Music Therapy and cancer

Music therapy is a well-established profession that off ers treatment
approaches found effi cacious in addressing a range of needs and issues
presented by cancer patients and families. In oncology settings, music
therapy is identifi ed as a nonpharmacologic modality off ering soothing
and expressive benefi ts to those receiving this care. Specifi c music therapy
strategies are provided by board certifi ed music therapists to facilitate
meaningful changes in physiological, psychosocial, and spiritual
processes. In the following, the use of music therapy in this context will
be summarized, including a review of methods, common approaches
and specialized areas of practice.

Music therapy has become widely incorporated into healthcare and
medical services around the world, and is an established profession
that can enhance the quality of life of patients, families, and staff .
Music therapy is the purposeful use of music to address physical,
emotional, cognitive, social, and spiritual needs of individuals of all
ages.

It became formalized in both the United States and Europe in
the mid-twentieth century and was originally used for treating ailing
veterans returning from war. Th e profession expanded to services in
psychiatric and medical institutions, especially as education and training
became standardized and degree programs were established world
wide. Currently, those music therapists who have fulfi lled national
education and certifi cation requirements are employed internationally
in a wide variety of medical, rehabilitative, psychiatric, long-term care,
and wellness settings.

Music therapy in cancer care has been found to provide multiple
benefi ts. Music is intricately woven into the fabrics of life and takes on
deeper signifi cance during times of transition, loss, and grief. Music
therapists strive to assist patients, families, and staff in fi nding ways to
integrate the medium of music to ameliorate grief and suff ering, as well
as to relieve stress, anxiety, depression, and isolation.

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Examples of common techniques used in music therapy sessions:

• Songs: Song content may be used to express that which is diffi cult
  to express. Previously composed songs in sessions may be
  selected by the patient, family members, or at times by the music
  therapist to reflect themes of importance. As lyrics can help guide
  thoughts and images, songs can provide form, structure, and a pertinent
  frame of reference during times of doubt, fear, apprehension,
  or episodic pain. Singing in sessions involves the intimate presence
  of the human voice, an element that can help reduce anxiety and
  sense of isolation. Likewise, singing can provide various physiological
  benefits.
• Song writing: The personalized use of lyrics in sessions fosters selfexpression
  and communication. The music therapist commonly
  assists patients and families in creating songs with their own words.
  Such songs are oft en provided for or dedicated to their loved ones
  as “gifts”; or they may be written with special messages for others;
  or may be testimonials regarding their life stories.
• Chants: The use of common chants to verbalize prayers or meditations
  oft en provides further opportunities for patients and families
  to substitute lyrics with their own words. Likewise, chants may support
  cultural or spiritual themes of signifi cance. Repetition of vocal
  intonations, with or without words, is a way to focus attention and
  can reduce fatigue, increase relaxation, improve breath fl ow, and
  enhance expression.
• Toning: The use of nonlyrical vocalizations to enhance expression
  through the making of sounds with patient and family members.
• Music listening: Often patients elect to listen to soft music for
  relaxation during sessions. Th e therapist provides them with live
  harmonic and melodic instrumental music, or with lyrical music
  refl ecting desired images. This music is oft en improvised at the
  patient’s side, as the mood, rhythm, and timbre of music may be
  adapted spontaneously to meet patient needs. Therapists oft en
  guide patients into relaxation and listening techniques and off er
  recorded music for use after sessions. Th is technique can serve to
  help refocus attention during times of pain, fatigue, agitation, or
  insomnia.
• Music meditation: Music can be used to create a mood of peace.
  Patients may select mantras or words that refer to affi rmations or
  to peace as a way to focus thoughts and/or regain sense of personal
  value. This technique can redirect thoughts, improve sense of control,
  and enhance comfort and relaxation.
• Improvisation by therapist to meet patient and support needs: The
  music therapist improvises music, finding tempos and melodies
  that create the mood desired.
• Improvisation with patient: The music therapist provides the
  patient with instruments to facilitate creative expression through
  instruments.
• Audio recording: Special songs or complete sessions may be
  recorded and given by patients to families as “gifts.” Such audio
  recordings are generally designed by the patients and are presented
  to loved ones as memoirs and tokens of aff ection. Patients sometimes
  also use these recordings to return to feelings and states of
  comfort, pleasure, and peace.

Music therapists are applying psychotherapeutic skills in the care and treatment of cancer patients. Analytic music therapy has been found to benefi t some children and adult cancer patients through the uncovering of issues surrounding symptoms, some
of which are psychosomatically based.

Music therapists in oncology settings, as well as in other areas of healthcare, often base clinical work in various models of psychotherapy as they attend to the psycho-emotional and existential issues presented by patients and caregivers.

Often patients contending with life threatening or advanced illness seek support with existential issues, such as faith or the larger meaning of life. Music therapy naturally provides the means to sustain these quests, as music has innate associations with nature, infi nity and humanity across borders and throughout history. Various
music therapy strategies acknowledge spiritual customs and values and also
facilitate sense of hope, connection, transcendence, meaning, and faith.

Music therapy in the oncology setting can provide patients, family members,
and staff with multiple psycho emotional, physiological, and spiritual
benefi ts that can enhance coping and disease management. Th rough
interactive and personalized approaches, music therapy has been found
effi cacious in helping reduce adverse symptoms and restore relaxation
and personal well-being; off ering a means for self-expression; facilitating the processing of existential and spiritual issues; and in providing channels for communication and social engagement.

Music therapy embraces the therapeutic benefi ts of human contact and
the compassionate presence of the music therapist. Th us, it can off er a
supportive milieu within which patients and caregivers may potentially
find healing.

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Integrative Oncology: What is Music Therapy for Cancer Patients

Mandy Elliot, MS, LCAT, MT-BC, and Rosemary Obi, MS, LCAT, MTBC, senior music therapist at UR Medicine, discuss music therapy and share how it can help patients with cancer.

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