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Oncology Massage: An Evidence-Based Guide to Benefits, Safety, and Choosing the Best Practitioner for You

  • Writer: Kristyn Stolze
    Kristyn Stolze
  • 4 days ago
  • 14 min read

Updated: 8 hours ago



WELCOME

You may have found this guide because you or someone you love has cancer. You may want to know if massage therapy is safe, whether it actually helps, or whether the person recommending it to you is credible. You might be a massage therapist considering learning about oncology massage, or you might already be a colleague in this work. However you arrived, welcome.


This guide highlights some of the most recent research and meta-analyses in oncology massage to give an overview of how oncology massage can help, where we are still learning, and how to find the practitioner who is right for you.


INSIDE

      

THE INTEGRATIVE ONCOLOGY LANDSCAPE

Integrative therapies have increasingly become a key component of cancer treatment plans, and many leading cancer institutions offer integrative services that include massage therapy:



MY PERSONAL EXPERIENCE

Regional hospital systems can offer excellent options, and I personally worked as a massage therapist in the Integrative Therapies Program at the St. Charles Cancer Center in Bend, OR.


SAFETY: CAN MASSAGE SPREAD CANCER?

 

Many years ago, there was concern that massage therapy might increase the metastasis or spread of cancer in the body. While this may seem intuitive, it doesn't match what we know about cancer biology.


There is no clinical evidence that massage therapy, including manual lymphatic drainage, increases risk of cancer recurrence or metastasis (spreading of cancer cells from one place in the body to another).

What we know about metastasis: 

Metastasis is not a passive, mechanical event. Cancer cells aren't like seeds that easily shake loose from a tree and take root wherever they land. It is an extraordinarily complex biological process that requires cancer cells to acquire a very specific set of capabilities, most of which have nothing to do with circulation.


In order to spread, a cancer cell must:

  • Detach from the primary tumor. Cancer cells are held in place by adhesion molecules, which are kind of like velcro on the outside of the cancer cell that makes it stick to its tissue site. To leave, a cell must actively down-regulate these molecular anchors, which is like the cell turning 'off' its stickiness. This is a genetic change, not a mechanical one. No amount of shaking or massaging or faster circulation will make this happen.

  • Invade through surrounding tissue. The cell must produce enzymes that break down the extracellular matrix, which is a kind of structural scaffolding between cells. This is another active biological process requiring specific gene expression, not something caused by external touch.

  • Enter the bloodstream or lymphatic system (intravasation). The cell must penetrate the wall of a blood or lymph vessel. This requires molecular machinery that normal cells and many cancer cells do not possess. The cell won't naturally break through a vessel wall as a result of circulation or movement.

  • Survive in circulation. Even if a cancer cell does make it through all of those steps and find its way into the circulation, the bloodstream is a hostile environment for tumor cells. They are subjected to shear forces, which means they get bumped around and break apart as they whip through the bloodstream. In the bloodstream, they are attacked by immune cells (particularly natural killer cells), and deprived of the growth signals they depend on. The vast majority die. It's already pretty tough for cancer cells to enter the circulation in the first place, and research estimates that fewer than 0.01% of circulating tumor cells survive to form a metastasis.

  • Exit circulation (extravasation). Surviving cells must then adhere to a vessel wall in a distant organ and migrate through it, which is another active biological feat. Movement, pressure on the skin, or increased circulation do not affect this adherence.

  • Colonize a new tissue and establish a blood supply. If the cell makes it through all of these steps and arrives in a distant tissue, it then must adapt to an entirely foreign tissue environment and recruit its own blood supply (angiogenesis) to grow. Most cells that make it this far will still fail. Even if they arrive do in a distal tissue, they often remain dormant for years or indefinitely.


Comparing massage therapy to exercise

Exercise increases heart rate, blood pressure, lymphatic flow, and total body circulation much more dramatically than any massage session. If increasing circulation spread cancer, exercise would be the most dangerous thing a cancer patient could do, but we know this isn't the case at all.


