CONTRAINDICATIONS AND SAFETY GUIDELINES FOR BREAST CANCER MASSAGE
Do not perform any massage on breast tissue without the clients’ informed consent. It’s a good idea to have them sign a consent form.

Do not work directly on a tumor site while malignancy is present, to prevent cell shedding.

Wait 3-5 days after a chemotherapy treatment before you work with your client.

Do not work on anyone that is undergoing chemotherapy or radiation if you are having the slightest viral condition or cold.

Do not massage individuals with fever. Fever may indicate infection, which is a serious concern to those undergoing chemotherapy.

Allow at least 10 days before performing any stretch or massage to a lymph removal site. That can interfere with formation of new lymph vessels

Undrape only the area you are working with, and avoid stroking the nipple area

Use broad flat areas of hands and fingers; do not use deep thumbs and fingertips, unless you use x-fiber technique.

Do not use tapotements.

Over enlarged lymph nodes: Swelling may be an indication of infection virus or malignancy.

Do not passively stretch joints with malignancy present in the bone. Bone may be brittle and possibly degenerated, there for highly susceptible to fractures.

Be cautious with stretching and deep tissue work on lymph removal sites, to avoid irritation and lymphadema.

Skin is very sensitive during and post radiation, avoid deep strokes, cross-fiber and aggressive stretching. Avoid using oil before radiation treatment. It can interfere with the mapping of the area and might increase the likelihood of local burns. It is not recommended to apply heat to a radiated area.

Chemotherapy targets all rapidly dividing cells, and that includes normal blood cell, such as platelets. That can increase bruising and tissue damage. Deep tissue techniques should be avoided or closely monitored.
One of the side effects of Chemotherapy is Peripheral Polineuropathy. Deep pressure and heat should be avoided! Use cold compress on affected areas.

Guidelines for use of hydrotherapy: hot compresses increase the circulation, relaxes and softens adhered tissue. Cold compresses relieve congestion, and inflammation. Alternating between 3 min of hot with 1 minute of cold compresses will increase the circulation. Precaution: Areas of surgery are often numb due to damage to the nerves, patient may not be temperature sensitive!
Do not apply heat on malignant area.

Be aware of Menken (healing crisis). Patient may feel worse before he/she become better. Especially if major detoxification is happening either physically or emotionally.

COMPLICATIONS AFTER SURGERY

Numbness
Hypersensitivity
Heavy tightness around chest especially with reconstruction
Pins and needle
Nervy pain
Sunburn sensation
Loss of shoulder motion
Loss of arm range of motion
Formation of “tight strings of skin” due to lymph vessel shrinkage
Decrease in skin elasticity due to loss of skin
Tightness spasm and cramping of the pectoralis major muscle
Inflammation and formation of scar tissue (adhesive capsulitis) around the shoulders (Can cause “frozen shoulder”) and scar areas
Lymphadema

Reconstruction with other body tissue:

Blood vessels are disturbed and fragile.
Other areas where tissue was taken from are sore, and scarred.
Weakness in area where muscle has been taken for the reconstruction

Eeris Kallil CMT www.bodyworkwisdom.com www.bouldermassageforbreastcancer.yolasite.com

Questions and answers about massge and cancer
http://bodyworkwisdom.com/id33.html

When you join this group- can you tell us a bit about who you are and your work?

I've been a LMT 6 yrs. working with oncology PTs for the last 2 yrs. Have studied under Gayle McDonald, Tracy Walton and C. Chatman. Have spent the last yr. trying to educate the local community (DRs. included) on the benefits of qualified LMTs working with all cancer PTs. Not much headway though, so any suggestions would be appreciated. Thanks in advance.
Mary Lou Ross
www.douglasvilletherapeuticmassage.com
mlr4147@yahoo.com

Dear Mary Lou -

I enjoyed reading your post to the group. Thank you.

Your site is lovely. It is very professional and inviting.

Since Douglasville is a relatively small community and Atlanta is only 20 minutes away, perhaps marketing to the Atlanta oncology community would help build your practice.

http://www.healthgrades.com/local-doctors-directory/by-specialty/on... can provide a list of Atlanta oncologists.

Another suggestion would be to offer Saturday appts. and evening appts. so people working 8 to 5 could schedule appointments with you since those are people who are more likely to be able to afford to pay for alternative health care.

You've certainly studied with the finest. Perhaps you could contact them and ask for their marketing suggestions.

