TESORO, Guenever R.

BSN-3A
ASYNCHRONOUS ACTIVITY – MEDSURG (ONCOLOGY)

Effect of Music Therapy with Periorbital Massage on Chemotherapy-Induced Nausea and Vomiting in Gastrointestinal Cancer: A Randomized
Controlled Trial

In accordance to the study conducted by Dadkhah, B. et al 2019. The music and massage therapy are among the approaches of complementary medicine.
Patients with cancer have been hugely encouraged in recent years to use complementary medicine to relieve chemotherapy-induced nausea and vomiting.
In a qualitative study on the experiences of patients undergoing chemotherapy, patients were experiencing fatigue and exhaustion due to failure to control
nausea properly, resulting in prolonged intervals between chemotherapy courses. The present study was conducted to determine the effect of music and
periorbital massage therapy on chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancers. The method that they used is the
present single-blind clinical trial study was conducted on 60 patients with gastrointestinal cancer undergoing chemotherapy who were randomly assigned
to control and music plus massage therapy groups. Two interventions were concurrently carried out on patients in music plus massage therapy group
while receiving chemotherapy medication, but the control group received no intervention. Rhodes questionnaire was used to assess nausea and vomiting
before and 24 hours after chemotherapy. Data were analyzed using descriptive and analytical statistical tests (Chi-square and t-tests). The result of this
study was music plus periorbital massage therapy significantly reduced nausea and vomiting in patients undergoing chemotherapy compared to the
control group. In conclusion, according to the results, using music plus periorbital massage improves nausea and vomiting in patients undergoing
chemotherapy, and can be considered as a complementary medicine method in conjunction with other medicinal therapies to relieve symptoms of patients
with cancer.

Reference:
Dadkhah, B., Anisi, E., Mozaffari, N., Amani, F. & Pourghasemian, M. (2019, September 1). Effect of Music Therapy with Periorbital Massage on Chemotherapy-Induced
Nausea and Vomiting In Gastrointestinal Cancer: A Randomized Controlled Trail. Retrieved from PMC: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778310/
 Music in palliative care: a qualitative study with patients suffering from cancer

In accordance to the study conducted by Pommeret, S. et al. 2019. The palliative care unit is an emotionally challenging place where patients and their
families may feel at loss. Art can allow the expression of complex feelings. We aimed to examine how cancer patients hospitalized in the palliative care
unit experienced a musical intervention. They conducted a qualitative study based on semi-structured interviews. The study took place in a palliative care
unit from 18 January 2017 to 17 May 2017. Two artists performed in the palliative care unit once a week from 9:30 am to 5:30 pm. The data from patient
interviews were analysed based on an inductive approach to the verbatim accounts.
The accounts they gathered led them to weigh the positive emotions engendered by this musical intervention against the potential difficulties
encountered. The artists opened a parenthesis in the care process and brought joy and well-being to the palliative care unit. Patients also encountered
difficulties during the intervention: reference to an altered general state, to loss of autonomy; a sense of the effort required, of fatigue; an adaptation
period; reference to the end of life, to death; a difficulty in choosing songs.
Although music appeared to benefit the patients, it sometimes reminded them of their altered state. The difficulties experienced by patients during the
experience were also related to physical exhaustion. Additional studies are needed to determine the benefits of music for patients and their families in the
palliative care unit.

Reference:
Pommeret, S., Chrusciel, Jan., Verlaine, C., Filbet, M., Tricou, C., Sanchez, S. & Hannetel, L. (2019, October 7). Music in palliative care: a qualitative study with
patients suffering from cancer. Retrieved from BMC:https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-019-0461-2
 Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients with Breast or Gynecological Cancer: A Randomized Trial

