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Massage for cancer patients is a touch of care, controversy

December 22, 2014


ORANGE COUNTY, Calif. ó Nansea Gratz pulled off her fleece beanie, the kind with little ears, revealing wisps of gray hair on an otherwise bald head. She removed her fuzzy pink socks and asked an attentive massage therapist to touch her feet, because the peripheral nerves there were damaged and weak.

Seventeen months of chemotherapy for stage 4 breast cancer had taken their toll on this 61-year-oldís body from head to toe. But the once-avid swimmer and hiker was about to experience a short, blissful respite.

"Human touch ó thatís whatís missing in modern medicine," Gratz said on a recent Sunday at a clinic for massage therapists practicing modified techniques for cancer patients like her. "Doctors do not touch you anymore. They stare at their computers, looking at your scans."

Once Gratz was gingerly positioned on a massage table, her frail body covered by soft green blankets, Rochelle Leffler got to work. She dropped to her knees, bowed her head, closed her eyes, gently placed her fingertips atop Gratzís head and prayed for her hands to be healing.

After her prayer, she slowly stroked Gratzís back, moving her hands over the green blankets.

"Is that pressure OK for you, Nansea?" she asked.

"Itís wonderful."

Greet the Day, an Orange County nonprofit organization, is making inroads into local hospitals, convincing often-skeptical doctors to allow its specially trained therapists to give 20-minute massages to cancer patients at their bedsides. For 2015, it has added a fifth hospital to its roster.

Using careful, light massage to soothingly combat the assault that chemotherapy and radiation launch on the bodies of cancer patients isnít new.

Hospitals began incorporating it more than two decades ago. In 1994, The New York Times called it a growing trend in holistic medicine. In a 1999 publication, the National Cancer Institute found that about half of its cancer centers offered massage as an adjunct therapy.

But itís still not universally embraced.

Greet the Dayís executive director is Kim Mason, a yoga instructor with experience running nonprofits, but who had known little about oncology massage. Now much of her time is spent spreading the word about it, showing skeptics that, if done correctly, it can help patients feel better.

"My own doctor said to me, ĎWhy?í" she said. "We have approached hospitals and have had them say no. Weíre not in every hospital in Orange County. It was a process to get into the ones we got into."

Founded in 2005 by Dr. Christine Hrountas and massage therapist Johnnette du Rand Kelly, Greet the Day got its start offering spa services to cancer patients nearing the end of their treatment. Then it began bringing volunteers to infusion centers to massage cancer patients as they underwent chemotherapy.

Du Rand Kelly spent several months this year meeting with hesitant doctors at Long Beach Memorial Medical Center and Miller Childrenís and Womenís Hospital Long Beach before convincing them to allow Greet the Day therapists to work in their hospitals. She said she was peppered with questions about how massage therapists tweak techniques for patients who have had cancer metastasize to their bones, stem cell or bone marrow transplants, fevers and other conditions such as lymphedema and low white blood cell counts.

In theory, according to the American Cancer Society, massage could increase the risk of cancer cells moving to other parts of the body. It could also cause weakened bones to fracture, and even light touch might be uncomfortable to patients undergoing radiation treatment.

"As massage therapists, we grew up being told not to practice on cancer patients, because it would promote the spread of cancer. That started changing in the late í90s, early 2000s," du Rand Kelly said.

Now, her group is flourishing. Over the summer, it trained 28 nurses at UCI Medical Center to give hand, neck, shoulder and foot massages to consenting patients, and in the new year will start sending therapists to USC Norris Comprehensive Cancer Center.

Greet the Day has four paid therapists working in four hospitals in Orange and Los Angeles counties, 15 interns and 36 volunteer therapists who spend time at infusion centers.

It doubled its revenue to $45,153 in 2012, according to its most recent tax filing, thanks to increasing donations and grants, and nearly doubled it again last year, Mason said. For 2014, its volunteers and staffers had massaged 1,308 patients as of mid-November, more than in any other year.

"I would say this year we had a great year," Mason said.

Leffler, a certified massage therapist, describes herself as a "deep massage person" who kneads athletic types in her Hollywood practice.

Six years ago, cancer killed a close friend; five weeks later, it took her uncleís life. She had massaged their hands and feet, avoiding other parts of their bodies because she knew very little about how to do it safely ó it was not part of her training at massage school in the early 2000s.

In mid-October, when Lefflerís 77-year-old mother was diagnosed with cancer in a salivary gland, Leffler said, "It was like OK, now itís struck under my roof. And so that really motivated me."

It motivated her to enroll in an oncology massage course, and when she searched online for training courses, Greet the Day was one of the first hits. So for $450, Leffler enrolled in the groupís Institute of Integrative Oncology.

During the three-day workshop in November, along with a dozen other therapists and one nurse, Leffler reviewed clinical research and learned how to position bodies and which areas to avoid, including near the cancer site and spots affected by medical devices.

The two most important lessons: modifying the direction of stroke if a patient has lymph node or vital organ involvement, and adjusting pressure to prevent bruising, bleeding and inflammatory response and to protect bone integrity. Sometimes, du Rand Kelly said, the touch is comparable to picking a perfectly ripe avocado; other times itís so light itís a "weightless" application of lotion.

"There are times and there are places where one can work with a little more pressure, but itís a question of knowing when; thatís why we have the training," she said.

Pressure and speed could fatigue patients, but it could also cause blood cell counts to lower and lead to blood clots and nausea.

"If we use a pressure which is overly deep, it will trigger an inflammatory response," du Rand Kelly said. "When that happens, our white cells, which are already working overly hard and in short supply, have to move in."

The course culminated with the hands-on clinic, giving students the opportunity to massage patients who had volunteered with permission from their doctors.

"I feel like every cell in my body is very happy," said Paula Vincent, 56, of San Pedro, who has breast cancer. "The dichotomy of being pumped with toxic chemicals and having someone touch you in a gentle healing way, it balances out the experience of having the chemo so often."

Before massaging Gratz, Leffler asked questions about her tumor site, treatment history, medical devices and medications.

As soon as she touched Gratzís head, Leffler said, the emotions of losing her friend and uncle came rushing back to her. She started thinking of her mother, too.

"What I discovered is that ultimately itís really about focusing all of your attention on a human being, which massage always is, but the end result is different: Make someone feel better, give them the opportunity to escape," Leffler said.

 

 


McClatchy-Tribune Information Services