Four Strokes for Massage as Supportive Cancer Care

The client with cancer who is receiving massage treatments can derive both physical and emotional benefits from massage. Cancer survivors specify benefits from massage that include minimizing scar tissue formation, preventing lymphedema (the swelling that occurs in the limbs of many people with breast cancer), improved range of motion, and post-radiation skin survival.


In addition to tangible physical benefits, survivors often say that massage helped them feel more alive and/or hopeful regarding their medical outcome. Massage can help encourage a positive outlook, in itself an important resource, in fighting cancer. In addition, according to Massage and Compassionate Touch, [Dzuber; 2004], the author suggests that massage can be a welcome break to those who are lonely and ill, serving as an antidote to the impersonal, probing touches that we associate with modern medicine.


There are many types of massage appropriate for people with cancer. Swedish massage for example, with it’s long, flowing strokes tone soft tissues, stimulate circulation, improve oxygen flow and relax muscles, is a good option. Craniosacral therapy, polarity and reiki, are more gentle massage modalities and may also be appropriate. A few months after active treatment, other methods, such as trigger point therapy, lymph drainage, neuromuscular therapy, myotherapy and myofascial release, may be beneficial.


The authors of Massage for Supportive Cancer Care [], describe the application of four strokes for massage as supportive cancer care.


  1. Effleurage: The very slow stroking that should begin and end every massage. Light stroking is used to relax the client, while deep stroking empties the blood and lymphatic vessels. The massage therapist should begin effleurage by placing the hands very lightly on the area to be massaged, running hands slowly over the area, with the lightest possible pressure, making full contact with both hands. Continuous motion should be used, with the hands maintaining contact with the client’s body throughout the stroke.After five minutes of light stroking, the therapist can begin to deepen the strokes towards the heart, and lighten the strokes going away from the heart. The massage should never hurt; communicating with the client is key to inducing the relaxation response and to avoid causing pain. Deep effleurage can be used to decrease edema, but only with a physician’s approval.
  2. Petrisage, or kneading: Performed with either the palms, heels of the hands, or the fingertips. In this stroke, the therapist picks up the muscle tissue, moving it away from the bone with the goal of minimizing muscle spasms. Again, communication with the client is important to confirm the appropriate amount of pressure is applied.
  3. Tapotement: A “hacking” or “slapping,” performed with the sides of the hands, or by cupping the hands to sharply tap an area. This stroke is generally not appropriate for clients with cancer or other serious illnesses, and should be used only with a physician’s approval.
  4. Friction: Applying pressure, with one or two fingertips, in a circular motion over bony areas like the knees, pelvic bones, shoulders and knees. Focusing on one area for a prolonged time, then moving to the next location, is most effective. This stroke is helpful in reducing the incidence of decubitus ulcers (pressure sores) for individuals who cannot get out of bed, use wheelchairs for most of the day, or cannot change position to relieve pressure.


The following techniques may be effective for women with breast cancer:
Myofascial softening and spreading, acupressure and trigger point, manual lymph drainage, and cross fiber fractioning and skin rolling to release scar tissue are all good adjunctive therapies to the other treatments a client with breast cancer is receiving. The client with breast cancer can be positioned with a small pillow under the forearm and elbow on the side of the surgery.


Treating clients with cancer is a rewarding experience. We hope this article has helped you!  Have you treated patients with cancer, do you have any tips?  Leave them in the comments below.


P.S. This content came from our massage therapy continuing education courses, view course offerings here: