With approximately 12 million cancer survivors today in the United States alone, increased attention is being given to quality of life after cancer treatment. Cancer-related fatigue (CRF) is one of the most prevalent and debilitating symptoms experienced by people with cancer. It can persist for months or years after cancer therapy is completed and has a negative impact on all areas of function. Meaningful evidence-based treatment options for CRF are extremely limited and finding safe, inexpensive, and effective interventions for managing this distressing symptom are urgently needed. Basic research on neural-immune interactions has shown that pro-inflammatory cytokines can cause potent changes in behavior including reduced activity, fatigue, and decreased social behavior. Furthermore, research over the last decade has correlated more debilitating levels of CRF with increased levels of pro-inflammatory cytokines. Thus, investigation of therapeutic modalities that may decrease pro-inflammatory cytokines, decrease hsCRP, and increase anti-inflammatory cytokines in the setting of CRF represents a plausible target for intervention. Massage therapy is one of the fastest growing alternative therapies and has a high rate of acceptance for symptom management among cancer patients. Massage has been shown in smaller studies with cancer patients to modulate the immune system. Moreover, massage has been demonstrated to significantly decrease pro-inflammatory cytokines in normal subjects. There are no published randomized controlled trials examining either the role of massage as an intervention primarily for CRF or investigating its anti-inflammatory effects as a mechanism for its hypothesized improvement in CRF. This proposal investigates the effects of massage therapy on CRF among a homogenous group of breast cancer survivors. Our primary hypothesis is that Swedish Massage Therapy (SMT) will decrease CRF compared to a light touch condition and wait list control. Our secondary hypothesis is that SMT will ameliorate CRF by decreasing levels of pro-inflammatory cytokines, decrease hsCRP, and increasing anti-inflammatory cytokines. Our main exploratory hypothesis is that a decrease in CRF will increase quality of life among cancer survivors.

Public Health Relevance

Fatigue is the most common and poorly managed symptom among the approximately 12 million cancer survivors in the United States and occurs across all cancer types and treatments. Fatigue has a significant impact on quality of life and on all areas of function. Understanding the underlying cause of cancer-related fatigue as well as finding safe, inexpensive, and effective interventions, such as massage therapy, for managing this prevalent and distressing symptom is urgently needed.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Exploratory/Developmental Grants (R21)
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Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
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Khalsa, Partap Singh
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Emory University
Schools of Medicine
United States
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Kinkead, Becky; Schettler, Pamela J; Larson, Erika R et al. (2017) Massage therapy decreases cancer-related fatigue: Results from a randomized early phase trial. Cancer :