46 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 4
PATHOLOGY PERSPECTIVES
ONCOLOGY IMPLANTS
Massage clients who are undergoing cancer
treatment may have a variety of equipment to
manage, but these are probably the most common:
Radioactive Seeds
Some types of cancer are treated by injecting small
radioactive pellets, called seeds, on or near tumor
sites. Patients are usually counseled to avoid close
contact with others while the seeds are in place,
at least for several weeks. After they have been
removed or lost their potency, this caution is lifted.
Portacaths & PICC Lines
Portacaths (also called ports) and peripherally
inserted central catheter (PICC) lines are devices
that provide easy long-term access via an implanted
tube to the circulatory system for the administration
of medicine. PICC lines use veins in the arms,
while portacaths typically access the subclavian
vein. These devices carry a list of serious possible
complications, including blood clots, infection,
and occlusions. At their best, patients with these
devices can enjoy normal activities, including
exercise and massage, but the access area may need
special accommodation with position and pressure.
Ostomies
If colorectal cancer or some type of inflammatory
bowel disease has led to the removal of a substantial
part of the small or large intestine, a patient may
have an ostomy: a surgically created opening
to the digestive tract that allows liquid fecal
material to accumulate in a changeable bag.
It is important to reiterate that the list above
is very much abbreviated. Massage therapy clients
may also have implanted mesh to repair hernias
and other wounds; shunts that drain excessive
cerebrospinal fluid into the abdomen; drains for
chronic infections; and any number of other devices.
Most of them come with few restrictions, but the
massage therapist who works with these clients
must be diligent about getting enough information
to help keep clients safe and comfortable.
ADVICE FROM THE EXPERTS
To help create a practical application for all this
information, I consulted with several therapists who
work with medically frail people. I asked, "What
are the most important things massage therapists
RESOURCES
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Epstein, L. and E. Nof. "Complications
of Cardiac Implants." WebMD.
Accessed January 2014. www.
medscape.com/viewarticle/777897.
Gordon, R. "10 Most Common Medical
Implants and Info." Medical Directions.
Accessed January 2014. www.
medical-directions.com/10-most-
common-medical-implants-and-info/.
Needleman, S. "New Medical Devices Get
Smart." The Wall Street Journal (August
2012). Accessed January 2014. http://
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396390444318104577587141033340190.
Neurotech Network. "Pain Management
Systems." Accessed January 2014.
www.neurotechnetwork.org/educate_
pain_management_systems.htm.
Prahlow, J. A. "Implanted Medical Devices
Encountered at Autopsy." Accessed
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The American Chronic Pain Association.
"Understanding Medical Devices for Pain
Management." Accessed January 2014.
www.theacpa.org/uploads/78472299-
31c1-4063-bcd4-50fbc3d5714b.pdf.
US Food and Drug Administration. "Implants
and Prosthetics." Accessed January
2014. www.fda.gov/MedicalDevices/
ProductsandMedicalProcedures/
ImplantsandProsthetics/.
WebMD. "Spinal Cord Stimulation for
Chronic Pain." Accessed January 2014.
www.webmd.com/back-pain/spinal-
cord-stimulation-for-low-back-pain.
