TREATMENT: Music Therapy

USES: To stimulate communication and reduce symptoms associated with cancer and cancer treatment, including pain, anxiety, depression, and mood disturbance.

SUMMARY: Music has been used throughout history as a supportive and palliative method in the practice of medicine. It emerged as a formal discipline in the United States in the late 1940s. Music therapists—musicians who also receive intensive training as counselors or mental health therapists—use music instead of words to reach and assist patients. They manage the psychosocial and communication issues faced by patients and family members, and are especially effective in end-of-life care or when patients become withdrawn and noncommunicative.

Controlled trials indicate that music therapy produces emotional and physiologic benefits by reducing anxiety,[1] stress,[2] depression, and pain.[3]

In a large trial of 500 surgical subjects randomized to control, recorded music, jaw relaxation, or a music and jaw relaxation combination, music led to significant decreases in both pain intensity and related distress associated with pain.[4]

In a randomized study conducted at Memorial Sloan-Kettering Cancer Center, 62 cancer patients undergoing autologous stem cell transplantation were randomized to receive music therapy or standard care. Anxiety, depression, and total mood disturbance scores were significantly reduced in patients who received music therapy, compared to those in the standard care group.[5]

Music was also effective among cancer patients with chronic pain.[6] Data from other studies suggest that music alleviates anxiety in patients receiving radiation therapy,[7] improves the quality of life in those with terminal cancer,[8] and reduces anxiety and increases comfort in pediatric cancer patients.[9]

DR. CASSILETH: Music is a powerful tool that can evoke latent emotions, induce a range of emotional states, and enhance communication. It also offers a creative, lyrical, and symbolic means of addressing spiritual needs, and is increasingly used in end-of-life care. Hospital-based music therapists typically bring portable instruments—guitars, small drums, bells, and the like—to the bedside, so that able patients may participate. Depending on the patient’s needs and abilities, however, such therapy may involve music performance, listening, writing, or discussion about lyrics.

Through the use of music, trained therapists can effectively reduce patient and family anxiety and depression, alleviate pain, and encourage communication in many patient populations and circumstances. Music therapy can be used for patients of any age and in a variety of settings, including hospitals, clinics, cancer centers, or homes.

Data from randomized, controlled clinical trials suggest benefits of music in managing symptoms associated with cancer and its treatment, including pain, anxiety, depression, and mood disturbance.

Because music therapy is a pleasant, noninvasive, and effective complementary modality, many major institutions across the United States have integrated it into standard care.