Warmly, Ariana Vincent, Ariana Institute,
target="_blank">www.arianainstitute.com

Mary Lou wrote:

I've been a LMT 6 yrs. working with oncology PTs for the last 2 yrs. Have studied under Gayle McDonald, Tracy Walton and C. Chatman. Have spent the last yr. trying to educate the local community (DRs. included) on the benefits of qualified LMTs working with all cancer PTs. Not much headway though, so any suggestions would be appreciated. Thanks in advance.
Mary Lou Ross
www.douglasvilletherapeuticmassage.com
mlr4147@yahoo.com

Hello Mary Lou and welcome! I thank you for your posting as well, and Ariana has some great input.
I would like to add another idea or two-
Offer a free talk at the hospital about the benefits of massage for the cancer patient; you can also contact PT offices and cancer support groups to offer talks. Try to target and educate the people vs. the medical personnel, they might have more invested in learning how to make their life better and they are the ones that might take it back to their doctors.
Go to different that fund raiser events for cancer like Relay for Life and the Avon walk and see if you can become more visible offering massages.
Good luck- it sounds like you got a lot of knowledge and experience!
Eeris

Hi, I'm a friend of Mary Lou, she directed me here. Mary Lou and I met in a Gayle MacDonald class in AZ. I've been an LMT for 5 yrs and oncology massage became my primary therapy right away. I have studied under Gayle MacDonald and G. Klose where I got my CLT. I do volunteer work for a hospice also. My scope has broadened from primarily oncology to MS, Parkinson's, and ALS pt's. What we use for oncology is also excellent for many of these other diseases and they all need therapeutic touch. Thanks for making the effort to establish this form of communication.
Anita Bakke
omaz@cox.net

Hello Anita- nice to have you in this group- Looking forward to your input! I to am affiliated with a PT clinic that started as a cancer clinic and expanded into Parkinson's. Yes they all need out touch!

And to all- sorry for the typos on my previous comment..:)

Hi Ya'll Mary Lou, also directed me here too. Just like Mary Lou and Anita, I have attended Gayle MacDonald class in AZ, NM, TX. I also went to G. Klose with Mary Lou. I've been in the business for 4 years. My practice is primarily medical issues from Parkinson's, MS, OA & RA and Fibro but I am trying to get to the DRS for oncology. I am about to volunteer at the VA Hospital in Fort Worth, to help with a study program for scar tissue.

Mary Lou, you are quite the networker! :) question for all of you: how much of breast cancer info is covered in Gayle MacDonald's class?

Gayle addresses all forms and aspects of cancer in her two books and classes. Each provides a full comprehensive view of oncology. She touches on various forms of cancer while giving a better knowledge about the medical issues and details of cancer such as metastasis, understanding and isolating variables such as pain, fatigue,lymphedema, etc., Both her classes and books provide the therapist with vital knowledge designed to best suit the needs of the patient.

I suggest to everyone if you have not taken a class by Gayle, Tracy, or one of the certified teachers out there, this should be your direction. Gayle's books are available at most on line media outlets such as amazon. The titles are "Medicine Hands Massage Therapy for People with Cancer" ISBN 978-1-84409-0907 and "Massage for the Hospital Patient and Medically Frail Client" ISBN 0-7817-4705-8. These are excellent reference materials to have on hand. I refer to them often.

Good Morning,

Hello there Eeris,

I just completed an advance course in Massaging Cancer Patient in Michigan. I have contacted many hospitals in my area and none of them have Cancer Massage available... So how do I start to get clients in my office or shall I say myself out there ... I hope that you can help me get there....

Hello Beth- Welcome to our group.
Are you in the Chicago area? I have a friend/colleague in Chicago who helped started a massage program in a hospital- I can ask her for details or connect the two of you if you are interested.
Here is a copy of a previous post for a question similar to yours, you may try some of these ideas-
Contact local PT offices and cancer support groups to offer talks about the benefits of massage for the cancer patient. Try to target and educate the people vs. the medical personnel, they might be more invested in learning how to Improve their quality of life.
Contact cancer conferences organizations in your area and offer to be a speaker.
Offer talks at the hospitals, medical centers, community centers, senior centers etc;
If you are not the speaker kind, go to different fundraising events for cancer like Relay for Life and the Avon walks they always have a need for massage therapists volunteers see if you can become more visible offering massages.
If you have time to volunteer at cancer organizations- I started by facilitating a Breast cancer support group. (Breast cancer network of strength is one 1-800-221-2141. www.networkofstrength.org )
Side note: Cancer patients may be often financially stressed and will not be able to afford to fully pay for a session- I always offer a sliding scale.
If you haven't done so yet- make sure to put on your business card and brochures that you do oncology massage- just to start identifying yourself with that field and setting your intentions in that directions.

