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Posted by Brenda Hynes, Jan 14 2007 8:44PM

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Cancer - Reflexology & Massage - treating clients with previous history

I have been asked to give some reflexology treatment to someone with a previous history of cancer. In 2001, pancreatic cancer, removed pancreas, spleen, gall bladder, portal vein. More recently this person had a further operation last year to remove cancer of the breast which has not spread since. She has had massage treatments before which she has gained great benefit from, but is finding it difficult to find a therapist who is happy to treat her, in view of her medical history. I feel also this is too soon to treat and would feel more confident in treating with medical approval.
Any views on giving both reflexology/ massage to clients with a previous history of cancer would be very much appreciated.
Clare Humphrey
Jan 15 2007 12:42PM
Hi Brenda

I have treated several clients recovering from cancer with massage and aromatherapy. I have always asked them to seek the approval of their consultant and once they have, I have written (with my clients permission) to the consultant and GP to confirm which therapy is being carried out. I also made sure that the consent form was signed and fully understood and that they understand that massage is not a cure for cancer. I have no experience of relexology but I am sure that the benefits of massage far outweigh any risks so long as the usual contraindications regarding surgery and radiotherapy are observed. One of my clients has since said that massage helped her with body image following surgery for breast cancer and that it was nice to be touched in a "non-medical" way.

I found the following publications useful:

Massage for People with Cancer published by The Cancer Support Centre, Wandsworth, London ISBN 0-9523224-0-4

Aromatherapy for Health Professionals by Len & Shirley Price ISBN 0-443-06210-2 see pages 125 & 247.

Hope this helps you. In the end, if you feel it's too soon for your client to receive treatment, I guess you have to go with your gut instinct and advise accordingly.



Brenda Hynes
Jan 15 2007 8:23PM
Thanks Claire that's really useful. I find our job is never dull, there's always something new to learn in dealing with different situations and conditions.

thanks again for your advice!

Brenda
John Dent
Jan 31 2007 5:14PM
CThA is interested in the opinions of members who regularly treat clients who have or have had any form of cancer.
The 2 questions are:
1. "Should CThA lead the way in establishing post-graduate qualifications for those who wish to state that they have a specialist skill and knowledge in treating cancer patients such that both patients (and their partners) and the medical profession will have more confidence in the ability of the therapy to help them.?"

2. If so: "Should such qualifications include a sufficent study of cancer, the correct contraindications and an awareness, with the ability to assist, of the emotional state of such clients and their families. The cours to be taught BOTH by a person who is qualified in cancer as a subject (oncology nurse trainer, oncology lecturer etc.)AND by a therapy lecturer in the therapy who has her/himself a full experience of treating clients with cancer?"

At present there are many courses and day workshops that offer training in the use of a therapy for cancer patients and CThA has to decide if it can accept diplomas issued by such for listing on members' treatments and for insurance.

There is at present no national standard and no agreed procedures for this. CThA is aware - and is in duscussion with - several course providers who offer quality courses but at present there is no understanding of the right "standard" to apply.

If you have a keen interest or experinec in thsi area please do give your views here.

Many thanks
John Dent
General Manager
Angela Rawlins
Feb 5 2007 6:09PM
Hi John

When I first qualified in reflexology cancer was a contra-indication. However over THE years and some postgrad courses in reflexology, cancer is now more a 'consideration'. With reflexology you are boosting the immune system which helps the person cope with the treatments. There are varying views on how and when you treat the person.

Courses by therapists that treat people who have cancer can be very valuable to the therapist who has not got the experience as they, and I speak from experience can be frightened to treat them.

With regards to the medical professionals, some are very accepting and say 'anything that helps', others say 'No, I do not want you to do that', so the sufferer just feels they have to do what they are told.

I have treated a friend who had liung cancer and she found reflexology and Reiki very helpful. I have also treated a patient with terminal ovarian cancer and according to her daughters found the treatments exceedingly beneficial. I could also tell this as I used to get calls when the lady was in particular discomfort.

