Complementary therapies


Body-based practices

The term body-based practices refers to complementary therapies that work directly on your body. They may also be described as bodywork or touch therapies.

Some techniques are passive – therapists apply some form of touch or manual pressure to your body. Examples include aromatherapy, massage and reflexology.

Other practices require you to actively undertake a series of movements to stimulate and stretch different parts of the body. Examples include yoga, tai chi and Pilates.

Some of the body-based practices discussed in this section have a strong mind–body connection, so they benefit both physical and emotional health. These include yoga, tai chi and qi gong.

Benefits

The benefits of body-based practices include reducing tension, anxiety, insomnia and pain, and increasing energy, vitality, quality of life and wellbeing. Exercise, even if gentle, can also improve stamina, muscle tone (strength), flexibility and agility.

Side effects/safety

To reduce the potential for harm, check the practitioner is qualified.

Acupuncture

What it is

Acupuncturists put fine, sterile needles just under the skin into energy channels called meridians to stimulate energy flow. Each meridian has many acupuncture points along its path.

Why use it

Acupuncture is based on the theory that the placement of needles into certain points of the body unblocks and moves qi ( vital energy) to strengthen and reduce physical and emotional symptoms. Research suggests that the needles stimulate the nervous system and the connective tissue in the body, and help produce certain biomolecules such as hormones.

What to expect

After a consultation, which may include tongue and pulse analysis, the practitioner gently positions sterile needles into points on your body. The needles are left in place for 30 seconds to 30 minutes, and may be stimulated manually by twirling the needles, or by using a machine (called electro-acupuncture). You may feel a tingling or dull aching sensation, but should not feel pain. Acupuncturists may also implant and cover special needles called press needles, which can remain in place for several days.

Evidence

The main areas of research into acupuncture for cancer are chemotherapy-related nausea and vomiting, and it is included in clinical guidelines for dealing with side effects. Evidence suggests acupuncture may also reduce anxiety, fatigue, hot flushes and some types of pain. It's not clear whether acupuncture helps relieve dry mouth and chemotherapy-induced tingling in the hands and feet (peripheral neuropathy), but several studies are underway.

Some qualified and registered acupuncturists in Australia have special training and experience in treating cancer-related conditions. Ask your doctor whether this is offered at your treatment centre.

Aromatherapy

What it is

The use of essential oils extracted from plants for healing relaxation. They are used mainly during massage but can also be used in baths, inhalations or vaporisers (oil burners).

Why use it

When inhaled or absorbed through the skin during massage, the oils have a positive effect on the body's tissues.

What to expect

The aromatherapist blends essential oils and adds them to a base (carrier) oil before being applying them to your skin during a massage.

Evidence

There is limited evidence that aromatherapy may have positive short-term effects on pain and anxiety in people with cancer. Studies of people with advanced cancer show that aromatherapy improves sleep and quality of life.

Oils used in bodywork

Base (or carrier) oils are usually made from kernels or nuts, such as almonds. Sometimes mineral oil is used instead as it is odourless.

Reactions to oils are rare, but some people find they irritate the skin or the smell makes them feel nauseous or gives them a headache.

Before being applied to the skin, base oils are diluted with essential oils, such as lavender or tea tree.

Let your therapist know if you have had reactions to oils in the past, or if you find certain smells unpleasant.

Exercise techniques

What they are

Exercise and physical activity cover four types of exercise:

  • aerobic
  • strength training
  • balance
  • flexibility.

Why use them

Exercise is generally accepted as being beneficial for improving strength, flexibility, mobility, fitness and general wellbeing. Some treatment centres have exercise physiologists and physiotherapists who are specially trained in exercise interventions for people with medical conditions and injuries.

What to expect

To help avoid injury, start each session with a warm-up and finish with a cool-down. Do aerobic exercise at a level you are comfortable with. Aim to do 2–3 strength sessions each week, with rest days between sessions. To maintain flexibility, include 3–4 stretch sessions a week.

Evidence

Research suggests that exercise benefits most people both during and after cancer treatment.

See Exercise for People Living with Cancer to find out about programs in your local area or call Cancer Council 13 11 20.

Aerobic exercises

Aerobic exercise uses large muscle groups and causes your heart rate to rise. It may reduce the onset of side effects and their severity, maintain mood and improve energy levels.

Examples include walking, swimming, running and cycling, but everyday activities such as gardening and housework count.

