Written by Patricia McNamara in her book "Massage for People with Cancer". Available at Desana for $20.00

Massage offers a safe and warm holding place for the person with cancer. Deep human compassion and caring are communicated without words and without threat. It is a gentle, non-invasive form of therapy. It addresses the whole person in a gentle, human and uncomplicated way. So often when people are diagnosed with cancer, the focus is on the cancer site(s) and not on the person. As one client put it, pointing to her right breast, "I suddenly was just this lump here and this was all that mattered".

The essential elements of massage are both simple and profound. In its essence it is touch. Touch is a vital and basic form of communication, conveying nuances of feeling, often more expressively and effectively than verbal communication. In depressive states, caring touch can increase self-esteem and encourage verbalisation of feelings and, for the terminally ill, touch affords comfort and support both for the ill person and for relatives. For those for whom there is no considered benefit in pursuing medical intervention, massage allows the person to feel cared for.

Through massage a person may talk about their problems and experiences and give voice to the appropriate emotions. When there is not enough time for self-disclosure with integration of the feelings expressed, body therapies can produce a state of relaxation more quicly for the client than verbalising their feelings.

When people are seriously ill with cancer, massage is often brought in because "nothing else can be done". Thise sense of hopelessness and giving up on the perosn with cancer has a very profound and disturbing effect. Paul, a 35 year old man, said "I know the doc has given up on me... he doesn't know what I feel inside. Coming to see you, I know you support me and believe in me." This young man died two and a half years after I first saw him. The prognosis was never good but he baffled his doctors by outliving all of their predictions. He did not get a message from me or any of the Centrre staff that "of course you will live forever". What he did receive was deep, intimate and personal contact at a time of great pain, crisis and loneliness in his life.

In the words of Dr. Nadia Coates "Massage is an integral part of the care of anyone who is wounded or sick and in need of emotional healing and renewal. It is a necessary therapeutic tool in rehabilitation and palliative care, even when there is no hope of a cure. It soothes the pain and provides a very real form of tender loving care. it eases the burden, bringing forward the movement of peace and surrender".

Some people diagnosed with cancer just cannot accept what is happening to them. They can burn up a lot of energy suppressing their feelings. Clare, a very fit, active 45 year old woman could not believe she had cancer. She had married late in her life and was very happy with her marriage. She kept pretending that life was going on as normal. When massaged, she got in touch with her shock, pain, tears and her disbelief that she had cancer. She was a woman who found it hard to express her emotions, and massage helped to facilitate that process. She always said she felt more relaxed after her session.

The anxiety experienced during cancer treatments can become a way of life. Fiona, a young woman of 30 with Hodgkin's disease was very tense when I first saw her. I worked with gentle touch. Over the course of a few weeks, her breathing deepened and she reported, "I'm sleeping much better and hadn't realised I was so tired." Through the massage she relaxed and let go for the first time in months. Throughout her treatment she worked hard on keeping going. The massage gave her permission to stop.

Massage affects the whole person, body, mind and spirit. Its results are always qualitatively measurable. Over the recent years, the findings from studies show how the mind and emotions affect the functioning of the immune system. A sense of calmness, joy and humour have been seen to reduce secretion of stress hormones and release endorphins - the body's natural opiates. In this climate, with more and more chemical neurotransmitters being identified, the link between the experiential and the physiological world has become more easily understood "scientifically".

Fear burns up a lot of energy through mental anguish and anxiety, and physically through the holding patterns which keep the body's muscles and tissues tense. It reduces the quality of breathing, which sets off another series of chain reactions known as the stress cycle. With the mental and physical energies disturbed, disturbed emotional energy can only follow. The cycle may be triggered from any entry point (physical, mental, emotional or spiritual) and once begun, it affects the whole person.

Physiologist Hans Seyle introduced the term "general-adaptation syndrome" (GAS) TO describe the body's response to stress. He divides the syndrome into three phases:

1. The Alarm Reaction. The body prepares for fight or flight. The sympathetic nervous system comes into action. In response to the flow of adrenaline, the heart beats faster, the pulse and blood pressure rise, blood is re-routed, breathing becomes faster and shallower, and all other physiological changes take place that facilitate coping with an emergency situation.

2. The Resistance Stage. If stress continues over a long period, the resistence stage is initiated. Blood pressure remains abnormally high, and metabolism is geared to help the body resist the effects of the stressor, whether fighting cancer, infection or dealing with an emotional problem. Levels of many hormones are elevated in this phase.

3. Exhaustion. The body appears to be unable to utilise available cortical hormones and may succumb permanently to the stressor.

Seyle has suggested that chronic stress is harmful because of the side-effects of long-term elevated levels of cortisol. This can inhibit normal immune response, exhaust the adrenal glands and leave the body in the vulnerable position of being unable to defend itself. Liz Hodgkinson adds "When stress hormones are permanently being produced in excess quantities, the immune system cannot work properly, and the way is opened up for all kinds of infections to come in and internal organs to be put under sever strain."

Massage can reverse the effects of the stress cycle by calming the sympathetic nervous system, causing a reduction in adrenaline flow.

This is seen by the slowing down of the heartbeat, lowering of blood pressure, deeper breathing and a reduction in the levels of adrenaline and related hormones in the blood.

Massage can have a direct effect in reducing the symptoms of stress and anxiety, leaving people in a calmer and more relaxed state to deal with their cancer treatment programmes.