It takes time, work and most of all- word of mouth, especially if you are in an area where massage is not as acceptable or associated as a luxurious regiment rather than a health necessity.
Best of luck, keep us posted on your progress!
Eeris
www.bodyworkwisdom.com

Hi Eeris,

I live in the southern suburbs just outside of chicago... That would be awesome if you have your friend e-mail me b_rosentreter@yahoo.com... I have tried contacting hospitals already and will be volunteering for an organization called Fayes Light. I also volunteer for a Relay of life and have contacted Chirst Hospital because they have a childrens cancer area and the breast cancer center which stated that they were going to have two organized meeting and the children's didn't know anything... however the Breast Cancer stated that it wouldn't be benifical for me since it would be more of caregivers.. However she did give me a person name and I called however i called on friday and this week she's on vacation. However the first person I spoke with stated that they did have an informational nite/day but it's when I gone on vacation. So I am going to call her back and ask if I can come in and massage the patients when they are getting chemo... As for talks surely I can talk about what I learned however I really do not have first hand knowledge under my hands to actually compare apples to oranges....I'll let you know.... Beth

Beth- I am waiting to hear back from my friend. I gave her your info. Sounds like you are doing all the right things, the rest is time and persistence. Keep the good work!

Hello to all new members Kelly, Jenny, Sharity, Jessica, Anna, Larua, Pamela. I hope I did not forget anyone.
Please bring your input and questions for discussion.
I will be traveling Sep 14th -26 so I apologize if I will not be around to greet people or respond.

Hi Eeris,
How's everything? I am still searching on facility for Oncology Massaging. Did you ever get ahold of your friend? I was hoping that your friend could help me out in some way... I am so glad to see that there are so many massage therapist that massage for cancer, it is so beautiful.
Beth

Beth I did not hear back from her. I think she is traveling but i will send her an email again! Ee.

thank you very much, I will be out of town from 9-28 thru 10-5...

I was informed of a new website for general breast cancer education KnowBreastCancer.org

Check it out for valuable information!

Beth- are you still interested in contacting my friend? I can send it via a message :)

I'm just joining the group, and I'd love to hear what others can tell me about lymphedema. Is there any new info about who may be most susceptible...and why?

The best resource for LyE related topics I have found is http://www.lymphnet.org and they have published positional papers on risk reduction etc. Factors that associated with high risk of LyE are irradiation of the axilla (scarring prevents fluid flow), incision oblique rather then transverse, infection in the arm, and excess weight.
The last statistics regarding rates of post surgical LyE (Dr. Bruno Chikly):
Radical mastectomy with no radiation 3 in 10
Radical Mastectomy with radiotherpy on chest 1 in 3
Radical Mastectomy with radiotherpy on axilla 6 in 8 (radition causes micro scarring preventing lymphatic flow)
Modified radical mastecomy no radition 18 in 81
Modified radical mastecomy radiotherapy on chest 2 in 14
Modified radical mastecomy radiotherapy on axilla 37 in 66
partial mastectomy (lumpectomy) and axillary dissection with radiotherpy on chest 11 in 48
partial mastectomy (lumpectomy) and axillary dissection with radiotherpy on axilla 21 in 48

hope this helps.
CJ

Thanks for the site Carol and the stats too. Nice to have a site with some real stats we can use when talking to Dr.s and their RN's.
Mary Lou

Hi Carol, thank you, the site you referenced is a goldmine of information to share with patients and oncology nurse colleagues. I am not a lymphedema specialist myself, but as an RN, LMT I always ask clients who has had treatment about lymphedema awareness, and It surprises me that so many women say they are not told much about precautions and management when they are initially discussing treatment plans for breast cancer.

