The Music as a Therapy Integrated to Palliative Care of Patients with Cancer
Mustafa Levent1, Ozgur Tanriverdi2
1Mugla Sitki Kocman University Faculty of Medicine, Department of Internal Medicine, Mugla, Turkey
2Mugla Sitki Kocman University Faculty of Medicine, Department of Medical Oncology, Mugla, Turkey
The purpose of this paper is to show benefits of listening music and music therapy in supportive cancer care. Cancer is a chronic disease that has many complications such as vomiting, pain, anorexia and fear of death. Cancer also effects the patients’ social, economic and physical life. Music therapy is an alternative supplementary treatment for cancer patients. There are many benefits of music therapy. It can be used to reduce the pain, decrease stress level and improve mood. Therefore music therapy can be used to promote wellness, enhance communication, and facilitate personal development. Although there is evidence that music therapy is effective in reducing cancer’s adverse outcomes, extend of these interventions is unknown. If we consider music therapy as an additional therapy, it should be integrated into the psycho-oncology. We discuss the positive effects of music therapy in cancer patients to use it as a non-pharmacological treatment for promoting wellness and quality of life.
Keywords: Music Therapy; Palliative Care; Cancer
It can be thought that Art is a huge area where there is no limit and sad that you can find anything you want on it. Art has the potential to enhance people’s mood, feelings, behaviors [1,2]. There is a strong connection between art and health since the ancient times . Doing some creative activities can reduce stress and depression. It is like a port to get away from the emotions associated with diseases [1, 2]. For example there is evidence that music therapy can decrease the degree of anxiety [1, 3]. In addition, movement based creative expression, like theater, has a great effect on self-esteem, problem solving, and psychologically well-being. Furthermore, people that wrote about their bad memories, faced with them, show excellent progress on physical health.
They also had got better immune system function [1, 4].
Music therapy is a profession that can be described as using music and musical activity to provide people’s physical, psychological, social and mental needs. Music therapy methods are quite different from other forms of treatment . Especially when we look at the old medicine, it is possible to see music therapy as using on psychological disorders, eye disorders, spasms, muscle and joint disorders, fatigue [1,5]. Music also has positive effect on blood pressure, heart rate, psychological and behavioral status . Today, areas of music therapy is quite large. It is used on fight of neurology, cardiology, and psychiatry as a supplementary tool in the treatment. And of course it is a part of supportive cancer care which accompanies medical treatment .
Cancer and Music Therapy
Cancer is one of the most unfavorable diseases that causes many problems for people and their families. Patients with cancer struggle both diseases’ symptoms, problems related to treatment and other unpredictable effects . Most common behavior of these people is fear of death and suffering from burden of cancer including psychological, economic causes. Actually, this fear has a deep impact on their life quality and personal relationship. The thought of death makes them feel sad, nervous, upset and most of other negative emotions [1-3, 5].
Music has a special language, therefore it is universal and the world’s only common language. Many people are able to express themselves better with music and music can reveal their feelings. The development in medicine bring some new ideas on oncological treatment such as using music therapy on patients with cancer [8, 9]. And studies have shown that there is big benefit to use music therapy on negative emotions [1, 8]. Music therapy in cancer care is an emerging field. Bringing music into oncology is a radical challenge because there is not much experiences about it. Moreover, music therapy in cancer care is not done only by the professional music therapists, but volunteers and unpaid carers can take part this formation. However, it is yet not acceptable among oncologists as a palliative care on cancer. For example, a study about learning perspectives of medical oncologists regarding music therapy for patient with cancer in Turkey, first published survey among medical oncologists worldwide, showed that only %23 [n=26] of participants have an experience with music therapy .
Patients with cancer are prone to anxiety and depression. Music provides joy, relaxation and socializing. Music therapy in oncology is used all types and stages of cancer and is very helpful to reduce many symptoms like sadness, anxiety, fear of death. Maybe it is not curative but it has a deep impact on patients’ behavior and feelings .