A 30-minute brisk walk increases cardiac output by 3-4 times the resting rate, while a massage session produces modest, localized changes in tissue perfusion by comparison. Yet exercise is not contraindicated in cancer and is actively and enthusiastically prescribed.


In fact, multiple large-scale studies have demonstrated that regular physical activity during and after cancer treatment is associated with reduced risk of recurrence and improved survival, particularly in breast, colorectal, and prostate cancers. The American Cancer Society, ASCO, and every major oncology guideline recommends exercise for cancer patients.


Massage, which produces far less circulatory change than a walk around the block, operates well within the range of what oncologists already consider safe and beneficial.


A hospital-based cohort study from Chi-Mei Medical Center analyzed 1,106 women diagnosed with stage 0-3 breast cancer. Patients who received MLD for breast cancer-related lymphedema were compared with those who did not. After years of follow-up, the study found no increased risk of breast cancer recurrence in patients who received MLD.

 

A review published in the Journal of the Society for Integrative Oncology by researchers from Emory University's Radiation Oncology Department specifically addressed whether manual treatment of lymphedema could promote metastasis. Their conclusion: cancer research supports the position that MLD does not contribute to the spread of disease and should not be withheld from patients.

 

Massage therapy, when provided by a therapist trained in oncology protocols, is considered safe for cancer patients. The SIO-ASCO guideline, the Cochrane Collaboration, a long list of healthcare institutions, and the National Comprehensive Cancer Network all include massage in their recommended or offered supportive care approaches.


PAIN                                                 

Pain is a common side effect of cancer and its associated treatments, and it is also one of the areas where we have the most research on how massage therapy can help.

 

What the research shows:

 

A 2025 systematic review and meta-analysis published in the Journal of Clinical Nursing analyzed 36 randomized controlled trials involving 3,671 cancer patients. This is a large evidence base by clinical research standards. The analysis found that massage therapy produced statistically significant reductions in pain compared to control groups.


The 2022 joint clinical practice guideline issued by the Society for Integrative Oncology (SIO) and the the leading professional body for cancer physicians, the American Society of Clinical Oncology (ASCO), formally recommends massage therapy for pain management in oncology patients. This guideline was developed by an international panel of oncologists, integrative medicine specialists, and researchers who reviewed 227 studies. It represents the current standard of care.


Massage therapy was specifically recommended for chronic pain following breast cancer treatment and for pain during palliative and hospice care, with the panel noting that benefits outweigh risks.

 

What this means for you: 


Massage is not a replacement for your pain medication or your oncologist's pain management plan, but it is an additional tool that, for many people, reduces the overall burden of pain and may allow for more comfort during and after treatment. Some patients find they need less medication with regular massage support, though this should always be discussed with your medical team.


ANXIETY & MOOD                                                               

If you have felt anxious, depressed, overwhelmed, or emotionally numb since your diagnosis, you are not alone. These are all very common reactions, and the evidence for massage therapy's effect on anxiety in cancer patients is among the strongest in the research literature.


The same 2025 meta-analysis of 36 RCTs mentioned above found significant reductions in anxiety among cancer patients receiving massage therapy. Multiple earlier systematic reviews reached similar conclusions.


The SIO-ASCO guidelines also recognized massage therapy as part of integrative approaches for managing anxiety and depression in adults with cancer, issuing a separate guideline on this topic in 2023.


FATIGUE                                                                  

Cancer-related fatigue is different from normal tiredness. It doesn't resolve with rest like 'normal' tiredness might, and it affects your ability to think, work, maintain relationships, and feel like yourself. If you are experiencing this, please know it is a very real clinical symptom and it's very normal to go through an adjustment period as you find the right balance of rest and activity during and after treatment.


A systematic review of randomized controlled trials looking at massage therapy for fatigue management in breast cancer survivors found encouraging evidence that massage can reduce cancer-related fatigue.


A separate 2023 meta-analysis in Supportive Care in Cancer came to a similar conclusion across cancer types. The evidence here is still developing but very promising.

