Music therapy for Cancer Patients

Since the beginning of time, music has always been a pathway to improve health and healing among people from around the world. Most recently, you can now find it being used in multiple hospital settings as a therapeutic way to positively impact physical symptoms and psychological problems of cancer patients. “Music therapy is an established health profession that uses music and the therapeutic relationship to address physical, psychological, cognitive and/or social functioning for patients of all ages and disabilities (American Music Therapy Association, 2019).” With the aid of a trained certified musical therapist, nurses provide musical therapy sessions customized and adapted to fit the special needs and abilities of patients in order to maximize personal results. Supplemented with medication, a patient’s short- and long-term cancer treatment can benefit overall from music therapy which helps to strengthen their ability to cope with their debilitating disease process.

 In America, over 482, 543 deaths have occurred from cancer during the first decade of the 21st century (Gramaglia et al., 2019). Cancer is a significant diagnosis that creates a serious life event that causes stress to the patient and their families. Patients with cancer suffer from anxiety, pain, and depression as they progress through traumatic interventions that often have side effects that take a toll on the body and mind. These symptoms can include addition, drug dependency, blood pressure, weak vitals, drowsiness, nausea and vomiting, and lack of motivation (Jasemi, Aazami, & & Zabihi, 2016).

 There have been many studies that show the effectiveness of music therapy. Different models worldwide present music as a painless, non-invasive, cost saving patient intervention. Music has no limitation to its use and can be applied to patients of any age, setting, or degree of disease. Improving quality of life is the main goal of music intervention in that it provides a way for all those to benefit without the fear of potential side effects. For many people, music connects them to their emotions and is often a way to be socially connected. That is why music can be an effective form of therapy for people with cancer.

Music Therapy: Origins

Since ancient times, the healing power of music has helped to heal and affect the human spirit. Old pillars inscriptions found in Egypt and Greece believed music worked like a healer, as it creates a sense of relaxation to reduce one’s anxiety (Jasemi, Aazami, & & Zabihi, 2016). Western medicine only began to integrate music during World War II, as the need for holistic care in patient therapies was recognized to improve a patient’s quality of life. Today, music therapy can be used towards clinical change in health care settings such as oncology, general surgery, psychiatry, drug and alcohol rehabilitation, and palliative care (Popkin & Gubili, 2017). Nurses work with a certified music therapist towards developing an individualized music experience adapted to a cancer patient’s level of needs and abilities. The shared goal is to utilize the healing aspect of listening to music to effectively create an environment of relaxation that helps alleviate the perception of pain and anxiety while dealing with a chronic debilitating disease.

Cancer is a significant disease that changes a person’s life and is a source of stress for the individual and their family. Patients suffer from short- and long-term effects from their invasive procedures and medications. Over time, cancer can cause psychological and physiological deterioration of the self, and the effort to manage the pain starts to impair quality of life (Krishnaswamy, 2016).  Utilizing music therapy as an option for a nonpharmacological intervention may be the key towards patients developing strong coping skills. On the American Music Therapy Association webpage, their company misson states they aim to “Advance public awareness of the benefits of music therapy and increase access to quality music therapy services in a rapidly changing world (American Music Therapy Association, 2019).”

When used to reduce pain, music therapy offers hospitals an easy therapeutic process that is low risk, non-invasive, and cost effective. Evidence from previous music studies shows that somatic and psychological symptoms of cancer patients are positively affected when analyzing the level of pain perceptionafter a music intervention (Jespersen, Vuust, Abildgaard, Gram, & Johansen, 2018). If combining holistic musical intervention with traditional pharmaceutical treatments can produce positive outcomes for suffering cancer patients, then pursuing a strategy approach to holistic palliative care should be explored. 

Music Therapy: How it works

In a clinical setting, the effectiveness of music therapy based interventions vary according to each cancer patient’s level of pain, anxiety, and depression. As part of an interdisciplinary health team, a music therapist trained in areas of psychology, biology, and music theory analyze and evaluate a patient’s musical preference and personal background. Nurses consider hearing disabilities, physical limitations, current level of pain, and vitals before and after the session. Personalizing the session through personal music choice can positively affect a patient because music has an arousal regulating effect. Fast or slow tempos can help raise or lower the heart rate, and facilitate positive emotions in memory retrieval (Jespersen et al., 2018). When a session is complete, evaluations are made based on patient response, and changes are made to ensure goals are reached. 

 Music therapy sessions can be done various ways. It can be one individual, or as a group. It can be multiple sessions, or just once. It can include live musicians, personal instruments, or even songs through a CD player. The purpose is to elicit any range of positive emotions, from excitement to being calm. For patients with end stage cancer, one session creates a perception of improvement in their quality of life, even as their health declines (Krishnaswamy, 2016). 

Music therapy sessions can be interactive or passive. In an interactive technique, music experience is not required. Patients are encouraged to sing, clap, or tap their feet to music. If they are able, they can also participate playing a variety of instruments. This type of receptive engagement creates a mood of peace, relaxation, and increases a patient’s level of comfort. With passive therapy, a variety of recorded music is presented using headphones or astereo. Most often, a patient’s own CD collection is utilized in the session. When used with relaxation techniques, music therapy patient’s report muscle relaxation and an easement of symptoms.