Balance exercises

Balance is the ability to control your body's position whether standing still or moving. Having good balance can help prevent falls and is important for daily activities such as walking, and going up and down stairs.

Examples include yoga, tai chi and Pilates.

To find an appropriate exercise program, ask your GP for a referral to an exercise physiologist or physiotherapist, or call Cancer Council 13 11 20.

Strength training

Also known as resistance training or weight training, strength training involves making your muscles work harder than usual against some sort of resistance.

Strength training can be done with hand weights, special elastic resistance bands, weight machines at gyms and your own body weight.

Flexibility exercises

Flexibility exercises stretch your muscles and help improve your range of motion. Being flexible gives you more freedom of movement for other exercises as well as for everyday activities.

Examples include yoga, tai chi and Pilates.

YWCA Encore offers a free eight-week program of gentle waterbased exercise and relaxation for people who have had breast cancer. For more details, visit ywcaencore.org.au.

Other movement therapies

Alexander technique

Although not a type of exercise, this therapy teaches people ways to improve posture and movement, and to use muscles efficiently. By changing the way people use their body, they can enhance mental and physical functioning on many levels.

Bowen technique (Bowtech)

A practitioner applies gentle pressure over acupuncture and reflex points to massage the muscles and soft tissue and tendons. A Bowen session lasts up to an hour and the average number of treatments is 3–4.

Feldenkrais method

This series of guided movements focuses on balance and flexibility. It helps people become more aware of the way they move and how this contributes to, or compensates for, bad posture, pain and mobility restrictions. Trained practitioners use touch, movement, guided imagery and mindful body awareness to stimulate the brain to make improvements to movement and posture.

Pilates

This system of strengthening and stretching exercises is designed to develop the body's core (abdominals, lower back and hips). It encourages the mind to be aware of its control over the muscles and to correct postural habits that have contributed to pain, reduced mobility and poor coordination. Pilates started as a form of physical therapy.

While studies with cancer patients are limited, these forms of practitioner-led movement exercise are generally considered to be beneficial for improving breathing, strength, flexibility, mobility, fitness and general wellbeing.

Massage

What it is

Massage involves moving (manipulating) muscles and rubbing or stroking soft tissues of the body. There are many different styles of massage. Oncology massage therapists are specially trained to adjust pressure, speed, duration and direction of strokes to provide a safe session for a person with cancer at any stage of disease.

Some types of massage can reduce lymphoedema (swelling caused by a build-up of lymph fluid). This is called manual lymphatic drainage.

Why use it

All styles of massage aim to promote deep relaxation in tissue by applying pressure to the body's muscles and pressure points. This helps to release both muscular and emotional tension. The style of massage used for people during or after cancer treatment will depend on the treatment they're having.

Over the years, there has been a general concern that massage can increase the risk of cancer cells spreading to other parts of the body. However, there is no evidence that this happens.

Massage may be available in some hospitals and palliative care units. Ask your doctor or nurse if it's offered at the centre where you are having your treatment. To find a private practitioner trained in oncology massage, visit oncologymassagetraining.com.au and enter your postcode in the "Find Your Nearest Therapist" box.

"Having a regular massage with a lymphoedema practitioner means that someone else is keeping an objective eye on my lymphatic arm to assess changes. It's also helped me maintain my mobility and flexibility, and relieved discomfort and tightness." - Lilly

What to expect

Massage usually occurs in a warm, quiet room. It can be given while you either lie on a massage table or sit in a chair. The therapist uses a variety of strokes on different parts of the body. When performing massage on a person with cancer, therapists may need to adjust their pressure and avoid certain areas of the body.

Some styles of massage are done with you fully clothed; others require you to undress to your underwear so the therapist can use oil to move their hands over your skin more easily. The therapist may place pillows under different parts of your body so they're supported. Let the therapist know if you need anything to feel more comfortable, such as a change in pressure or another blanket. You may like to close your eyes during the massage.

Evidence

Many scientific studies have shown that oncology massage is effective in reducing symptoms such as stress, pain, anxiety, depression, nausea and fatigue in people who have had chemotherapy or surgery for cancer.

Specialised lymphatic massage can help reduce the symptoms of lymphoedema.

Massage concerns for people with cancer

Chemotherapy

This drug treatment affects the whole body. If you have a chemotherapy port, massage should not be done in this area. Some people who have chemotherapy experience tingling in their hands or feet (peripheral neuropathy), and may find they bruise or bleed easily. Massage should be light with no pressure on the affected areas.