 

CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY

Chemotherapy-induced peripheral neuropathy (CIPN) can feel like numbness, tingling, pain, or cold sensitivity in the hands and feet. It can develop during or after treatment and affects up to half of patients receiving platinum-based or taxane chemotherapy. It's one of the most common reasons doses are reduced or treatment is stopped early. Pharmacological treatment options exist, but are limited. Duloxetine is the only medication the American Society of Clinical Oncology (ASCO) currently recommends for CIPN pain.


Studies are catching up what massage therapists have been observing for years, which is that massage seems to help with both immediate and longer term relief of CIPN pain. A 2019 assessor-blinded randomized controlled trial found that massage applied before each paclitaxel infusion significantly reduced neuropathic pain and improved quality of life. Nerve conduction studies confirmed objectively measurable improvement in nerve function.


A pilot RCT from MD Anderson Cancer Center found sustained symptom improvement with massage that lasted beyond the treatment period. One group had 3 massage therapy sessions/week for 4 weeks and the other had 2 sessions/week for 6 weeks. Both groups felt better, and the best outcomes overall were associated with the higher frequency group.


Most recently, a 2023 network meta-analysis comparing all non-pharmacological therapies for CIPN across 46 randomized trials and nearly 3,000 patients found massage to be among the most effective options for pain relief, neuropathy symptom reduction, and quality of life improvement.


LYMPHEDEMA & MANUAL LYMPHATIC DRAINAGE

If you had lymph nodes removed or radiated as part of your cancer treatment, you may be at risk for lymphedema. This is different from normal bloating or puffiness and refers to chronic swelling that occurs when fluid cannot drain properly from the body's tissues.


Manual Lymphatic Drainage (MLD) is a specialized, very gentle massage technique designed to support lymphatic flow. It is a core component of Complete Decongestive Therapy (CDT), which is the standard of care for lymphedema management worldwide.


What the evidence shows:


A Cochrane systematic review examined MLD for breast cancer-related lymphedema. The review found that MLD is safe and well-tolerated. Particularly when added to compression bandaging, MLD provided additional reduction in swelling, and the benefit appeared strongest for people with mild-to-moderate lymphedema.


A 2024 retrospective analysis of intensive MLD application during a 3-week decongestive therapy period demonstrated strong volume reduction in breast cancer-related lymphedema. This study suggests the best results come from a higher frequency of treatments over a shorter period of time rather than intermittent treatment over long time periods.

 

Some things to consider with MLD:

 

MLD is undeniably relaxing. In my own practice, clients report feeling deeply relaxed after MLD treatments and consistently say they feel things like 'less sluggish,' 'less puffy', or 'like it gets everything moving.'


That said, it's good to be wary of any overly bold claims related to MLD, especially if anyone claims to produce dramatic results after a single session. While positive and promising, the evidence is not conclusive enough yet to say exactly how much MLD alone can do. We see the best results when MLD is combined with compression therapy and performed frequently over a relatively short period of time.


What is clear: MLD is safe, well-tolerated, and many patients report subjective improvements in comfort, heaviness, and tissue quality, whether or not measurements capture this. Based on what I see in my own practice, I believe research will continue to demonstrate and quantify the benefits of MLD.


QUALITY OF LIFE

 

The 2025 meta-analysis found significant improvements in quality of life for cancer patients receiving massage therapy. This included physical comfort,emotional well-being, and functional capacity.

 

Quality of life may sound abstract, but when you are living through treatment, it is arguably the most concrete thing there is. It is whether you can sleep, whether you can tolerate being touched by the people who love you, whether your body still feels like you. These are the outcomes massage therapy can support.

 

Cancer asks you to hand your body over to medicine in ways that can feel profoundly disorienting. Oncology massage is one way to reclaim your body as something that can still experience comfort, safety, gentleness, and care. The evidence supports its use, and your oncology team can confirm whether it is appropriate for your specific situation.


