Breast-cancer patients who received two 30-minute sessions of massage therapy per week for five weeks showed significant reductions in depression and anxious depression, according to a recent study.

The research, “Depression, mood, stress and Th1/Th2 immune balance in primary breast cancer patients undergoing classical massage therapy,” involved 34 breast-cancer patients. Inclusion criteria were tumor size of less than or equal to T2, nodal state of less than or equal to N2 and disease onset less than or equal to four years ago. Surgery, chemotherapy and radiation had to be completed at least three months prior to the start of the study.

Exclusion criteria were distant metastases, lymphedema of arms or breasts, inflamed skin in the area of massage therapy, psychiatric diseases and treatment with anticoagulants, cytostatics, corticosteroids, antidepressants or opioids.

Subjects in the study were randomly assigned to either the massage group or a control group. Those in the control group continued receiving standard medical care. Those in the massage group received two 30-minute massages per week for five weeks.

Evaluations were the same for all subjects in the study, and they occurred at the same three points in time. The first assessment took place at baseline, before any intervention began. The second assessment took place at the end of the five-week intervention period. The third and final assessment took place six weeks after the end of the intervention.

The methods of evaluation were the Patient Health Questionnaire, the Berlin Mood Questionnaire, the Perceived Stress Questionnaire and a blood sample. The blood withdrawal took place at the same time of day for all patients.

Researchers aimed to measure how massage therapy would affect depression, anxiety, stress and mood, as well as the Th1/Th2 ratio in breast-cancer patients. According to the researchers, Th1/Th2 ratios reflect immune balance and represent immunity against tumors and infections.

One massage therapist administered the massage-therapy sessions for all subjects in this study. The massage protocol consisted of stroking, kneading and friction to the sternocleidomastoid muscles, trapezius muscles, rhomboid muscles, small neck muscles, supraspinatus muscles, teres major muscles, levator scapulae muscles, autochthonal back muscles, latissimus dorsi muscles and pectoral muscles.

Results of the research revealed a significant reduction in both depression and anxious depression among subjects in the massage group at the end of the five-week period. Stress and mood did not show any significant changes, and the Th1/Th2 ratio registered a slight improvement in the massage group.

“In summary, classical massage therapy has been shown to significantly reduce depression in breast-cancer patients,” state the study’s authors. “Therefore, an integration of classical massage into treatment and aftercare of primary cancer patients, particularly breast-cancer patients, appears very recommendable according to the presented results.”

Authors: Michaela Krohn, Miriam Listing, Gracia Tjahjono, Anett Reisshauer, Eva Peters, Burghard F. Klapp and Martina Rauchfuss.

Sources: Department of Psychosomatics and Psychotherapy, Department of Physical Therapy and Rehabilitation, and Institute of Radiology, Charité University Medicine Berlin, Germany. Originally published in Support Care Cancer (July 2010).

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