Radiation therapy

The skin may be sensitive to touch after radiation therapy. It may look red and appear sunburnt. If you are having radiation therapy, you should avoid massage to the treated area as you may find even light touch uncomfortable. Massage oils may make already irritated skin feel worse.

Surgery

Recovery after surgery takes time, and it's important to avoid massaging the area of the operation. However, gentle "lotioning" massage with soft hands or gently holding other areas can provide comfort and support.

Risk of lymphoedema

If you've had lymph nodes removed from the neck, armpit or groin during diagnosis or treatment, or if you've had radiation therapy to these areas, you should only have a very gentle massage in that area of the body. Ideally massage needs to be part of a manual lymphatic drainage or total lymphatic drainage treatment. Therapists not trained in these techniques should avoid the affected area. To find a registered lymphoedema practitioner, see lymphoedema.org.au.

Bone fragility

Radiation therapy or medicines, or the cancer itself, may cause the bones to become more fragile. Care should be taken to avoid undue pressure.

Qi gong

What it is

Qi gong – pronounced "chee goong" – is part of TCM. "Qi" means vital energy and "gong" means work. Qi gong combines movement with controlled breathing and meditation. It may also be considered an energy therapy.

Why use it

Movements performed in qi gong keep the flow of energy running through the body's energy channels. This can help improve quality of life, including mental and physical wellbeing.

What to expect

Wear comfortable clothes. The session starts with warm-up exercises to loosen the body. The instructor then guides you through a series of slow movements, which help you become more aware of your energy. Classes might also include meditation while you are lying down, sitting, standing or walking.

Evidence

Clinical studies suggest that qi gong improves quality of life and reduces fatigue, pain and anxiety. Anecdotal evidence shows that it helps to improve general fitness.

Reflexology

What it is

A form of foot and hand massage. It's based on the belief that certain areas on the feet and hands or "reflex points" correspond to the body's internal organs and systems, like a map.

Why use it

Many people find reflexology relaxing. By pressing on reflex points, meridians are unblocked and this can promote health on the related area of the body.

What to expect

After talking through your case history, you remove your footwear. While you are seated or lying down, the reflexologist works with their hands on your bare feet, possibly using cream or oil. Usually reflexology feels like a relaxing massage, although sometimes the therapist's touch can be subtle.

Evidence

Several clinical trials have looked at using reflexology for pain, anxiety, breathlessness and quality of life. Studies have involved small groups of people, so it is difficult to say whether the reflexology had any effect.

Tai chi

What it is

A part of TCM, tai chi combines gentle movement, deep breathing techniques and meditation. Movements create stability in the body, reflecting an ancient Chinese concept of balance known as Yin and Yang.

Why use it

The breath work of tai chi is calming and meditative. Creating and holding the poses helps to loosen and strengthen the muscles. Tai chi can be modified for groups that are less mobile.

What to expect

During class there will be serene music playing. The class usually starts with warm-up exercises. You will be shown different moves and assisted to perform them. The instructor may use names to describe the poses, for example, "white crane spreads its wings". The movements are simple to start with, then become progressively harder, with many parts of the body needing to move to achieve the pose. Classes end with cooling down and relaxation.

Evidence

Studies have shown that tai chi improves quality of life, balance, agility, flexibility and muscle tone in cancer survivors. It can also help reduce anxiety, depression and stress.

Yoga

What it is

Yoga involves holding postures (asanas) with the body, slowing and deepening the breath, and focusing the mind. Yoga originated in India and is now popular around the world. There are many styles of yoga with varying intensity – from gentle, such as hatha yoga, to vigorous, such as ashtanga and Iyengar yoga. Some styles may not be suitable during some stages of cancer.

Why use it

Yoga helps both physical and emotional health.

What to expect

Wear comfortable clothes. You may be asked to remove your shoes before entering the yoga room. You usually need a yoga mat – this may be available in class. Most classes last for 1–2 hours. A typical routine involves focusing on quietening the mind and working with the breath. A session usually begins with warm-up stretches followed by a series of yoga postures, and ends with relaxation. Some cancer centres offer yoga classes that are geared to people during cancer treatment or recovery.

Evidence

Clinical research has shown that yoga has positive effects on decreasing stress and enhancing quality of life. The focus on breathing may also help reduce pain.

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