Massage & Bodywork

SEPTEMBER | OCTOBER 2021

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34 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 1 even with the lightest stimulus of any kind, can arise from small-fiber damage. And if agents of the autonomic nervous system are affected, then the patient may develop intolerance to heat, excessive sweating, gastrointestinal symptoms, and problems with the regulation of blood pressure. CIPN AND MASSAGE—AND WHAT THE RESEARCH SAYS My recommendation for working with clients dealing with cancer and the consequences of cancer treatment is to seek out advanced education to be knowledgeable enough to offer safe and effective massage therapy to this population. As we consider potential risks and benefits for massage therapy in the context of a client who is living with CIPN, a few variables are important to pin down. We need to know what they are treating with their chemotherapy, and at what stage of their treatment they are. We need to know what other complications of their cancer or cancer treatments might be present. And we need to know how their CIPN affects them—with the understanding that symptoms can change from one day to the next. Once we have managed the possible risks, which may include suppressed immunity, bone and organ involvement, and several other issues, we can think about what kind of touch might be most supportive and helpful. This is where it gets really interesting. As we mentioned, one of the challenges with CIPN is that it doesn't respond well to most treatment interventions. And because it can be severe enough to require that a chemotherapy regimen be interrupted, it can put patients at risk for poorer outcomes. If only there were a way to deal with CIPN that was gentle, safe, and well-accepted by patients . . . I have some good news! A handful of small-scale studies, including case reports and clinical trials, suggest that skilled massage therapy could have a positive impact on CIPN, both as a treatment Resources Çakici, N. et al. "Systematic Review of Treatments for Diabetic Peripheral Neuropathy." Diabetic Medicine 33, no. 11 (November 2016): 1,466–76. https://doi.org/10.1111/dme.13083. Han, Seunggu. "What are the Best Remedies for Neuropathy from Chemo?" (October 26, 2018). www. medicalnewstoday.com/articles/323481. Ji, R. R. et al. "Neuroinflammation and Central Sensitization in Chronic and Widespread Pain." Anesthesiology 129, no. 2 (August 2018): 343–66. https://doi.org/10.1097/ALN.0000000000002130. Johns Hopkins Medicine. "Small Fiber Sensory Neuropathy." Accessed June 14, 2021. www.hopkinsmedicine.org/ neurology_neurosurgery/centers_clinics/peripheral_nerve/ conditions/small_fiber_sensory_neuropathy.html. Nelson, Roxanne. "Massage Therapy Gives Relief from Chemo-Related Neuropathy." (October 28, 2019). www.medscape.com/viewarticle/920479. Neuropathy Commons. "Neuropathy Overview." Accessed June 14, 2021. https://neuropathycommons. org/neuropathy/neuropathy-overview. Noh, Gie Ok, and Kyung Sook Park. "Effects of Aroma Self- Foot Reflexology on Peripheral Neuropathy, Peripheral Skin Temperature, Anxiety, and Depression in Gynaecologic Cancer Patients Undergoing Chemotherapy: A Randomised Controlled Trial." European Journal of Oncology Nursing 42 (October 2019): 82–9. https://doi.org/10.1016/j.ejon.2019.08.007. Office of Communications and Public Liaison National Institute of Neurological Disorders and Stroke at the National Institutes of Health. "Peripheral Neuropathy Fact Sheet." Last modified March 16, 2020. www.ninds.nih.gov/Disorders/Patient-Caregiver- Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet. Schreiber, Anne K. et al. "Diabetic Neuropathic Pain: Physiopathology and Treatment." World Journal of Diabetes 6, no. 3 (April 2015): 432–44. https://doi.org/10.4239/wjd.v6.i3.432. Siao, Peter, and Michelle Kaku. "A Clinician's Approach to Peripheral Neuropathy." Seminars in Neurology 39, no. 5 (October 2019): 519–30. https://doi.org/10.1055/s-0039-1694747. Zajączkowska, Renata et al. "Mechanisms of Chemotherapy- Induced Peripheral Neuropathy." International Journal of Molecular Sciences 20, no. 6 (March 2019): 1,451. https://doi. org/10.3390/ijms20061451. Zhang, H. et al. "Dorsal Root Ganglion Infiltration by Macrophages Contributes to Paclitaxel Chemotherapy Induced Peripheral Neuropathy." Journal of Pain 17, no. 7 (July 2016), 775–86. https://doi.org/10.1016/j.jpain.2016.02.011.

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