5 essential questions: Keep it simple in oncology massage

Safe oncology massage is less about knowing every detail of our client's signs and symptoms, and more about responding to their needs on the day of the massage. 

A few basic questions can distill the information we need, and guide us in adapting pressure, position, duration and site to ensure safe, individualized massage.

1. What Is happening in our client’s body right now?

Two clients with the same type of cancer may have completely different treatment histories, side effects, energy levels, medications, and physical limitations.

I want to know:

• Are they currently receiving treatment?

• What side effects are they experiencing?

2. Are there areas or systems that need massage adaptation?

(aka contraindications and precautions in oncology massage)

Oncology massage is about adjusting rather than avoiding.

This question helps identify:

• radiation sites

• tumour locations

• bone involvement

• surgical areas

• ports or PICC lines

• lymphedema risk

• fragile tissue

• pain or sensitivity

3. How is the client feeling today?

(aka Whole person care in oncology massage)

A client’s condition can change dramatically from week to week — or even day to day.

Someone who tolerated a full-body massage comfortably last month may arrive today exhausted from chemotherapy, unable to lie prone, or emotionally overwhelmed.

This question reminds me not to make assumptions.

I pay attention to the client’s big picture:

• energy level

• stress level

• mobility

• emotional state

• current pain or discomfort

  
  

4. What is the goal of today’s session?

Not every session is intended to “fix” presenting signs and symptoms. Having clear goals helps guide clinical decisions.

Sometimes the goal is:

• relaxation

• sleep support

• reduced anxiety

• nurturing touch

• helping someone reconnect with their body

• improved mobility

5. What adaptations will help this client feel both safe and comfortable?

Safety and comfort are connected, but they are not identical. A session may be clinically safe while still feeling physically or emotionally uncomfortable for the client.

This final question helps bring everything together:

• positioning supports

• pacing

• pressure

• draping

• communication

• session length

Oncology massage is clinical reasoning in action.

As our clients progress through their cancer treatments, their presentation in our treatment rooms can become increasingly complex. The above 5 questions orient us to the essentials: The information gathered can be sifted through our oncology massage-aware critical thinking and provide a treatment that best suits our clients on the day of this massage. Which might be very different than their last or their next massage.

All we have to do is listen, with care, and respond, with intention. The benefits will show up in our client's receptiveness to our treatment, and their body's awareness that its' needs have been respected.

Enjoy your work!