HOW TO CHOOSE A QUALIFIED ONCOLOGY MASSAGE THERAPIST

 

I am often asked what the difference is between oncology massage and regular massage. In terms of technique, oncology massage is much, much more gentle than a standard Swedish massage. It is also similar in terms of overall technique and setting.


The massage is generally performed on a massage table using oil or other massage cream. Some hospitals have therapists on site, or you might see someone in private practice. You should expect an oncology therapist in private practice to take extreme precaution when it comes to cleanliness and to be mindful of scent sensitivity.


Your therapist will consider your unique situation to ensure your body is supported and safe. An oncology massage therapist will be familiar with ports, ostomy bags, tender skin during radiation, and surgical recovery; they will be prepared to make sure you are comfortable. Your therapist might wear gloves, especially if you have recently had chemotherapy. This is a very normal precaution to keep both you and the therapist safe, especially within the first 72 hours of treatment.


Oncology massage is often more about what we don't do than any particular special technique. The most important thing you get from a trained oncology therapist is that we understand how to keep your body safe. 


Massage therapists who practice Manual Lymphatic Drainage (MLD) or Complete Decongestive Therapy (CDT) should be certified in these modalities by a reputable training program. Look for MLD or CDT in their credentials and be cautious of anyone claiming to practice lymphatic drainage who isn't certified. Oncology massage doesn't have a comparable credential (yet), but here are some things to look for when finding a therapist:


  • Specialized oncology massage training: At a minimum, your therapist should have completed 32 hours of coursework specifically in oncology massage. Ask about their training hours and where they studied.

  • Understanding of your treatment: Your therapist will likely ask about your diagnosis, treatment phase, medications, and surgical history. If they don't ask, that is a potential source of concern. You might want to learn more about their training and experience or ask for references if you feel unsure.

  • Communication with your medical team: A good oncology massage therapist will want to know if they have permission to coordinate with your oncologist, especially during active treatment. Creating a bridge is a sign of clinical seriousness, not overreach.

  • Willingness to modify: Oncology massage is very tailored to your specific needs at each session. Oncology massage therapists understand how different the days can be during treatment, and your therapist should be able to adjust your session to meet you where you are in that moment.

  • Caution and slowness: Sometimes the first few oncology massage sessions can be frustrating if you have received a deeper form of massage before and prefer more pressure or feel like you can 'take it'. This is understandable! You know your body, and you know what feels good. Cancer treatment can affect your body's baseline in unexpected ways, so even if you feel a little bit impatient to have a deeper session, it's actually a good sign if your therapist is uncompromising about starting slow. It doesn't mean they don't respect your needs. It means they are firmly committed to keeping you safe and honoring your body's limits.

  • Honesty about limits: A trustworthy therapist will tell you how they can help but will be clear about what falls outside their scope. Be cautious of anyone who claims to treat everything, offers medical advice beyond their scope of practice, or tries to influence your treatment decisions.


Preferred Practitioner Resources

REFERENCES 

 

These are the primary sources cited in this review. All are publicly available through PubMed, the Cochrane Library, or the publishing journal's website. If any links don't share full article text, your oncologist should be able to access the full text of these studies for you.


  1. Bao T, et al. A Retrospective Cohort Study on the Preliminary Efficacy of Massage Therapy for Chemotherapy-Induced Peripheral Neuropathy Among Cancer Patients. Integrative Cancer Therapies.2025;24:15347354251323258. PubMed | Full Text

  2. Bergmann A, Baiocchi JMT, Rizzi SKLA, Allende RGM. Manual Lymph Drainage in Cancer Patients: What is the Scientific Evidence and Clinical Recommendations? Revista Brasileira de Cancerologia.2021;67(1):e-131055. Full Text (PDF)

  3. Cole JS, Olson AD, Dupont-Versteegden EE. The Effects of Massage Therapy in Decreasing Pain and Anxiety in Post-Surgical Patients With Breast Cancer: A Systematic Review and Meta-Analysis. Global Advances in Integrative Medicine and Health. 2024;13:27536130241245099. PubMed | Full Text

