Mind-Body Therapies and Massage
Aromatherapy and Essential Oils
Aromatherapy is the therapeutic use of essential oils (also known as volatile oils) from plants (flowers, herbs, or trees) for the improvement of physical, emotional, and spiritual well-being. Aromatherapy is used by cancer patients primarily as supportive care for general well-being, and with other complementary treatments (e.g., massage and acupuncture) and standard treatment. Refer to the PDQ summary on Aromatherapy and Essential Oils for more information.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy is a type of psychotherapy that helps patients change behavior by changing the way they think and feel about certain things. It is used to treat mental, emotional, personality, and behavioral disorders. Components of cognitive-behavioral therapy include the following:
- Cognitive distraction and reframing (cognitive restructuring): Focuses on positive thoughts and images instead of negative thoughts and behaviors. Refer to the Cognitive-Behavioral Interventions section in the PDQ summary on Pain and the Nonpharmacologic Management of Sleep Disturbances section in the PDQ summary on Sleep Disorders for more information.
- Relaxation and imagery: Simple relaxation techniques used for episodes of brief pain or discomfort (e.g., during procedures). Brief, simple techniques are preferred when the patient’s ability to concentrate is compromised by severe pain, a high level of anxiety, or fatigue. Refer to the Cognitive-Behavioral Interventions section in the PDQ summary on Pain and the Nonpharmacologic Management of Sleep Disturbances section in the PDQ summary on Sleep Disorders for more information about cognitive behavioral interventions. Refer to the Treatment of Anticipatory Nausea and Vomiting section in the PDQ summary on Nausea and Vomiting for use in treatment of anticipatory nausea and vomiting.
Psychotherapy for depression has been offered in a variety of forms. Most interventions have been offered in both individual and small-group formats, and have included a structured educational component about cancer or a specific relaxation component. Refer to the Psychotherapy section in the PDQ summary on Depression for more information about psychotherapy for depression. Refer to the Treatment section in the PDQ summary on Cancer-Related Post-traumatic Stress for information about the use of CBT for post-traumatic symptoms.
CBT has also shown promise for the treatment of insomnia in patients with cancer. Refer to the Management section in the PDQ summary on Sleep Disorders for information about sleep studies in cancer patients.
Hypnosis is a trance-like state in which one becomes more aware and focused and is more open to suggestion. Under hypnosis, a person can concentrate more clearly on a specific thought, feeling, or sensation without becoming distracted. Refer to the Psychosocial Interventions for Distress section in the PDQ summary on Adjustment to Cancer: Anxiety and Distress for more information about hypnosis used for pain relief, and refer to the Cognitive-Behavioral Interventions section in the PDQ summary on Pain for information about the use of hypnosis in a clinical trial to decrease presurgical distress.
Manual Lymphedema Therapy
Manual lymphedema therapy is a massage to encourage the flow of lymph fluid out of the affected arm or leg and move it to healthy lymph nodes, where it can drain. Refer to the Manual lymphedema therapy section in the PDQ summary on Lymphedema for more information about manual lymphedema therapy.
Massage therapy is an integrative modality that has been investigated as an adjunct to supportive care interventions in managing cancer-related pain. Preclinical and clinical trials have found that massage reduces pain by reducing cortisol levels, increasing serotonin and dopamine levels, stimulating the release of endorphins, and stimulating blood and lymphatic circulation. Refer to the Integrative Modalities section in the PDQ summary on Pain for more information about the role of massage in the management of cancer pain.
Music Interventions for Pain
Music therapy and music medicine interventions have been used to relieve acute and chronic pain related to noxious procedures and treatments and the disease process. Refer to the Integrative Modalities section in the PDQ summary on Pain for information about studies investigating the effect of music on pain.
Qigong is a component of traditional Chinese medicine that combines movement, meditation, and controlled breathing. The intent is to improve blood flow and the flow of qi. Some trials, mostly with small sample sizes, have indicated that qigong may improve quality of life and fatigue in cancer patients. Refer to the Exercise section in the PDQ summary on Fatigue for more information about how qigong is being studied in cancer-related fatigue.
Spirituality and religion are important to most individuals in the general population, according to national surveys. In health care, concerns about spiritual or religious well-being have sometimes been viewed as an aspect of complementary and alternative medicine, but this perception may be more characteristic of providers than of patients. Refer to the PDQ summary on Spirituality in Cancer Care for information about religion, spirituality, spiritual well-being, and health.
Some trials, mostly with small sample sizes, have indicated that tai chi may improve quality of life and fatigue in cancer patients.
Yoga is an ancient system of practices used to balance the mind and body through exercise, meditation (focusing thoughts), and control of breathing and emotions. Yoga is being studied as a way to relieve stress and treat sleep problems in cancer patients. Refer to the Mindfulness-based stress reduction for survivors of breast cancer section in the PDQ summary on Adjustment to Cancer: Anxiety and Distress for information about a clinical trial that used meditation and yoga to reduce stress in breast cancer survivors.
- Zeng Y, Luo T, Xie H, et al.: Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complement Ther Med 22 (1): 173-86, 2014. [PUBMED Abstract]