Massage entered oncology care in an unusual way. Patients sought it out and reported meaningful benefits long before a substantial research evidence base existed, so the field developed largely through clinical experience and patient testimony.
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Because practice often outpaced the science, early concerns focused on whether massage might increase the risk of metastasis, contribute to fracture in areas of bone involvement, worsen lymphedema, or dislodge blood clots. As a result, many programs adopted highly conservative approaches, emphasizing distally applied therapies such as reflexology or touch-based therapies such as reiki, which avoided direct manipulation of affected tissues. These approaches continue to provide meaningful support for many people living with cancer while reflecting the cautious mindset that characterized the early years of oncology massage.
Over time, research and accumulated clinical experience helped address many of these concerns. The longstanding fear that massage could promote metastasis, for example, was not supported by the evidence. Through the work of professional organizations such as the Society for Oncology Massage, along with educators, researchers, and clinicians, the field gradually shifted away from long lists of contraindications and toward individualized assessment, thoughtful treatment modification, and evidence-informed clinical reasoning.
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This evolution changed the questions the field was asking. Rather than simply asking whether massage could be provided safely, clinicians began asking how massage could best support people living with cancer, how treatments could be tailored to specific symptoms, treatment-related side effects, and phases of care, and how oncology massage could align with the broader movement toward individualized, patient-centered cancer care.
Three things Paige Mullins learned from developing the massage intervention for the Integrative Medicine for Pain in Patients with Advanced Cancer Trial.
Developing a massage protocol for the IMPACT study underscored that practitioners’ clinical reasoning and patient-centered understanding developed in clinical practice is critical to the research conversation.