Music Therapy: Assessing the outcome

To evaluate the effectiveness ofmusic therapy, nurses obtain subjective and objective patient data before and after a musical session. If effective, physiological changes that can occur include improved respiration, lower blood pressure, improved cardiac output, and lower heart rate (American Music Therapy Association, 2019). Information such as quality of pain, levels of anxiety, present mood, heart rate, blood pressure, and observable facial expressions are compared and documented. After therapy, some key phrases patient’s use to describe their sessions as familiar, soothing, predictable, and relaxing (Jespersen, Vuust, Abildgaard, Gram, & Johansen, 2018). The goal of music therapy is to achieve a patient report of less stress, a reduction in their pain perception, and an overall general wellness displayed through expressions of positive statements. 

Music therapy for cancer patients is effective because listening to music makes people feel good. It is calming and relaxing. Patients are free to explore their feelings of fear, anger, and depression using the process as an emotional outlet. Music creates a healing environment that distracts away from the daily invasive, painful cancer treatments, and will even help with communication and cooperation in the healthcare setting. An example of this is pediatric patients experiencing cancer. In a trial where the children underwent a lumbar puncture procedure, those exposed to televised music reported feeling more relaxed, having less pain and reduced anxiety about the procedure (Popkin & Gubili, 2017).

Music therapy: Cultural considerations

The idea that music has the power to heal exists over all parts of the world, across traditions, cultures, and generations. Music supports human interaction between those involved and creates a sense of community within a therapeutic context. Musicalcollaboration andinteraction from patient and family allows medical providers insight into specific cultural and social backgrounds. Music therapy is unique in that it stresses the importance of a relationship between the patient, nurse, and therapist because sessions are developed to reflect a patient’s personal identity in relation to their background, and economic and social factors.

Culturally, the perception of music utilized for music therapy is important because it impacts the efficacy of treatment. Cancer patients from India can request to hear the tones of traditional Indian raga Anandabhairavi using Veena and flute instruments. End stage cancer patients may be comforted bedside by sacred vigil songs played by harp to invoke a mood of tranquility and imagery of Heaven. Patients can request any melody they prefer, so requests can range from Celtic melodies, to Chinese folk music, to Taiwanese folk songs. This therapy provide a valuable, individual experience creating a musical environment which in turn, can elicit a response to music impacted by their personal choice.

Conclusion

Finding ways to improve a patient’s quality of life as they face cancer is important. Music therapy has been a long standing, non-invasive modality that is cost effective, can easily be implemented in a clinical setting, and has no side effects. The purpose is not to heal, but to provide a sense of comfort, alleviate physical symptoms of stress, and provide a coping process that can be individualized to the patient’s needs and abilities. Many hospitals that utilize music therapy treatments, though further studies will be needed to ensure that it continues to promote total patient wellness and that it meets their ongoing needs during the disease process. Musical activities can take place in clinical setting-wide variety and supports cancer patients at any stage of disease, while promote patient wellness, emotional well-being, and overall quality of life. Music therapies aim to meet patient needs as they receive their diagnosis and go through treatment. Increasing evidence, tolerability, ease of application and use, advantageous cost-benefit ratio, and appreciation shown by patients support its continued research in the field (Gramaglia et al., 2019).

It is not the music but the specific qualities of the therapy that patients can benefit from.

The treatment supports holistic total care to a patient well-being, Music provides recovery of self-identity, meaning, and coherence, musical empowerment to the everyday life of the individual patient.Music offers a range of benefits to address physical, emotional, social, existential needs. Promotes relaxation, reduce anxiety and stress, relieves discomfort, reduce patient experience of pain, Tx related symptoms, Opportunities for self-expression and positive experiences, though more studies are recommended on how music therapy number of music studies, music varieties, and durations on cancer pain and its acceptability in consideration towards future applications.

References 

American Music Therapy Association. (2019). https://www.musictherapy.org/

Gramaglia, C., Gambaro, E., Vecchi, C., Licandro, D., Raina, G., & Pisani, C. (2019). Outcomes of music therapy interventions in cancer patients-A review of the literature. Critial Reviews in Oncology/Hematology, 138, 241-254. Retrieved from https://doi.org/10.1016/j.critrevonc.2019.004 

Jasemi, M., Aazami, S., & & Zabihi, R. (2016). The Effects of Music Therapy on Anxiety and Depression of Cancer Patients. Indian journal of palliative care, 22(4), 455-458. http://dx.doi.org/https://doi:104103/0973-1075.191823

Jespersen, K., Vuust, P., Abildgaard, N., Gram, J., & Johansen, C. (2018). Kind of blue: A systematic review and meta-analysis of music interventions in cancer treatment. Psycho-Oncology, 27 (2), 386-400. http://dx.doi.org/https://doi.org/10.1002/pon.4470 

Krishnaswamy, P. (2016). Effect of Music Therapy on Pain and Anxiety Levels of Cancer Patients: A Pilot Study. Indian journal of palliative care, 22(3), 307-311. http://dx.doi.org/doi:10/4103/0973-1075.185042 

Popkin, K., & Gubili, J. (2017). Music Therapy: Relevance in Oncology. Retrieved from https://www.ascopost.com/issues/july-25-2017/music-therapy-relevance-in-oncology/