Angela
Angela Pilborough
Feb 11 2007 6:41PM
I work in a hospice as a complementary therapist, so it it possible to use massage and reflexology on patients with a diagnosis of cancer.However it is in my view essential to have an understanding of the cancer that the person has, the treatment they are currently undergoing and make sure that the GP is aware of your interventions> There are a few contra indications and these need to be respected and understood. Usually training courses do not cover this information so further training is required.This boosts the confidence of the therapist,ensures the safety of the treatment and will promote the further integration of comp therapy in cancer care.The psychological benefits have been proven many times.
Angela Rawlins
Feb 12 2007 8:56PM
Hi Angela

Where did you get your training?
Lydia Nightingale
Mar 12 2007 9:07PM
"Should CThA lead the way in establishing post-graduate qualifications for those who wish to state that they have a specialist skill and knowledge in treating cancer patients such that both patients (and their partners) and the medical profession will have more confidence in the ability of the therapy to help them.?"

yes there are several providers of these courses including Christie Hospital's (an internationally recognised NHS cancer hospital in Manchester) Complementary Therapies Training Unit. their clinical lead, Dr Peter Mackereth, has just published a book with Ann Carter that answers many of the issues raised - "Massage andBodywork: Adapting Therapies for Cancer Care" ISBN-10: 0 443 10031 4

there is also an issue with insurance. i contacted IGPP/ Embody after doing a Christie's post-graduate course and was told that my insurance would only be valid in a cancer care environment,eg hospital, hospice. therefore your IGPP/ Embody insurance would not cover you for private practice

hope this helps with your query
regards
lydia
John Dent
Mar 13 2007 3:12PM
Hi
Thanks - yes it does. However there is as yet no definition of what level and extent of knowledge and experience is needed for a complementary therapist to be able to claim that she/he is "qualified" to treat clients who have cancers. Nor what level and type of treatment can be undertaken.
The national body, GCMT, does not cover this at all yet.

On insurance I have asked our broker to comment.
Basically, the standard insurance policy states that you must not carry out treatments that are outside the level and content of your qualifications. Many Massage and other therapy qualifications have certain medical conditions contra-indicated unless permitted by a doctor. So to treat outside that is flirting with the possibility that a claim would not be upheld by the insurer.
Some bodies are now suggesting that where a doctor will not give permission the therapist should obtain a disclaimer from the client. We at CThA are a bit concerened because usually in law if a professional practitioner should not do something and goes ahead anyway at the request or demand of the client, then this is not a sufficient excuse and the professional should know better and would be guilty of negligence.

This is why we are keen to have accepted standards for such treatments which the insurers may be willing to accept.
John Dent
Angela Rawlins
Mar 13 2007 9:00PM
Hi

I attended a seminar on treating cancer patients with reflexology conduted by Edwina Hodkinson for The Association of Reflexologists. I think she used to work as a nurse in the Manchester hospital. One thing that was mentioned on the seminar was - walking briskly, or having a hot bath may spread the cancer as they stimulate the lymphatic system. Obviously the utmost care should be taken when treating a patient with cancer.

I have had clients in the past who have suffered from cancer and some doctors take the line 'if it helps, continue' however, there are those who are dead against any form of complementary therapy. I have had a friend who was so worried about contra indications and if she was doing the right thing, she left the profession.

I think it would be terrible if clients who want help get turned away from every door. Complentary therapists only want the best for their patients and I am sure they will behave with care and consideration. What ambiguous information does is to make the therapist feel unconfident in their ablities.
Norman Dunsby, MSc, PgDip
Apr 3 2007 11:30PM
I have worked in specialist palliative care for 10 years and worked with a myriad of cancers and terminal illnesses. I agree with John Dent insofar as trying to establish an approved course nationally so that therapists can learn about cancers from professionals in the field. Like Lydia Nightingale, I have completed a Post Graduate Clinical Diploma from the wonderful team of hard working and pioneering people lead by Dr.Peter Mackereth at Christies Hospital in Manchester, who have won awards from F.I.H and other bodies for their work and educational courses.

Perhaps contacting the Integrated Therapies Unit at Christie Hospital, Wilmslow Road
Manchester M20 4BX to discuss setting up a course as most of their work is done inconjunction with the University of Salford. All the courses taught are supported by evidence based practices and excellent academic approaches. Like many places, the unit depends upon selling their courses and donations to continue their work and this in turn goes into providing patients with the best possible care in the field of Integrated Therapies.

There is a F.I.H publication which was produced (to which I was a participating contributor) called; National Guidelines for the Use of Complementary Therapies in Supportive and Palliative Care - ISBN 0 9539453 5 9 up to date and well researched worth investing in a copy. This is outling the best evidence-based practices within
palliative care.

Norman Dunsby, M.Sc PgDip
Angela Rawlins
Apr 4 2007 12:57PM
Thank you Norman for that helpful information

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