oncology massage
After gaining knowledge of how the lymph system can be compromised, this therapist is able to determine the best way to massage, proximal to distal, away from a node removal surgical site

When I consider how I became an oncology massage therapist, I am always reminded of my mother, who had cancer.

When I was growing up, cancer was referred to in my family as the “C” word. We did not have an awareness of how to deal with her cancer diagnosis and its effect on her, my father and us, their eight children. Though we were in the trenches with the enemy, our family approached the subject with stealth silence. Cancer came in and altered our world, leaving me, all of us, to figure it out.

During one of her few visits home from treatments she was receiving at Sloan Kettering in New York, I remember my mother sitting next to me on the couch in the living room. Her beautiful brown eyes and painted red lips were in the forefront of my mind. I asked about her funny balding head. She placed my hands on the growing sprouts of soft, baby-fine hair. I smoothly and lovingly glided my hands, gently feeling the silky newness. Feelings of peace and connection ensued.

Little did I know or begin to understand, until years later, how this experience in childhood would be an unconscious thread of motivation behind my desire to take my massage practice into the direction of oncology. 

What’s Your Motivation?

What is the value appropriated to becoming a massage therapist who specializes in services for those living with cancer? The desire may grow out of a deep longing to reduce suffering for individuals. Others may find that it is a way of giving back after healing from the loss of someone who had cancer. For others it may simply be another skill set to pursue.

Whatever the reason, a conscious and deliberate evaluation of one’s motives and skills is needed in order to maintain healthy boundaries and move forward in the direction of “do no harm.” To provide safe and effective oncology massage, a therapist must have the confidence and clinical skill to serve a population of individuals who are at risk for blood clots, lymphedema, infection, and poor reaction to inappropriate levels of pressure.

Oncology Massage is Individualized

Oncology massage is a term and service that is often undervalued and misunderstood by massage therapists, clients, spas and hospital administrators. Massage looks very different in the arena of treatment, early recovery and long-term recovery.

In other words, massage services are different for different stages of treatment and recovery, as well as for each individual. This means there are ongoing assessments and adjustments made to fit the client.

Oncology massage research results are as varied as approaches to massage therapy. Qualitative and quantitative research has demonstrated the efficacy of massage in reducing anxiety and pain; increasing clients’ esteem for their bodies; and supporting other quality-of-life areas often diminished with cancer, such as poor sleep, fatigue and depression.

Competent oncology massage therapists offer a depth of support and relief to those who are experiencing negative side effects from chemotherapy, radiation, surgery and other treatments for cancer. Through education and experience, therapists must learn a specific body of knowledge and develop critical thinking skills that will be needed in order to ask clients the right questions and listen for specific answers.

Understanding the significant side effects of cancer treatment such as low blood counts, pain syndromes and mobilization issues that occur as a result of treatment are just a few issues that have to be addressed clinically. 

Oncology Massage Education

Currently, those who attempt to elevate the practice of oncology massage to a level of professionalism that is respected and appreciated cannot enforce standards of education, as there is no one unifying entity or licensing body comparable to that of nursing or physical therapy.  Those seeking oncology massage are left to the discretion of the therapist’s own understanding of their level of competence.

It is unclear what demonstrated level of skill is needed to be able to include oncology massage in one’s scope of practice as a massage therapist. Untrained therapists or those with little training in oncology massage, hired into hospitals, clinics or spas where there isn’t a clear understanding of the knowledge base needed to provide safe massage, may unknowingly take on more than they can clinically handle, leaving clients at risk and therapists in a constant state of uncertainty.

Despite these challenges, many educators in the field of oncology have followed the leadership and teaching of authors and oncology massage therapist pioneers. These professionals have put forth the basic understanding that all people living with cancer may experience massage or therapeutic touch when thorough assessment reveals the parameters needed to provide the right pressure, positioning and site provisions necessary. They also posit that those who have been in ongoing recovery continue to need special clinical considerations.

Developing clinical skills and ongoing training in the nuances of oncology massage can start by attending an Introduction to Oncology Massage weekend training. These courses offer a springboard from which a therapist can gain the initial understanding of types of cancer, cancer treatments, side effects and the cautious approaches needed.

A therapist who has the desire to continue to learn and grow in oncology massage can receive further education, supervision and connection to a mentoring body of educators and experienced therapists. Mentoring educators Tracy Walton and Associates (tracywalton.com); Gayle McDonald and Associates (oncologymassageeducationassociates.com); and Healwell (healwell.org), to name a few, can provide further study and support beyond introduction courses in oncology massage. Such organizations are able to provide answers to concerns and questions that inevitably arise as services are rendered.

The emotional experience of working with those living with cancer requires empathy and an ability to listen to clients without personal bias or unresolved losses that could muddy the therapeutic waters. Senior therapists can assist in providing awareness and the much-needed process of unwinding issues that may interfere with a newbie’s ability to be in the present moment with a client.

Furthermore, there are supportive institutions that provide resources and credibility to oncology massage, including the Society for Oncology Massage (s4om.org). Also, the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) offers a new certification course in oncology massage.

Bodies of professional volunteers, who strive to support the safe delivery of massage to people who have been diagnosed with cancer by promoting education standards, engaging in research and vetting massage therapists who want to be recognized in their oncology massage therapist directories, regard the profession in a serious and thoughtful manner. There are long-standing professional educational resources that provide training and education within hospital settings, chemo infusion labs and hospice.

The Therapeutic Relationship

Massage services in cancer treatment and recovery are individualized and differ in emotional intensity. Massage therapists who are present and aware of issues related to a client’s acute trauma, resulting from a single incident or chronic trauma from repeated and prolonged negative experiences, can better facilitate providing a safe and comforting environment.

oncology massage
Practitioners, especially those who are seasoned professionals, often find they need to dial back on their level of pressure, utilizing a “whole hand” surface approach. This can be difficult for those who are used to using heavy-handed techniques. Even the pressure of gentle, general Swedish massage may be too much for someone in active cancer treatment.

Proper training, engagement in self-care and supervision are key to awareness development. Those on the cancer journey need massage therapists who are able to provide services, with the acumen to keenly observe and ask pertinent questions for treatment planning and ongoing care.

A therapeutic relationship that is saturated with healthy boundaries and services provided within the therapist’s scope of practice, in a nonjudgmental approach, adds to the effectiveness and quality of services provided. A client who is able to rest assured that the focus of “do no harm” is at the basis of the oncology massage service increases the client’s ability to let go and retreat into the massage and the moment at hand, unfettered.

Jacqueline Algaier, oncology massage therapist

Jacqueline Algaier, LMT, is a nutrition and essential oils educator and oncology massage therapist with 22 years of massage therapy experience, including in University of Pittsburgh Medical Center hospitals and Western Psychiatric. She studied oncology massage at Peregrine Institute. Algaier was a drug and alcohol counselor and prevention specialist. She teaches an introduction to oncology massage course online through the National Certification Board for Therapeutic Massage & Bodywork, and also offers a practical class on a case-by-case basis.