Friday, August 12, 2011

Music Lowers Anxiety and Boosts Mood in Cancer Patients

From Medscape Medical News > Oncology

Roxanne Nelson

August 12, 2011 — Listening to music may have a beneficial effect on anxiety, pain, mood, and quality of life in cancer patients, according to a new Cochrane systematic review.
The findings from the review, which included 30 trials and a total of 1891 patients, suggested that music therapy and music medicine interventions might also have a beneficial effect on heart rate, respiratory rate, and blood pressure in cancer patients.
"The evidence suggests that music interventions may be useful as a complementary treatment to people with cancer," said lead researcher Joke Bradt, PhD, MT-BC, associate professor in the Department of Creative Arts Therapies at Drexel University, Philadelphia, Pennsylvania.
"Music interventions provided by trained music therapists as well as listening to prerecorded music both have shown positive outcomes in this review, but at this time there is not enough evidence to determine if one intervention is more effective than the other," she noted in a release.
Dr. Bradt also pointed out that when patients can't be blinded to an intervention, there is an opportunity for bias when they are asked to report on subjective measures such as anxiety, pain mood, and quality of life. Therefore, these results need to be interpreted with caution.
The researchers point out that the quality of evidence for some outcomes was low because of the small numbers of trials that have been performed. Further trials could help increase certainty in the findings and improve understanding of music's impact on distress, body image, and other aspects, for which research is currently too scarce to draw any conclusions.
 
Therapeutic Across Specialties
During the past 2 decades, there has been an increasing interest and a growth of research on the effects of music and music therapy for medical patients, which encompassed a variety of specialty areas, note the authors. For example, music has been used to lessen anxiety for both adults and children before or during surgical procedures and to decrease tension during chemotherapy or radiation therapy. It has also been used to reduce the adverse effects of treatment, to improve mood, to enhance pain management, to boost immune system functioning, and to improve quality of life.
As recently reported by Medscape Medical News, music therapy can improve the symptoms of depression when added to standard antidepressant treatment.
Music stimulates the mind and triggers images, metaphors, and emotions that often are preconscious by nature, explained the lead author Jaakko Erkkilä, PhD, from the Finnish Centre of Excellence in Music Research, University of Jyväskylä, Finland.
 
Music is kind of an emotional language.
"In other words, music is kind of an emotional language with a lot of abstract, unformed psychic ideas," Dr. Erkkila told Medscape Medical News. "It enriches communication, stimulates and even evokes speech, and through these qualities is an excellent way to deal with and consider mental problems that are emotional by nature. Making music is also a physical activity, thus enabling functioning and bodily communication."
Benefits Mood, Physiologic Responses
In the current review, the Cochrane authors examined the effects of music therapy or music medicine interventions on psychological and physical outcomes in cancer patients with cancer.
A total of 36 references reporting on 30 trials were included in the review. Nine trials included participants who underwent chemotherapy or radiation therapy, 8 examined the effects of music during procedures or surgery, and 13 trials included general cancer patients. In addition, 4 studies evaluated music interventions with pediatric patients.
The results of 16 trials suggest that music therapy and music medicine interventions may have a beneficial effect on anxiety, which is consistent with the findings from 2 previous Cochrane systematic reviews that evaluated the use of music with coronary heart disease patients and the use of music with patients receiving mechanical ventilatory support.
The pooled estimate from 3 trials suggested that music might help improve the mood of people with cancer, but 5 studies that specifically looked at depression did not find evidence of an effect of music.
When looking at physical symptoms, 6 trials showed that music may have a moderate pain-reducing effect, although no effect was noted for fatigue or physical status.
The authors also found evidence that music interventions may have a beneficial effect on several physiologic responses, including reducing heart and respiratory rates. These results are also consistent with findings from another Cochrane systematic review on the use of music with coronary heart disease patients, which also found a reduction in heart rate.
Single trials that were included in this review supported a beneficial effect of music on mean arterial pressure and immunologic function, but not for oxygen saturation level. Furthermore, although the results suggested that music may benefit quality of life, there was no support for an effect on spirituality.
Cochrane Database Syst Rev. 2011;8:CD006911.

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