In accordance to the study conducted by Alcantara-Silva, TR. et al. 2018. Fatigue is one of the most commonly experienced cancer symptoms, affecting 70% to 100% of the
people undergoing cancer treatments.1,2 Cancer-related fatigue (CRF) is defined by the European Association for Palliative Care as a subjective symptom of tiredness, weakness,
or lack of energy.3 The National Comprehensive Cancer Network describes CRF as a subjective, distressing, and persistent symptom of physical, emotional, and/or cognitive
tiredness or exhaustion related to the disease or its treatment. The purpose of this study is to investigate the influence of music therapy on the reduction of fatigue in women with
breast or gynecological malignant neoplasia during radiotherapy, since it is one of the most frequent side effects of this type of treatment, and may interfere with self-esteem, social
activities, and quality of life. Experimental Design: Randomized controlled trial (control group [CG] and music therapy group [MTG]) to assess fatigue, quality of life, and
symptoms of depression in women undergoing radiotherapy using the Functional Assessment of Cancer Therapy. This was a prospective, randomized study using music therapy to
alleviate fatigue and depressive symptoms. Participants were female patients recruited from a cancer treatment hospital located in the Midwest region of Brazil. Inclusion criteria
were the following: (1) diagnosis of breast or gynecological cancer, (2) age between 20 and 80 years, (3) scheduled to receive radiotherapy (teletherapy or brachy therapy) planned
for 20 or more sessions, and (4) score of 70 or more points in the Karnofsky Performance Scale Index. The music therapy sessions were conducted by a trained and experienced
music therapist (TRM Alcântara-Silva). The participants in the MTG had individual 30- to 40-minute music therapy sessions twice a week right before the radiotherapy sessions,
in the therapist’s office, in a cancer treatment hospital. The equipment used in the music therapy sessions included the following: a fourth-generation iPod Nano (Apple Inc,
Cupertino, CA) and a Powerpack model SK-2 speaker. The selection of songs for the second listening was patient-chosen by participants in the MTG, each of whom gave the
music therapist a list of her favorite songs. In this study, most songs chosen by the patients approached themes similar to the feelings they were experiencing during radiotherapy,
such as loss, loneliness, and sorrow. Familiar songs play an important role in music therapy, because they allow latent contents to emerge, and they also help the patients to become
aware of their problems and look for more adaptive coping strategies, leading to a better understanding of the treatment, and alleviation of the symptoms for most individuals. The
biological facts underlying the results found in this study may be connected to the relationship of music with deep brain structures involved in the processing of emo-tions.
Therefore, music plays a major role in self-regulation of emotional contexts. Music is also involved in the regulation and genetic expression of dopamine, as well as in the
alterations in the levels of serotonin, cortisol, and oxytocin. Hence, it is possible to affirm that the positive response obtained with the action of music in the therapeutic context,
applied by a qualified music therapist, is based on biopsychosocial grounds. Music therapy can be applied as an integrative treatment during radiation therapy and has the potential
to affect fatigue. In this study, statistically relevant responses were found regarding fatigue, quality of life, and symptoms of depression. Continuous assessment of results, in the
beginning, during, and after radiotherapy is also relevant. Moreover, assessment during radiotherapy allows professionals to rethink and adjust the procedures aimed to achieve
effective responses to treatment, as well as minimize the number of patients who abandon it.

Reference:
Alcantara-Silva, TR., Freitas-Junior, R., Freitas, N. & Junior, W. (2018, January 7). Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients With Breast or
Gynecological Cancer: A Randomized Trial. Retrieved from ResearchGate: https://www.researchgate.net/publication/324416589_Music_Therapy_Reduces_Radiotherapy-
Induced_Fatigue_in_Patients_With_Breast_or_Gynecological_Cancer_A_Randomized_Trial
 The Effects of Music Therapy in the Pain Management of Patients with Breast Cancer

In accordance to the study conducted by Gomez, E. C. et al 2015. American Music Therapy Association (2010), determined music therapy to have shown
significant effect on patient ’s self-reports of pain reduction, relaxation, respiratory rate, behaviorally observed and self-reported anxiety levels. The study
aims to help cancer patients to have simple and convenient non pharmacological pain management measure. Methods Utilizing quasi-experimental
design, subjects were purposively and randomly selected from Jose R. Reyes Memorial Medical Center- Cancer Institute (n=24). Subjects in the
experimental group were subjected to music therapy for one hour, twice a week for 6 weeks (total of 12 sessions). Subjects were given the chance to
choose their music type (classical or lullaby) which was delivered using iPod nano and Philips Ultra lightweight headset. Subjects in the non-equivalent
comparison group were subjected to observation period for the same duration and frequency. The effects of music therapy in the following parameters:
level of pain and vital signs (temperature, blood pressure, cardiac and respiratory rate) were evaluated pre and post treatment using the measuring
devices- blood pressure apparatus, thermometer, numeric pain scale (Rich, 2010) and vital signs monitoring sheet. Wilcoxon Signed Rank Test, Paired
Samples Student ’s T-test, and Mann-Whitney U-test were used to test the differences across the parameters between the experimental and non-
equivalent comparison groups. Result Subjects in the experimental group showed statistically signi ficant decrease in their pain scale (p-value=0.00),
cardiac rate (p-value=0.04), and respiratory rate (p-value=0.01) when compared from the non- equivalent comparison group. Conclusion Music therapy is
effective in the pain management of patients with breast cancer.

Reference:
Gomez, E.C., Arimas, R.A., Calupcupan, F., Garcia, R.V., Batac, RK. & Aleta, ES.M. (2015). Retrieved from bmj:
https://bmjopen.bmj.com/content/bmjopen/5/Suppl_1/bmjopen-2015-forum2015abstracts.110.full.pdf
 The Effects of Music Therapy in the Music Therapy Reduces Radiotherapy- Music in palliative care: a qualitative Effect of Music Therapy with
Pain Management of Patients with Induced Fatigue in Patients with Breast study with patients suffering from Periorbital Massage on Chemotherapy-
Breast Cancer or Gynecological Cancer: A cancer Induced Nausea and Vomiting in
Gomez, E. C. et al 2015 Randomized Trial Pommeret, S. et al. 2019 Gastrointestinal Cancer: A
(Philippines) Alcantara-Silva, TR. et al. 2018 (United States) Randomized Controlled Trial
(Brazil) Dadkhah, B. et al 2019 (Iran)
Background and Objective Objective: The purpose of this study is to Objective: Aimed to examine how cancer Background and Objective:
American Music Therapy Association (2010), investigate the influence of music therapy patients hospitalized in the palliative care The present study was conducted to
determined music therapy to have shown on the reduction of fatigue in women with unit experienced a musical intervention. determine the effect of music and
significant effect on patient ’s self-reports of breast or gynecological malignant periorbital massage therapy on
pain reduction, relaxation, respiratory rate, neoplasia during radiotherapy, since it is chemotherapy-induced nausea and
behaviorally observed and self-reported
one of the most frequent side effects of vomiting in patients with gastrointestinal
anxiety levels. This study aims to help cancer
patients to have simple and convenient non this type of treatment, and may interfere cancers.
pharmacological pain management measure. with self-esteem, social activities, and
quality of life.
Methods: Utilizing quasi-experimental Methods: Randomized controlled trial Methods: We conducted a qualitative Methods: The present single-blind clinical
design, subjects were purposively and (control group [CG] and music therapy group study based on semi-structured interviews. trial study was conducted on 60 patients with
randomly selected from Jose R. Reyes [MTG]) to assess fatigue, quality of life, and The study took place in a palliative care gastrointestinal cancer undergoing
Memorial Medical Center- Cancer Institute symptoms of depression in women unit from 18 January 2017 to 17 May chemotherapy who were randomly assigned to
(n=24). Subjects in the experimental group undergoing radiotherapy. The music therapy control and music plus massage therapy
2017. Two artists performed in the
were subjected to music therapy for one hour, sessions were conducted by a trained and groups. Two interventions were concurrently
palliative care unit once a week from 9:30 
twice a week for 6 weeks (total of 12 experienced music therapist (TRM Alcântara- carried out on patients in music plus massage
sessions). Subjects were given the chance to am to 5:30 pm. The data from patient therapy group while receiving chemotherapy
Silva). The participants in the MTG had
choose their music type (classical or lullaby) individual 30- to 40-minute music therapy interviews were analysed based on an medication, but the control group received no
which was delivered using iPod nano and sessions twice a week right before the inductive approach to the verbatim intervention. Rhodes questionnaire was used
Philips Ultra lightweight headset. Subjects in radiotherapy sessions, in the therapist’s office, accounts. to assess nausea and vomiting before and 24
the non-equivalent comparison group were in a cancer treatment hospital. hours after chemotherapy. Data were analyzed
subjected to observation period for the same using descriptive and analytical statistical
duration and frequency. tests (Chi-square and t-tests).
Results: Subjects in the experimental group Results: In a comparative analysis of the CG Results: The accounts we gathered led us to Results: Music plus periorbital massage
showed statistically significant decrease in and MTG, taking into consideration the 3 weigh the positive emotions engendered by therapy significantly reduced nausea and
their pain scale (p-value=0.00), cardiac rate phases of assessment, the fatigue profile was this musical intervention against the potential vomiting in patients undergoing
(p-value=0.04), and respiratory rate (p- at similar levels at the beginning of the study difficulties encountered. The artists opened a chemotherapy compared to the control group.
value=0.01) when compared from the non- for patients in both groups and improved in parenthesis in the care process and brought
equivalent comparison group. the final phase of treatment in both groups. joy and well-being to the palliative care unit.
However, the participants in the MTG showed Patients also encountered difficulties during
statistically significant improvement com- the intervention: reference to an altered
pared with the CG patients under the same general state, to loss of autonomy; a sense of
conditions. Therefore, it is possible to infer the effort required, of fatigue; an adaptation
that the participants in the MTG experienced period; reference to the end of life, to death; a
improvement in fatigue symptoms because of difficulty in choosing songs.
 music therapy. In this study, music therapy
significantly reduced the symptoms of
depression, and hence it can be considered an
adjuvant therapy for the treatment of cancer
patients.
Conclusion: Music therapy is effective in Conclusion: Music therapy can be Conclusions: Although music appeared to Conclusion: According to the results,
the pain management of patients with applied as an integrative treatment during benefit the patients, it sometimes using music plus periorbital massage
breast cancer. radiation therapy and has the potential to reminded them of their altered state. The improves nausea and vomiting in patients
affect fatigue. In this study, statistically difficulties experienced by patients during undergoing chemotherapy, and can be
relevant responses were found regarding the experience were also related to considered as a complementary medicine
fatigue, quality of life, and symptoms of physical exhaustion. Additional studies method in conjunction with other
depression. Continuous assessment of are needed to determine the benefits of medicinal therapies to relieve symptoms
results, in the beginning, during, and after music for patients and their families in the of patients with cancer.
radiotherapy is also relevant. Moreover, palliative care unit.
assessment during radiotherapy allows
professionals to rethink and adjust the
procedures aimed to achieve effective
responses to treatment, as well as
minimize the number of patients who
abandon it.

