Yesterday when I finished completing my LinkedIn account, I was prompted that one of my connections was a part of the Society For Oncology Massage group. Since I am a member of the actual society itself, I clicked on it, interested to see what great things were being shared...
To my dismay I found a conversation facilitated by the administrator of the group that was based on a false premise. Namely that it is unsafe to use deep pressure during manual treatment of chemo-induced peripheral neuropathy to the plantar surface of the feet due to *DVT/PE risk. What was her basis for this bold claim? Her “12 years of experience” as a massage therapist as well as “asking the oncologists and physical therapists she works with”. She went on to say in a later post that “physicians don’t always know” the safe parameters for massage and cancer patients. EXACTLY, care to cite some actual sources?
Later I was on Facebook and saw there was a new post on the Society For Integrative Oncology page. Interested, I clicked. A person posted a question about which essential oils people were using in their practice, to which someone replied that all essential oils were unsafe in the hospital setting because of “contact dermatitis”. Most of the time contact dermatitis wouldn't even be an issue because usually essential oils in the clinical setting are inhaled rather than directly applied. Sigh.
As a massage therapist working in a cancer center, I was frustrated that no one seemed to take me seriously. I commonly felt I was treated as if I had no clinical expertise whatsoever by the staff, who humored my presence more than welcomed it. Nurses would frequently ask (in front of patients) if I would also give the patient a pedicure along with their plantar CIPN treatment. As a nursing student, I can now understand why. Without an evidence-based practice, you cannot make quantifiable statements, which doesn’t leave you a lot to hang your hat on in terms of interventions. At the time I didn’t understand the importance of sharing the evidence with my fellow hospital staff. There actually IS a growing abundance of clinical research on integrative medicine and cancer patients, but one must understand the need to use it (or for that matter be able to fully comprehend a peer reviewed journal).
The basis of most “integrative” modalities-such as massage, essential oils, Reiki etc- is unfortunately very loosey goosey, and is often taught by oral tradition. Rarely is a truly clinical approach used for these modalities, aside from in the research setting. This becomes a problem when the “experts” in our field can’t AGREE, and may or may not be using a scientifically sound logic as the basis for their practice.
Is manual treatment safe for cancer patients? Are essential oils appropriate for hospital use? If we can’t get our story straight, I don’t blame the world of allopathic medicine for having a hard time letting us practice in hospitals to our fullest potential. I think this is unfortunate, because the research is there for us to use, and our patients could benefit from us doing so. I sincerely hope things will improve in the future, and I am personally committed to backing all my CAM treatments with peer reviewed research.
* Due to diminished sensory perception, one actual risk of deep manual treatment to the feet of a CIPN sufferer could be at risk of superficial tissue injury. No studies have been done on the subject, nor have any findings of this been reported in any research on manual CIPN therapy.
Quick NCBI Resources for commonly used CAM treatments:
No comments:
Post a Comment