Hi - My name is Bill Curry, and I have been doing massage since 1990. My very first paying client asked me to include the breast area as she had multiple problems have large breast. I said my wife would not like me to do that, and said sorry. When I told my wife of the situation she said, "You're a professional aren't you"? I said yes, then she said, "Your not going to do anything else are you"? I said of course not. So she said, "do you know what to do"? I was stunned. My wife was encouraging me. So she explained that women have their issues and who was going to address them. Certainly not the doctors, nurses, husbands or boyfriends. She said she like it when I gave her her massage, and I was totally professional when doing her, and she had relief with her massage since she had large breast with fibro problems and other complications. She thought that everyone should be able to experience this. I thought she might be a little crazy, but then I talk to my instructor (Dr.) who tough me, and she said, "Oh yeh, about 20% of the women I do have that included with their massage". I couldn't believe I was hearing about this. I asked why she didn't teach it in class, and at that time it was unheard of. She said that she might just as well hang a red light in front of the school. She said people were not ready for it in the real world. So, we went over a few techniques and that is where I got my start. After that, the women that I started with was so pleased at the non sexual relief she had that she told a few of her friends. The next thing I knew I was getting busy. Apparently, men were afraid to go there, and I think that the average man would have trouble doing it. I also noticed that women were not doing it either. It seemed that when I would talk to other women massage practitioners, they all felt uncomfortable with the whole idea. The one lady said she just couldn't bring herself to do it. When I spoke about it with my clients to find out, why me? They told me that somehow, it felt natural. I also heard said, that a normal massage would never be the same without having the breast included.
Since 2000, I now work in an oncology unit part time (one day a week), and 2/3s of the women I do have it included as part of a breast maintenance routine. Over the years I have found breast cancer, and have refereed them to a doctor, and although I never diagnose, I always will discretely ask when there last mamo was, and tell them I think it is time to get checked again, that something doesn't feel right to me. I know what is wrong, but I cannot tell them that. I have found that, DCIS feels like a thread under a table cloth, and that invasive Ductile Carcinoma feels like a small mass out of context (look for changes), and the differences between lumps and lymph nodes. You get the picture. There is a lot more I can share, but at the moment I need to get ready to do a body scrub and a massage at 6:30. So I will leave you with this. On my web site, I have a lot of links and information for both the client that does not want the breast area included and for those that do. Self breast exams links and other good stuff.
BillCurryMassage.com
There is other information that I did not put on my web site, but will share later. For instance, did you know that there is an Oncology massage organization?
Be Well!
Bill

Eeris,

Yes I am still interested in possibly hooking up with you friend.. You can give her my e-mail address b_rosentreter@yahoo.com and we can communicate that way... I still have not gotten any responses out here. I can not beileve that the response to what we do is not very favorable. I know that If I was going thru cancer I certainly would want any relief I can get.

So please pass my name on to anyone that can be of help... I greatly appreciate it...

Thanx a bunch...

Hi Bill welcome and thank you for sharing. I agree Healthy breast massage is not practiced much because of all the taboos that we have to deal with. I think therapists also should check their state regulations for breast massage. Things got stricter in the last few years. Correct me if I am wrong- I think that it is now recommended/required to have a signed consent from a client before doing breast health massage.
Here is an article I found about breast massage. www.massagetherapy.com/articles/index.php/article_id/115/Breast-Mas...

Hello Eeris - What a nice unusual name. I like it! So, here's the scoop. Cheryl Chapman (teacher of Breast Massage - also an oncology nurse) back in 2003 was responsible for a bill in the legislature that in effect removed the word breast from the areas not to be worked on. That is the short version. This paved the way for schools to offer it with the states approval. As long as the person has had a 500 hour course and has been certified as a massage practitioner or therapist, and has completed a breast course in a state approved school, and the course has passed the educational requirements, then it is legal. The term used here is, "As long as it is within the scoop of practice". Signed consent is not mandatory, but I recommend it. I was in the group that was responsible for the passing of the Massage Licensing Law, passed Jan 13, 2008. We are in stage 2 of 3 stages of the implementation of this bill as we speak. My best guess is, the bill will be implemented by January 2010. I have had some negative feed back regarding the passing of this bill, but it was going to happen with or without me there. So I decided to get involved. This way I had some input, and was able to help make it a bill we all could live with. I myself believe in less regulation the better, but if it was going to happen, I didn't want anyone taking our rights away, and dictating what we can and can't do. The reason I tell you this, is that I am up on the law to a certain degree regarding massage. Thanks for calling attention to the article you mentioned below. I have this link on my web site. Great article!

I am a little slow on adding comments. But here is my great news. I have done 4 lectures this month on oncology and massage with two hospital setting group, one church, and one with American Cancer Assoc. I have had 4 booking from these lectures and also booked 2 with chemo therapy patients(these two I am giving as bono but that ok because it will give me the rep, I am looking for). So, please do not give up. The director at American Cancer Assoc knows that the docs will give in with time or they will never here the end from me.
Delete Comment

wow, great news Theresa! I am always willing to work on cancer survivors for a lower rate and sometime give a session for free- its a great gift that we can give to our communities!

