Zusammenfassung
Das Mammakarzinom ist das häufigste Malignom der Frau. Obwohl die Therapie während der letzten Jahrzehnte stark verbessert wurde, leiden die Patientinnen oftmals an erheblichen psychischen Beeinträchtigungen wie Depressionen und Angststörungen. Mit steigender Tendenz werden daher in Europa und den Vereinigten Staaten zusätzlich zur Standardbehandlung komplementäre Therapien eingesetzt. Unter diesen ist die Massage eine der ältesten und meist angewandten Therapieformen. Verschiedene Massagetechniken von der klassischen Massage bis zur Fußreflexzonentherapie werden vorgestellt. Vierzehn Studien über Massage bei Tumorpatienten, vorwiegend Brustkrebspatientinnen, wurden in PubMed identifiziert und ausgewertet. Dreizehn Studien erfolgten nach kontrolliert randomisiertem Design und wurden in den Jahren 1990 bis 2006 publiziert. Die Massagetherapie bewirkte in den meisten Studien eine signifikante Reduktion der Schmerzwahrnehmung und Ängstlichkeit. Eine Verringerung des subjektiven Stresserlebens und ein entspannender Effekt konnte in fünf Studien in der Massagegruppe gezeigt werden. Zusätzlich zeigte sich in jeweils drei Studien eine signifikante Reduktion von Übelkeit und Fatigue. Keine konsistenten Ergebnisse wurden dagegen für den Einfluss der Massage auf die Depressivität der Patienten gefunden. Die vorliegenden Studien weisen einige methodische Schwächen auf. Die Zahl der kontrolliert randomisierten Studien ist immer noch sehr gering. Aus diesem Grunde besteht ein großer Forschungsbedarf auf diesem Gebiet an methodisch hochwertigen Studien nach den Kriterien der evidence-based medicine. Insgesamt wirkte sich die Massagetherapie positiv auf die Lebensqualität der Tumorpatienten aus. Es finden sich in der Literatur keine Hinweise für eine Streuung von Tumorzellen durch die Massage. Daher kann eine ergänzende Massagetherapie zusätzlich zur konventionellen Behandlung bei Brustkrebspatientinnen empfohlen werden.
Abstract
Treatment of breast cancer, the most frequently occurring malignancy in women, has become more effective in the past decades. Nevertheless, many patients suffer from attendant psychological disturbances such as depression and anxiety. Therefore, the number of patients using additional complementary medicine is increasing in Europe and the United States. One of the most frequently applied traditional therapies is massage therapy. Several massage techniques from Swedish massage to foot reflexology are described here. Fourteen studies dealing with massage therapy for cancer patients, most of them breast cancer patients, were identified by a PubMed research and reviewed. All studies except one were randomized and controlled, and were published between 1990 and 2006. In most of the studies there was evidence for the efficacy of massage in providing a significant reduction of pain and anxiety. In five studies relaxation and reduction of stress in the massage group was also observed. In three trials nausea and fatigue were found to be significantly reduced. Inconsistent results were found with regard to the influence of massage on depression. The reviewed studies had some methodological weaknesses. The number of randomized controlled trials is still small. There is a need for further studies with strong standards to investigate the efficacy of massage in cancer patients. In summary, positive effects on the quality of life of cancer patients were found in most of the studies. No risk of tumor cell spread was reported. Therefore, the use of massage therapy in addition to conventional treatments is recommended for patients suffering from breast cancer.
Schlüsselwörter
Lebensqualität - Angst - Depression - Schmerz - Alternativmedizin
Key words
quality of life - anxiety - depression - pain - complementary medicine
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Miriam Listing
Medizinische Klinik mit Schwerpunkt Psychosomatik und Psychotherapie
Charité - Universitätsmedizin Berlin
Luisenstraße 13a
10117 Berlin
eMail: mlisting@gmx.net
