Opinion on the safety of massaging dogs with malignancies is divided. In human cancer treatment, massage therapy is generally considered a safe and effective complementary therapy, when specific cautions are observed. Historically, massage was contraindicated in patients with cancer due to concerns that it’s stimulating effect on the circulatory system may enable malignancies to metastasize and spread through the body via the blood and lymph.

In human studies, these concerns have largely been dispelled. Numerous studies have shown that incorporating massage treatments into cancer patients’ conventional therapies yields many positive outcomes including:

• Managing pain

• Reducing anxiety levels

• Improving sleep quality

• Relieving distress from the symptoms of their condition

• Relieving fatigue and tension

• Relieving symptoms of cancer treatment.

In a study of breast cancer patients who received massage, the following outcomes were reported:

• decrease in anxiety, depressed mood, anger and hostility

• increase in dopamine and serotonin levels

• increase in Natural Killer (NK) cell number. NK cells are a type of lymphocyte that destroy a wide variety of cancer and virus infected cells and are involved in eliminating metastases (secondary malignant growths).

While there is a body of literature that demonstrates the general safety of massage for human cancer patients, when some adaptions are made, there is limited research into the effects of massage on canine cancer patients. However, based on recent human studies, the following points may be extrapolated to devise a safe and effective treatment protocol for massaging dogs with cancer.

1. Treatment plan

The treatment plan should clearly define the objectives of a treatment which will vary depending on the stage of the illness.
In post-operative stages or during radiation therapy, the treatment objectives may be to:

• Reduce scar tissue

• Aid healing

• Address the side effects of immobilisation

• Manage pain

• Reduce anxiety

During the palliative care stage, the treatment objectives may be to address pain, anxiety, and fatigue.

The treatment plan should also identify possible side effects and devise strategies for managing them. Possible side effects from massage may include: bruising, swelling, and a temporary increase in muscular pain.

Finally, the treatment plan should consider the dog’s demeanour and experiences in the clinical setting, particularly their sensitivity to touch, bearing mind they may have negative associations with invasive examinations or painful palpations.

2. Adaption of technique

For the safety of canine cancer patients, the therapist should consider adjusting the pressure of the massage and joint movements used. While there is no evidence that massage in patients with cancer increases metastatic spread, direct firm pressure over sites of active tumours should generally be avoided.

Therapists may consider use of light pressure for effleurage, light kneading and some trigger point therapy, as required, taking particularly note of the pressure and stroke direction around the following:

• radiation sites,

• areas of fragile or sensitive skin,

• surgical scars,

• areas of pain or discomfort,

• bruises.

Modification of pressure is particularly important where there is a risk of lymphedema when lymph nodes have been removed or radiated. Massage stroke pressure, direction and the amount of heat needs to be managed in areas served by the affected lymph nodes to avoid damaging the lymphatic structures in that area. This precaution generally limits massage in the affected limb and adjacent trunk quarter (in humans).

Additionally, the therapist should strictly observe normal contradictions for massage particularly the presence of:

• Open wounds or lesions

• Edemas

• Inflammation

• Acute post operative period

• Communicable diseases / infections

• Tumours

Finally, in dogs with cancer, massage should avoid the sites of medical devices such as ports or IVs.

3. Adjust massage positions

Consideration needs to be made for the position of the dog during a massage. Depending on the dog’s condition, they may not be comfortable staying in a single position for the duration of a treatment. The therapist should be particularly vigilant of the dog’s body language and allow them to move so they are comfortable.

4. Focus on body areas most affected by immobilisation

Depending on the stage of the dog’s condition, they may be considerably less active or even immobile. A massage treatment plan should therefore target body areas that are most affected by being inactive namely the neck, shoulders, back, and hips.
Effleurage and passive range of movement techniques may be appropriate to address the likelihood of muscle atrophy.

5. Adjust length of massage

For dogs with cancer, the length of a massage treatment should be carefully planned based on the dog’s tolerance for touch. The therapist should observe the dog’s body language and plan a short treatment of only 5 – 10 minutes initially.

Considerations for referring a canine patient for massage

When considering massage therapy for a dog with cancer, certified myofunctional therapists would require a clearance from your dog’s vet before considering a treatment.

As well as a vet clearance, the following information may be required to help the therapist formulate a treatment plan for review with your vet.

• Medications your dog may be taking particularly pain medication and anticoagulants. (See blog on http://www.fullstride.com.au/blog/dog-massage-effect-on-medication ) It would also be important to know the frequency with which your dog is taking the medication and the time of the day they are given.

• Likely intensity of pain throughout the dog’s body.

• Radiation therapy sites.

• Sites of lymph node removal or damage.

• Symptoms of the dog’s condition or side effects from medication such as constipation or nausea

• Other treatments that may affect the dog’s demeanour or sensitivity in particularly body areas e.g. regular blood tests

• Objectives of a massage treatment – what you and your vet want to achieve. For instance you may want to address the effects of immobilisation, relieve muscle tension or improve sleep quality.

Developing a suitable treatment plan for dogs with cancer needs to be a collaborative process involving you, your vet and the myofunctional therapist. At all times, massage should be considered as a therapy that complements conventional cancer treatment, certainly not as an alternative to it.

Full Stride provides myofunctional therapy (incorporating massage) in Brisbane’s north. I would welcome the opportunity to discuss how a treatment may improve your dog’s quality of life. Please contact me via the website or follow Full Stride on Facebook .

Until next time, enjoy your dogs.

Sources:

Collinge, W, MacDonald, G & Walton, T. 2012 “Massage in supportive cancer care” Seminars in Oncology Nursing, Vol 28 No 1: 45 – 54

Corbin, L 2005 “Safety and efficacy of massage therapy for patients with cancer” Cancer Control Vol 12 No 3

Ernst, E. 2009 “Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials” Support Care Cancer 17:333 -337

Hourdebaight, Jean-Pierre (2004), Canine Massage: A complete reference manual 2nd edition, Dogwise Publishing, Wenatchee WA, USA

Robertson, Julia 2010, The complete dog massage manual, Veloce Publishing Limited, Dorset UK

Robinson, Narda 2009 “Complementary alternatives for the critically ill” Published on http://www.veterinarypracticenews.com/April-2009/Complementary-Alternatives-For-The-Critically-Ill/

Sagar, S. M & Wong, R.K.W 2008 “Research and regulatory issues for integrative oncology” Current Oncology Vol 15

Smith, M.C, Yamashita, M.S, Bryant, L.L, Hemphill, L, & Kutner, J. S. 2009 “Providing massage therapy for people with advanced cancer: what to expect” The Journal of Alternative and Complementary Medicine, Vol 15, No 4: 367 – 371

Toth, M, Kahn, J, Walton, T, Hrbek, A, Eisenberg, D & Phillips, R.S 2003 “Therapeutic massage intervention for hospitalized patients with cancer: a pilot study” Alternative and Complementary Therapies

Vickers, A & Zollman, C 1999 “ABC of complementary medicine: Massage therapies” BMJ, Vol 319, November 1999