Significance:
Music therapy is a frequently used complementary and creative arts treatment in psychosocial cancer care (Bro et al., 2018). Particularly in advanced cancer populations and
palliative care, music therapy has recently received high attention in both research and clinical care (Stützlinger et al., 2018; Warth et al., 2019a).
Music is a kind of complementary medicine that affects the central nervous system, making the patient feel relaxed and recovered. Music therapy means the regular use of music to
maintain, provide and improve physical and mental health, such that the music therapist creates the desired changes in the patient's behavior and emotions by playing music in a
therapeutic or stressful environment.
Anxiety is currently recognized as an important factor for exacerbating nausea and vomiting. Hence, relaxation techniques such as music and massage are used to improve these
side-effects.
As a complementary medicine technique, massage therapy enhances blood flow and oxygenation of tissues, and thus creates a peace of mind and relaxation.
The biological facts underlying the results found in this study may be connected to the relationship of music with deep brain structures involved in the processing of emotions.
Therefore, music plays a major role in self-regulation of emotional contexts. Music is also involved in the regulation and genetic expression of dopamine, as well as in the
alterations in the levels of serotonin, cortisol, and oxytocin. Hence, it is possible to affirm that the positive response obtained with the action of music in the therapeutic context,
applied by a qualified music therapist, is based on biopsychosocial grounds.