Opinion: Cancer and Massage

Note: A revision was made to this blog 06/02/18 after Tracy Walton contacted me about leaving out the second part of her critique. The link to it is below. 

I feel compelled to offer my own opinion of the recent hullabaloo regarding a difference of opinion between Dr. Jeffrey Cullers and Dr. Ross Turchaninov and Tracy Walton about Oncology Massage. I have read the initial article put forth by Cullers and Turchaninov, the Wang et al study, the other research articles that were quoted by Cullers and Turchaninov, the initial response from Walton, and the second round, and feel compelled to comment. I have been a massage therapist, author, and educator for almost 20 years myself. My late husband was also a licensed massage therapist as well as a cancer patient, and this subject is dear to my heart.

For those who are unfamiliar, here are the links:


The original article by Dr. Jeffrey M. Cullers and Dr. Ross Turchaninov, Massage Therapy in Cases of a Newly Diagnosed Cancer

 

The critique from Tracy Walton, which appeared in Massage Today, Does Massage Spread Cancer

 

The second article from Tracy Walton, which appeared in Massage Today, Can Massage Spread Cancer in the Newly Diagnosed?

Another article from Walton,  Choosing Our Words Wisely…Language Matters which appeared in Massage Today

 

The original study from Wang et al, Manipulation Therapy Prior to Diagnosis Induced Primary Osteosarcoma Metastasis—From Clinical to Basic Research

 
First of all, Culler’s and Turchaninov’s  display of condescension towards Tracy Walton, and the standards of practice of the S4OM in general, is evident in their second response, “people are busy, but we are forced to address this issue so here we go again” attitude…it seems that neither thinks anyone should have dared to challenge them or offer any response.

Second, as every scientist including Cullers and Turchaninov are aware, or even a layperson with a basic knowledge of research (I fall into the latter category) knows, one research study does not an accepted scientific theory make. Research is meant to be replicated. If there was any subsequent replication of this study, I was unable to find it, and welcome anyone who is able to point to the replication of this one. I do not imply, nor does Walton, that Wang et al’s study does not have any value. She never said any such thing; she in fact referred to it as “an unusual and important contribution to discussion.” What she did say is that some important omissions existed in the paper: a lack of reporting of the timing of manipulation therapies prior to the diagnosis of cancer, and that the original study did not mention specific body areas that were massaged, pressure used, or joints moved–all valid points.

Third, the attack on Walton’s ethics is absurd. Yes, we are obligated to first do no harm, but due to the omissions in the original study by Wang et al mentioned by Walton , this is not even up for debate, although Cullers and Turchaninov have chosen to imply that it is. There is simply nothing in the study to indicate when a person had received massage prior to being diagnosed with cancer. That could be construed to mean that anyone who ever gets up in the morning with musculoskeletal pain and seeks a massage for relief better beware, because banish the thought, they might have bone cancer and that could affect their prognosis years down the line.

Simply put, the study was lacking some very important information, and to jump from that to accusations of unethical behavior on the part of Walton or any other massage therapist is unprofessional and beyond the pale. The statement that if there is even a 1% chance that MT could cause metastasis in a cancer patient between diagnosis and treatment, that is cause not to give a massage doesn’t ring true. None of us are guaranteed the next breath, and there is in all likelihood a 1% chance that any client could have a heart attack  and die on the table. Does that mean we shouldn’t give anyone a massage? No. It’s a big jump that  just doesn’t add up.

The S4OM has made invaluable contributions to the education and practice of massage therapy for cancer patients, as has Tracy Walton. That is not to minimize any contributions made by Cullers and Turchaninov, nor those of Dr. Wang. The organization does not feel that this one study from Wang et al, nor the subsequent discussion that ensued between Walton and Cullers/Turchaninov, warrants any change in their current standards of practice. Walton stated that the authors brought up interesting points, but they do not add up to a change in OMT practice. I feel confident that Walton and the S4OM do everything they can to keep up with current research and that whenever a change in their standards of practice are actually warranted, they will be implemented.