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Editor’s Note: The information contained in this article is intended for informational purposes only. Working in this field must be done within scope of practice, in Western medical partnership, and with adequate education and training.

As cancer becomes increasingly prevalent in our society, the likelihood of encountering a client with cancer or desiring to work specifically with this illness is growing in the massage therapy field. Being aware of massage therapy’s risks, protocols and preferred modalities for a person living with a cancer diagnosis is crucial before interfacing with this disease.

Massage’s Risks

The primary risk of working with cancer is the possible encouragement of its spread. Since medical technology cannot yet accurately predict when, how or why it occurs, the spreading of malignancy takes place at any time, and could potentially be blamed on any therapeutic intervention. Massage poses such a risk because metastasizing cancer cells are believed to utilize the body’s circulatory system to spread. As massage therapy generally increases local and systemic circulation, it is easy to see why bodyworkers are cautioned against working with individuals harboring malignancies.

In addition to the risk of metastasis, people undergoing Western medical treatment for cancer are likely to be very weak. Aside from surgical intervention, the two primary treatments for cancer include chemotherapy and radiation. While chemotherapy is more systemic and radiation therapy is more localized, both kill just about everything in its path, making the body’s immune system virtually defenseless.

  • White blood cells are destroyed along with cancerous cells during traditional cancer therapies. A person with an extremely low white blood cell count will be unable to protect themselves from any external pathogens. Until these individuals’ immunity recovers, the slightest introduction of germs can have devastating consequences. Extreme attention to hygiene must be practiced in this situation.
  • In addition to cancerous cells, cancer therapies also eliminate blood platelets. Without platelets, anything more than light pressure will not only result in severe bruising, but could also lead to uncontrolled internal bleeding. Obviously, a person with low blood platelets must only receive the lightest of touch therapy.
  • Weakness and fatigue are often the most encountered symptoms during cancer treatment. Talking on the phone or walking across the room can be exhausting feats a person in this situation hopes to accomplish. A normal-length bodywork session can sap the person of what little amount of energy they have, as it is too much for a body fighting cancer to handle. Very short sessions, less than 10 minutes, are a more realistic goal for those who are extremely weak.
  • Traditional cancer therapies can be very drying to the body, which explains the typical presence of an IV. Considering the lack of fluids to escort out any toxins released from bodywork, a massage that is too intense can easily maximize the stress on the liver and kidneys, and can push the client into a toxic reaction. Again, short and light bodywork can circumvent this complication.


There are four critical elements of massage therapy protocol for people in cancer treatment, and they are very straightforward.

  1. The first is obtaining physician permission. Only the client’s doctor has the authority to clear them for massage. Be prepared to discuss your plans with the physician and request permission in writing. A person in a clinical trial will likely not receive the okay from their physician, as it may skew the results.
  2. The second is communicating with your client. Judging if the work is too intense for your client is most accurate when you communicate freely with the recipient. Make certain they inform you if feeling dizzy, nauseous, suddenly exhausted or otherwise unwell.
  3. The third is documentation. Documenting your work in the traditional style of SOAP notes will protect you and your client from accusations or legal action. Additionally, it may provide enlightenment when the patient recovers quickly.
  4. The fourth is compassion. Working with this population is not only demanding and dramatic, but requires unremitting compassion. Most professionals in the massage therapy field are overflowing with this quality, but it is essential in working with cancer.

Preferred Modalities

As dictated by the risks, the preferred massage modalities for a person in cancer treatment center on being gentle. Enhancing muscular, blood or lymph circulation is much too aggressive for a person battling cancer. Styles that incorporate a light touch and focus on energy healing are the safest and most effective for clients in such a vulnerable state.

Therapeutic Touch Therapy is the most effective, well-known alternative therapy for individuals in cancer treatment. In fact, there is so much research on its efficacy that many registered nurses administer Therapeutic Touch to cancer patients. Reports on this type of gentle energy work claim that for people with cancer, it decreases pain, improves vitality, increases physical functioning and benefits their mood.

As our understanding of the benefits of touch therapy for cancer broadens, practitioners working with this population will become increasingly in demand. If you decide (with physician permission) to work with a client in therapy for a cancerous condition, make certain you are aware of the risks, protocols and best method of bodywork administration. Armed with the permission and knowledge necessary, compassion is the remaining ingredient to bringing the wonders of touch to a person who could really use it.

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More Information:

Cancer: Massage Benefits and Precautions