Additionally, in a study on the 30 adolescents in 1999 in Florida, after the music therapy sessions, on the right front of the brain of activation increases and get back to normal, and getting better with the depression . Similarly, listening to music has several good effects on cancer patients. Patients listening to music while receiving chemotherapy or radiotherapy, feel relax, comfortable and get rid of the idea of loneliness, death and fear .
Music therapy can be done individually or as a group therapy. Participation in a group music therapy create strong emotions, take people out of isolation, increase contact with the outside world and provides improvement of posture and appearance. In a study made by Daykin et al.  group therapy was more preferred than individual therapy. And some of the participants chose in both group and individual format. According to Preti and Welch , the musical experience within a hospital setting embraces a few main features such as calmness, excitement, alleviation, cheerfulness.
Music therapy in cancer care can help patients’ experience of disease, handle with the side effects of the treatment like pain,
anorexia, losing weight and weakness . Additionally, patients with cancer has a weak immune system. A recent study which was accomplished by Pothoulaki et al. showed that music therapy has positive effects also on immune system .
In a result of all this approaches, there are some big changes in cancer care which affect music therapist so they become a part of complementary treatment. . Professionals prefer to keep patients shorter than past in the hospital and these trends bring about the idea that put music therapy into practice both in acute and supportive care . By the way, music therapy has relatively recently gained the professional status of state registration on many countries like United Kingdom . Nearly a third of organizations declared that they were planning to expand music therapy provision in future .
In opinion, when the options are reduced for enjoyment because of the cancer, music became a valued joyful activity for patients. Music therapy can be thought as a communication tool between the patients with cancer and their families or the other cancer patients, because music has the power to express the feelings by using minimum words. Music makes patients feel that they are not alone [1, 9, 11].
Music therapy and musicology integrated with palliative care on cancer
The Greek philosopher Pythagoras considered to be a founder of music therapy. Pythagoras defined music as a specific diet to restore and maintain the harmony of the body and soul . Florence Nightingale, founder of the modern nursing, observed beneficial effects of music on the soldiers injured in the Crimean War . Moreover, according to literature, music was used in hospitals in the 1900’s during anesthesia and analgesia . In a study, made by Cepeda et al. , music is found as an effective object that can help to reduce of pain and requirements for analgesic. Listening to music for treatment of acute or chronic pain is a low coast, safe and easily accessible way.
In a systematic review, standard care and standard care plus music therapy is compared with depression to learn efficacy of music therapy. Four of the five studies showed that there is a greater reduction in symptoms of depression among the patients
who take music therapy rather than standard cares .
A study, which was carried out by Geretsegger et al. , searched the effect of music on autism spectrum disorder. According
to the authors, music can help to fix some of the problems on these people like communication and social interaction . Similarly, an another review, conducted by Gold et al. , on the patients that have schizophrenia or schizophrenia- like illnesses to learn how music influences their moods and mental function, showed that music therapy as a complementary treatment to standard care helps them improve mental state and functioning if a suitable number of music therapy sessions are provided .
Music has been used in end-of life care and hospice settings to reduce anxiety, pain, to facilitate relaxation, to encourage expression of feelings. Krout  reported that single session therapies are more successful than group in observed pain control, relaxation and comfort. But another study showed that group therapy has better effects on quality of life of people diagnosed with terminal cancer .
In a result of these studies conducted on music therapy, mostimportant question may be whether musicology can be integrated
to palliative care on cancer or can be accepted by oncologists.In conclusion if all these roles of music are considered,music therapy can be thought as a cheap, no side effects, preparedfor each person separately, easily accessible and supplementarytreatment in cancer care.
Conflict of Interest: None
Cite this article: Tanriverdi O. The Music as a Therapy Integrated to Palliative Care of Patients with Cancer. J J Intern Medicine. 2015, 1(2): 006.