Role of massage therapy in cancer care.

The care of patients with cancer not only involves dealing with its symptoms but also with complicated information and uncertainty; isolation; and fear of disease progression, disease recurrence, and death. Patients whose treatments require them to go without human contact can find a lack of touch to be an especially distressing factor. Massage therapy is often used to address these patients' need for human contact, and findings support the positive value of massage in cancer care. Several reviews of the scientific literature have attributed numerous positive effects to massage, including improvements in the quality of patients' relaxation, sleep, and immune system responses and in the relief of their fatigue, pain, anxiety, and nausea. On the basis of these reviews, some large cancer centers in the United States have started to integrate massage therapy into conventional settings. In this paper, we recognize the importance of touch, review findings regarding massage for cancer patients, describe the massage therapy program in one of these centers, and outline future challenges and implications for the effective integration of massage therapy in large and small cancer centers.

Patients previously treated for lymphoma consume inadequate or excessive amounts of five key nutrients.

Adequate amounts of nutrients such as folate, vitamin A, iron, selenium and calcium are essential for general health including prevention of cancer. Yet, excess amounts of vitamin A, folate, and iron may also promote cancer. This study sought to determine whether adults who had completed initial treatments for B-cell lymphoma from 1 to 3 years earlier were consuming recommended amounts of these key nutrients and their interests in nutritional education. We surveyed 141 patients undergoing follow-up in the Lymphoma/Myeloma Clinic at The University of Texas M. D. Anderson Cancer Center using a validated food frequency questionnaire and supplemental questionnaire regarding nutritional interest. Nutrient intakes were estimated based on national databases of average content in foods and compared with recommended guidelines. One hundred forty-one participants returned complete questionnaires, but errors limited some nutrient estimates to 134 participants. Participants' mean age was 50, 55% were male, and 80% were non-Hispanic whites. Most participants (94%) were consuming either inadequate or excessive amounts of one or more of these key nutrients. Half of the participants were interested in receiving nutritional education. These findings are of concern because of their potential impact upon recovery and maintenance of general health and possibly cancer-related pathways after treatment.

Dietary and weight changes after treatments for lymphoma.

To estimate the current prevalence of overweight and any associations with self-reported changes in dietary patterns, we surveyed 141 patients who had completed treatments for lymphoma at The M. D. Anderson Cancer Center. We hypothesized that those who perceived that they were currently eating more fruits, vegetables, or whole grains would be more likely to be in a normal weight as body mass index (BMI) category. Usual food choices during the past year were assessed through the previously validated Block Dietary Data Systems Food Frequency Questionnaire (FFQ). Perceived increases in fruits, vegetables, or whole grains after treatment were assessed through supplementary questions. Height, weight, and medications were recorded from a retrospective record review. A majority of subjects were overweight or obese before treatment, and this proportion had increased when assessed a median of 20 mo after treatment. Patients perceiving that they currently consumed more fruits, vegetables, or whole grains were not more likely to be in a normal BMI category even after controlling for medications associated with weight gain as indicated by pharmaceutical company information. However, a majority of subjects consumed 40% or more of energy from fat and ate less than the recommended minimum of 5-a-day fruits and vegetables.

Discussing complementary therapies in an oncology setting.

When herbal or other biologic therapies are used with conventional treatments, adverse drug-herb interactions can occur. Of course, benefits can also be derived that decrease the side effects of conventional medicine and/or support general recovery, a sense of well-being, and health. Even though people with cancer typically use complementary medicines along with conventional treatment, many of them do so without informing anyone on their health care team. This lack of discussion is of grave concern, especially for ingestible substances. This article considers some of the barriers to open communication about complementary treatments and provides support for why it is the health care professional's responsibility to bring up the topic for both medical and legal reasons. Strategies for initiating and guiding an informed dialogue are described and important resources are provided.