For decades, the world of Swedish-based massage therapy followed a flat, absolute massage therapy contraindication for people with cancer, and this contraindication took root in other bodywork modalities as well. To the relief of professionals, teachers and clients, this practice has fallen out of favor. Helped by two books, Massage Therapy and Cancer, by Debra Curties, and Medicine Hands: Massage Therapy for People with Cancer, by Gayle MacDonald, the profession has challenged an old myth - that massage promotes the spread of cancer by increasing circulation. This myth was based on a primitive understanding of how cancer spreads and on uneven research on the impact of massage.

Fortunately, a much more thoughtful view has come into being, a perspective that makes room for massage with cancer patients, people at the end of life and cancer survivors. More sophisticated thinking about cancer itself and the impact of massage on the body have restored massage therapy to its rightful place in the care and support of people with cancer. Indeed, contraindications still exist, but more careful analysis of those contraindications has replaced the old, single contraindication. There is a sharper focus on which elements of massage are contraindicated for which clinical presentations of cancer. After years of practice, research and teaching in this special discipline, I've noticed developments along the way. I will share developments in two major areas: one in the area of research and professional conferences, and the other in education on cancer and massage.

Research and Conferences

In my last column, I wrote briefly about research on massage and cancer, and highlighted one of the strongest controlled studies available, involving patients in chemotherapy (www.massagetoday.com/archives/2006/05/13.html). People with cancer are a focus of research, as a search of massage research databases will show. Research papers are great, but it's especially exciting to learn directly from the researchers themselves. This is why I like attending conferences, or, if I missed a conference, reading the abstracts and proceedings afterward.

In fact, the first U.S. conference devoted entirely and exclusively to cancer and massage will be held in Toledo, Ohio, May 11-12, 2007. Titled "The Oncology Massage Healing Summit," it features Gayle MacDonald as the keynote presenter and diverse sessions on massage research, lymphedema, oncology massage program development and pediatric massage. Eastern approaches for symptom management, medical ethics, scar work and case studies also will be presented. Oncology massage therapists are eager for this meeting of the minds, hearts and hands. For more information, contact Mercy College Continuing Professional Education department at (419)251-1799 or vicki.marsh@mercycollege.edu.

Other national gatherings foster dialogue among researchers and clinicians. The Society for Integrative Oncology holds its third annual conference in Boston, Nov. 10-12, 2007. There will be a special Satellite Symposium on Massage Therapy on Nov. 9. Visit www.integrativeonc.org for more information. At this fall's AMTA National Convention in Atlanta, I will offer one session on massage and chemotherapy, and another on recent massage and cancer research. The conference details are at http://amtamassage.org/education/NationalConvention2006.html. Recently, the May 2006 North American Research Conference on Complementary and Integrative Medicine was held in Edmonton, Alberta. An impressive array of presentations included a large handful of presentations on massage research, and several of those included or focused on cancer. Abstracts from the conference are viewable at www.imconsortiumconference2006.com. Last year, the Massage Therapy Foundation presented "Highlighting Massage Therapy in CAM Research" in Albuquerque, N.M. A large number of people presented on massage therapy and cancer. The proceedings from this conference can be ordered on CD-ROM from the foundation at www.massagetherapyfoundation.org.

Education

Several years ago, there were just a few educators and training programs in existence; now, the list has more than doubled. Moreover, I notice training is getting longer. Now that we've refuted the old contraindication and put a finer point on things, there is a lot to say about cancer and massage. Changes in length, focus, setting and implementation are evident in the following trainings, which is just a partial list of those available. Contact information for each is at the end of this article.

First, Cheryl Chapman has added a course in mastectomy massage to her offerings, believing that the specific aspects of breast care after surgery and reconstruction deserve special focus.¹ Debra Curties offers training in breast massage, including breast pathologies following cancer surgery.² This focus is needed in a profession that counts many breast cancer survivors among its many consumers.

At Beaumont Hospitals in Michigan, Charlotte Versagi offers a five-day course at the School of Oncology Massage.³ In general, hospitals are offering more training. MD Anderson Cancer Center offers a course in Houston, as well as a review of complementary therapies on its Web site.⁴ And Houston Community College offers a course, including practical work, at nearby Baylor Breast Care Clinic.⁵ Two extensive certificate training programs exist. A 300-hour program is at the Scherer Institute of Natural Healing in Santa Fe, N.M.⁶ A 274-hour program is at the Colorado School of Healing Arts in Lakewood, Colo.⁷

These offerings suggest therapists welcome more instruction and hands-on time. Indeed, many of us who offer shorter courses have lengthened them or added additional levels of training. After years of offering "Medical Massage for the Cancer Patient," Memorial Sloan-Kettering added Level II training to its offerings.⁸ Led by Wendy Miner, this course is offered in New York. Likewise, I have added advanced training to my own course for additional work on case studies, research, hospital work and marketing.⁹ Moreover, the AMTA has responded to the need for information on the topic by offering an online course, "Cancer and Massage: Essential Contraindications," which I put together with them in two parts.¹⁰

As I said before, this is by no means a complete list of educational offerings, and the list is getting longer. These expansions in the field come as no surprise to me. Massage therapists have wanted and needed to work with people with cancer for a long time, and they have faced various barriers to this important work, including the old contraindication. The surge of growth in oncology massage is satisfying an old need, a backlog and a sacred calling in the massage profession.

It seems that each time I touch a client in my private practice, I learn something new from their experience. It might be about cancer itself, new treatments or the things my client learns along their path and chooses to teach me as I walk with them. Whatever it is, it's always compelling and I am eager to share it with other therapists. Conferences, research and education offer chances for us to share our stories and hear what is going on in massage treatment rooms around the country. It's an exciting time to be in the work.

References

1. Cheryl Chapman's offerings on cancer and mastectomy are described at www.cherylchapman.com.
2. Visit www.curties-overzetpublications.com for Debra Curties' books and trainings.
3. Beaumont Hospitals School of Oncology Massage: www.beaumonthospitals.com/pls/
   portal30/site.web_pkg.page?xpageid=allied_home_.
4. MD Anderson's "Complementary/Integrative Medicine Education and Resources": www.mdanderson.org/departments/cimer.
5. Houston Community College's flagship program: http://secollege.hccs.edu/departments/ctce/
   massagetherapy/cancermassage.html.
6. Scherer Institute certificate training program in Santa Fe: www.schererinstitute.org/oncolcertinfo.htm.
7. Colorado School of Healing Arts Web site: www.csha.net/advanced/oncology.html.
8. MSKCC's training, part of its integrative medicine program: www.mskcc.org/mskcc/html/11802.cfm.
9. Visit www.tracywalton.com for various offerings at basic and advanced levels.
10. MTJ online course options: http://amtamassage.org/journal/home.html.