Two and a half years ago, when Judith C. Arntson, RN, MSN, CMT, CMLDT, COMT, went to City of Hope, a National Cancer Institute-designated comprehensive cancer center in Duarte, Calif., for breast cancer treatment, she felt like she had come full circle. Early in her nursing career — which now spans almost four decades — she had worked at the facility for six years. It was my favorite place to work, she says.
As a patient, she experienced the excellent care from a different perspective, which inspired her to once again serve oncology patients. As a cancer survivor, she says, I felt that I wanted to give something back. I came across a formalized educational program in oncology massage. I resonated so much with that. I thought, ‘That’s what I’m meant to do.’
It seemed a perfect fit. She had been a massage therapist since 1989 and now owns Wellness Naturally, A Nursing Specialty Practice in Chino, Calif. Although she had worked with oncology patients in her massage practice, she wanted the additional training to learn more about specific techniques, as well as to codify the information she had previously accumulated.
She graduated from the two-year certification course from Peregrine Institute of Oncology Massage Training in Santa Fe, N.M., in October, becoming a certified oncology massage therapist (COMT).
Growing Research BaseJudith C. Arntson, RN
A small but growing field of research supports the beneficial effects of massage for oncology patients, notes Tracy Walton, LMT, MS, a massage therapist, researcher, writer, and teacher in Boston. She has been training massage therapists in techniques of oncology massage for eight years and is working on a textbook called Medical Conditions in Massage Therapy for Lippincott Williams & Wilkins.
There isn’t a lot of research in general in massage therapy, but of the research that has been done, a lot of it has been done on people with cancer, Walton says. Of the available studies we have, the strongest support is for massage helping [ease] pain and anxiety.
A study published in the September 2008 edition of the Annals of Internal Medicine concluded that massage may have immediate beneficial effects on pain and mood among patients with advanced cancer.
Working with oncology patients requires some adaptations to traditional massage techniques, Arntson says. She notes that she adheres to the standards of practice that have been elucidated by the National Association of Nurse Massage Therapists, as well as the standards of practice that have been identified by the Society for Oncology Massage.
Oncology massage often requires adjustments in pressure, site restrictions, or positioning modifications, she says. For example, radiation sites should be avoided during a massage, as should limbs affected by lymph node removal; too much pressure can cause an episode of lymphedema. Someone who has a central line for chemotherapy may require a positioning adjustment, such as not lying on the stomach during the massage.
Even with her non-cancer patients, Arntson asks about cancer, radiation, chemotherapy, and lymph node removal. I don’t want to assume anything, she says. I do a complete assessment following the nursing process and speak with the client regarding what would be their goals for therapy. And then [I] discuss lifestyle issues, stressors, all those kinds of things. I suggest a treatment plan. Then we work together on joint goals, and we move on from there.
She is also certified in manual lymph drainage, which can be used to treat early lymphedema. It’s a very gentle motion, moving from proximal to distal, she says. The idea is to gently massage fluids from the areas where lymph nodes were removed to areas with functioning nodes. There are certain hand techniques that are very gentle, she says. It mimics the motion of the lymphatic system. It’s a very specific protocol that both the organizations that teach lymphatic drainage adhere to.
She estimates that 30-40% of her practice is in oncology massage and anticipates that percentage growing. For me, this is a calling, she says.