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The researchers conducted a national study called REST (Reducing End-of-Life Symptoms with Touch), which explored differences in physical discomfort and psychological outlook among 380 cancer hospice patients. Some got therapeutic message; others got a laying on of hands. Those who received effleurage – a smooth gliding stroke – petrissage – squeezing, rolling and kneading muscles – and trigger point pressure release – concentrated finger pressure to break cycles of muscle spasm and pain – reported more immediate pain relief and mood improvement than those who were merely touched. The differences were statistically significant, says Dr. Jean Kutner, a UC Denver expert in end-of-life care, who directed the massage/touch study. Kutner hopes they lead to more study of physical contact between the dying and their caregivers. The REST study indicates that any kind of physical contact seems to temporarily help relieve the pain and improve the mood of those in the last stages of life, even those with severe discomfort. “People in a hospice situation don’t have the day-to-day touch most of us do,” she explains. “This study is a good reminder that there are some benefits to that kind of physical contact.” Short-term relief from the responsible use of traditional massage techniques is important, Kutner continues, because it dispels the myth that such therapy is too physically demanding for dying cancer patients and hurts more than it helps. “People worry that if you massage someone with cancer, the cancer will spread,” says Kutner, an associate professor and head of the general internal medicine division at the UC Denver School of Medicine Not only is that not true, researchers found that in a regimen that included six half-hour treatments over three weeks, patients receiving therapeutic massage felt better physically and psychologically and showed more improvement in heart and respiration rates than those treated with simple touch. The most frequently massaged areas were the neck and upper back, followed by arms, hands, lower legs, and feet. Massage therapists tried to identify and treat as many as three pressure points per patient, per treatment. Therapists also modified their techniques for patients with fragile skin, posture problems, swelling or cancer that had spread to bones. They avoided massaging body sites that showed signs of inflammation, infection, injury, catheters or tumors. End-of-life care – also called palliative care - is a trend in medicine, especially as Baby Boomers swell the ranks of older Americans. Two decades ago, few, if any, hospitals had palliative care programs, Kutner points out. Now, about 30 percent do. In 2006, the American Board of Medical Specialties recognized hospice and palliative medicine as a board-certified specialty. In October, the U.S. will offer its first palliative medicine board exam to officially qualify physicians such as Kutner as specialists in the field. “It is a field that has been rapidly growing with the recognition that even if we can’t cure a disease, we need to keep people from suffering,” Kutner says. While the REST study produced important short-term results, neither the massage regimen nor the application of simple touch produced long-term, sustained pain relief or a reduction in the use of drugs to treat pain. On the other hand, says Kutner, no one who received the full round of massage or touch experienced increased pain or needed more pain drugs. That, in itself, is noteworthy, Kutner says, because hospice care usually comes when death is imminent. Indeed, some patients accepted into the study died before they could take part. “You would expect this population to get progressively worse,” Kutner explains. Patients in the REST study “stayed even.” “There is,” says Kutner, “some value to having people with a short life expectancy feel better, even for a short period of time.” The University of Colorado Denver School of Medicine faculty work to advance science and improve care as the physicians, educators and scientists at University of Colorado Hospital, The Children’s Hospital, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the UC Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is part of the University of Colorado Denver, one of three universities in the University of Colorado system. For additional news and information, please visit the UC Denver newsroom online. www.HealthNewsDigest.com Top of Page 
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