Bill- I hear you. If they are going to make some laws we might as well get involved. I thank you for doing that!

Great site with excellent information. It will take time to read and absorb everything. One question -- a quick review of the topics address massage for clients with breast cancer. What about MT's with breast cancer? Is there anyone there who would be willing to share their experience about this?

Carolyn, Glad you joined. I learned so much since I joined this site!
Did you mean Massage Therapists who had breast cancer? I had breast cancer 9 years ago and willing to talk and share with anyone. Let me know how I can help!

Eeris, actually I was looking for MTs who had breast cancer. I see you are one and I will check out your website. I was diagnosed in June but just had surgery in October (wanted to get my daughter off to college first). I'm wondering how "bc" affected your work as an MT, both from a practical standpoint (energy level, etc) and an emotional level.

Hello there Carolyn, sorry it took me a while to reply.
I was diagnosed in 2000 and had a bilateral mastectomy with reconstruction, but no chemo or radiation. From the moment i was diagnosed all i wanted was to go back to work- as soon as possible. I wanted life to go back to the way it was before cancer. So needless to say there was some denial process going on... I waited the recommended 10 weeks after the surgery, and went back to work, of course i did it gradually. Since I was not doing chemo or radiation my recovery was fast and my body did not feel overly taxed. I felt strong emotionally because i knew that i made the right decision for me. I have a heavy family history and strange enough there was a sense of relief to finally deal with it and move on, even thought it was difficult to go through it.
I decided to focus my practice on helping woman with breast cancer, and teach others about massage and breast cancer.
Working with other women made a big impact on my emotional healing.
The truth is that i feel really lucky. If it cost me the price of my breasts to stay here and raise my children , I am willing to pay that price.
I am happy to talk more if you would like to. please contact me via a personal message.

I remember a few years ago like 2006/07, I found a study from England that stated they did research on breast cancer & massage. As I recall the women who got monthly breast massage didn't get breast cancer. Does anyone remember this study? I am trying to refind it. I had it on an old hard drive & I seem to have lost it.

Hi Nancy - I would like to know more about that study from England. There are several studies that have proven the benefits of massaging the breast, be it self or otherwise. Even the bra manufactures recommend doing self breast massage every time you take off your bra. I have a lot to say on that subject, but for another conversation. A client of mine that is the top nurse at the hospital she works at said to me, that when she was in nursing school back in 1980, they knew that wearing a bra caused the breast to become more acidic and toxic. They also knew that this condition could lead to breast cancer due to the basic anatomy. The fact is that the whole body (including organs) use lymph vessels to eliminate waste products from the body that would otherwise be taken away by the blood vessels. Ninety percent of plasma, that goes in to the interstitial tissue areas, goes back in to the blood stream, and gets taken away, filtered out by the kidneys and you then urinate it away. The breast are the only organs that function differently then the rest of the body. Every lymph vessel in the body has lymph vessels with could be called one way valves, keeping the lymph moving in one direction. Through autopsy's they have found that the breast tissue has between 8 to 15% vessels with these one way valves. It is theorized that body was built or evolved with the breast moving freely, and as a result they drain through movement. So massaging the breast actually facilitates this need for movement and detoxifies the breast, taking them from acidic to alkaline. Cancer thrives in an acidic internment, and slows down to between a crawl and a stop in an alkaline internment. So alkaline diets are used for cancer patients to keep it from getting any worse as well as to heal the patient. The same can be said for keeping the breast moving. Not wearing a bra is one of these areas that of concern. Having the right bra for the right purpose is the best way to go, and not wearing one when possible. So the study you speak of says a lot. In countries where bras are not worn, it is no surprise they have a very low incident of breast cancer. One study back in 1992 showed that in these countries, women had a 1 in a 152 chance of getting breast cancer. In countries where bras are worn the risk factor goes to 1 in 7. Diet plays a big roll, but proper drainage of the lymphatic system in the breast plays a big roll as well. OK, enough said for now. I have lectured on this subject and other related breast issue since 2000, and there is a lot that I could say, but this is not a lecture. Is is possible to post a link on this site for others to see this study or is it in writing somewhere?

I hope I can still find it. I had it in a word program on my hard drive. I am still looking on several hard drives. I am still looking online as well. If I come across it again. You bet I will post the link & recopy it. Thanks for your information.