnicity. There is vast evidence which is easily available in the net.
Having combined the art and science of touch, PMT creates a safe, effective massage session for people with cancer. This is a modification of massage techniques which allows massage therapists to work safely with effects of cancer and cancer treatment. When a massage therapist works with a medically frail patient or one who is terminally ill, the work performed takes on a much different purpose when compared to a healthy client coming in for health maintenance purposes. Often the touch is much lighter and offered as much for psychological comfort as for easing physical pain. In many situations the only touch they have received has been either cold and clinical or painful. Simply being there and holding a person’s hand, or gently rubbing his or her back can soothe anxiety and increase comfort.
One of the benefits a massage therapist might consider is to teach family members how to offer comforting touch to the hospice or palliative patient and others interested in it. This allows the family member to be involved in the care of their loved one as the massage therapist will not be at the patient’s home for hours on end, where else family members might. Rather than feeling frustrated and helpless just sitting there, a family member will be able to give that gentle touch to a loved one. Being able to feel at ease touching a loved one with healing intent can go a long way in reducing the feelings of powerlessness in a life-altering situation
Another important aspect in working with chronically ill or terminal clients is making sure the massage therapist has a thorough knowledge of treatment plans by other team members, which would include knowing the type of medications being given and the potential for massage either increasing or reducing their effects. This would be true in both hospice and palliative according to situation where in a palliative care, light Swedish massage might be given to someone receiving chemotherapy or in hospice care where even more passive massage might take place.
Providing massage to very ill clients or to those who are in the last months or weeks of life is much different than massage for those who are healthy or suffering from life’s daily aches and pains. Compassion and patience are the main tools – with warm, healing hands coming in a close second. The rewards are many and the emotions can be intense. Being well prepared for this important work is vital.
We at Perak Palliative Care Society will continue to uphold the spirit of care and live up to our mission statement.
Massage at PPCS Centre
Massage at a client’s home