  4. Ezzo J, Manheimer E, McNeely ML, et al. Manual Lymphatic Drainage for Lymphedema Following Breast Cancer Treatment. Cochrane Database of Systematic Reviews. 2015;(5):CD003475. PubMed | Cochrane Library

  5. Godette K, Mondry TE, Johnstone PAS. Can Manual Treatment of Lymphedema Promote Metastasis? Journal of the Society for Integrative Oncology. 2006;4(1):8-12. PubMed

  6. Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical Practice Guidelines on the Evidence-Based Use of Integrative Therapies During and After Breast Cancer Treatment. CA: A Cancer Journal for Clinicians. 2017;67:194-232. PubMed | Full Text

  7. Huang TW, Tseng SH, Lin CC, et al. Risk of Breast Cancer Recurrence in Patients Receiving Manual Lymphatic Drainage: A Hospital-Based Cohort Study. Therapeutics and Clinical Risk Management.2015;11:349-358. n=1,106. PubMed | Full Text

  8. Izgu N, Metin ZG, Karadas C, et al. Prevention of chemotherapy-induced peripheral neuropathy with classical massage in breast cancer patients receiving paclitaxel: An assessor-blinded randomized controlled trial. Eur J Oncol Nurs. 2019;40:36-43. PubMed | ScienceDirect

  9. Kasseroller RG, Brenner E. Effectiveness of Manual Lymphatic Drainage in Intensive Phase I Therapy of Breast Cancer-Related Lymphedema — A Retrospective Analysis. Supportive Care in Cancer.2024;32:5. PubMed | Full Text

  10. Li et al. Non-pharmacological therapy for chemotherapy-induced peripheral neurotoxicity: a network meta-analysis of randomized controlled trials. BMC Neurol. 2023;23:485. PubMed Central | Full Text

  11. Lopez G, Eng C, Overman M, et al. A randomized pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy. Sci Rep. 2022;12(1):19023. PubMed | Full Text

  12. Mao JJ, Ismaila N, Bao T, et al. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. Journal of Clinical Oncology. 2022;40(34):3998-4024. PubMed| Full Text

  13. Memorial Sloan Kettering Cancer Center. Integrative Medicine and Wellness Service: Massage Therapy. mskcc.org. Accessed March 2026.

  14. Myint W, et al. Effectiveness of Massage Therapy for Cancer Pain, Quality of Life and Anxiety Levels: A Systematic Review and Meta-Analysis. Journal of Clinical Nursing. 2025;34(1):49-87. 36 RCTs, n=3,671. PubMed | Full Text

  15. Shan S, Lin L, Fang Q, et al. Massage Therapy Significantly Improves Cancer-Related Fatigue in Cancer Patients: A Meta-Analysis of Randomized Controlled Trials. Supportive Care in Cancer.2023;31(8):464. PubMed | Full Text

  16. SIO-ASCO Clinical Practice Guidelines: Integrative Oncology Care for Anxiety and Depression in Adults with Cancer. Society for Integrative Oncology / American Society of Clinical Oncology. J Clin Oncol. 2023;41(28):4562-4591. PubMed | Full Text

  17. Villar-Francos JJ, Orts-Gomez J, et al. Efficacy of Massage Therapy for Symptom Management in Cancer Patients: A Systematic Review and Meta-Analysis. Healthcare. 2025;13(24):3268. Full Text


This document is intended for informational purposes and is not a substitute for medical advice. Always discuss massage therapy with your oncology team before beginning treatment.


About Me: I am a Licensed Massage Therapist specializing in oncology massage and manual lymphatic drainage, and I work with cancer patients and survivors as part of their care team. I have a degree in Biology from Columbia University and spent several years doing clinical research at New York Presbyterian Hospital. I love learning, and I love getting down to the smallest biochemical details to understand how things work. I am passionate about making science and the wonder of the human body accessible to anyone who is curious to know more!


Evidence and information current as of March 2026.


© 2026 Kristyn Stolze, LMT

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