This toolkit is intended to address the information needs of members of current or potential recipients of massage.
Roles: Perspectives that stakeholders will bring to POEM.
Tasks: Specific tasks that users will want to accomplish
Information Needs: data that will be needed to accomplish these tasks and goals, including both internal content/structure and external resources
Interface Implications: visualizations and interactions that will be needed to help the user accomplish their tasks and goals.
Finding a Qualified Massage Therapist
Variations exists in the philosophy and education of therapists, with some massage therapists under the mistaken belief that cancer is a contraindication for massage and others perhaps discouraging patients from receiving either potentially curative conventional care or potentially harmful therapies. Thus, finding a massage therapist experienced and comfortable with both cancer patients and the conventional care commonly used is paramount.
Oncologists can help patients find a qualified massage therapist. Given that many cancer centers, hospitals, and hospices now have integrative medicine programs offering massage therapy, oncologists can ideally refer patients to seek treatment in these settings. If such programsbare not available, oncologists should encourage their patients to interview potential therapists or do so themselves to establish an ongoing consultant relationship for future referrals.
When interviewing a potential massage therapist, ask about education, experience, licensing, and certification. Consider only those with a minimum of 500 hours of training. Massage therapy schools voluntarily meeting criteria set by the Commission on Massage Therapy Accreditation have achieved and maintained a level of quality, performance, and integrity that meets meaningful standards. A directory of accredited programs is available on the Commission’s Web site (http://www.comtaorg/Home.htm). Specialized programs for advanced training in massage care of the patient with cancer are also available. Additional education and experience in working with cancer patients is a must, but specialized programs are not standardized, and not all states regulate massage therapists. A current list is available from the American Massage Therapy Association Web site (http://www.amtamassage.org/about/lawstate.html). If a therapist is licensed, the initials “LMT” (Licensed Massage Therapist) or “LMP” (Licensed Massage Practitioner) are used after the therapist’s name. In nonlicensing states, a therapist should have“CMT”(Certified Massage Therapist) as a minimum qualification. Beyond this, the initials “NCTMB” indicate that the therapist has voluntarily taken and passed an examination given by the National Certification Board of Therapeutic Massage and Bodywork.
The right massage therapist will be knowledgeable about risks and benefits of massage in a cancer population and should be comfortable communicating with the referring physician on an ongoing basis. They should see themselves as an extension of the patient’s healthcare team, not as a replacement. Some massage therapists may have experience with other complementary therapies and should agree to encourage the patient to discuss any suggestions on other therapies with their oncologist.
The cost of massage therapy visits, while relatively minimal when compared with the cost of some medications and other conventional treatments for symptom control, may be prohibitive for some patients as it is often not covered by insurance. There may be funds available for patients through charitable organizations, and this option should be explored. The cost of massage therapy will typically qualify for reimbursement through medical flexible spending accounts and usually will count toward medical expenses that can be itemized on federal taxes. Patients should be encouraged to verify this with their employer and/or tax accountant or attorney. A relatively new and intriguing area of research in massage therapy is exploring the idea of teaching caregivers to massage patients undergoing cancer treatment. If this approach can be shown to be feasible and effective in terms of reduced symptoms in cancer patients, it will present a more cost-effective and convenient approach.
