Name: Therapeutic Massage for Psychological Well-being in Geriatric Oncology (Video) | JoVE Journal
Uploaded: 2026-05-22T13:40:00.000+00:00
Duration: 3 min 59 s
Description: Learn a standardized Tui Na massage protocol for reducing anxiety and depression in elderly cancer patients. This method improves quality of life and offers a safe, non-pharmacological approach.

ai_agent_IP

ai_agent

maintenance

instantTrialDurationMinutes

isBiopharma

enableNewMyJoveSectionDesign

educationFeatures

seoMetaApi

ai_copilot_institution_blacklist

ai_chat_institution_blacklist

freeAccessWindow

ssoRoleCapture

scheduledMaintenanceBanner

joveLabsFeatures

disable_autoplay_for_bots

extended_trial_duration

5 minutes

Funding was provided by the Jiangsu Commission of Health (No. LKM2023030); the Jiangsu Health Development Research Center/State&#160;Contraceptives Adverse Reaction Surveillance Center (No. JSHD2021008); School of Elderly Care Services and Management/School of Aging Industry, Nanjing University of Chinese Medicine (No. 2025YLFWYGL018); &#8204;Jiangsu Provincial Administration of Traditional Chinese Medicine (No. MS2025003)

This protocol was adopted for a study registered in the International Traditional Medicine Clinical Trial Registry under Registration Number: ITMCTR2023000039. Written informed consent was obtained from all participants.
1. Research subjects
<ol>
	<li>Identify elderly cancer patients through daily electronic screening of oncology admissions across participating hospitals.</li>
	<li>Invite eligible patients during routine clinic visits using a standardized recruiter-led script and REDCap checklist.</li>
</ol>
2. Inclusion criteria
<ol>
	<li>Enroll patients with a confirmed cancer diagnosis (all cancer types acceptable), aged 65 years or older, who communicate normally and demonstrate no cognitive impairment (Mini-Mental State Examination &#8805; 24), assessed by specialists to have anxiety and/or depression (HAMD-17 &#8805; 7 or HAMA &#8805; 7) with symptoms present for at least 2 consecutive weeks, using anti-anxiety/depression medications.</li>
	<li>Obtain voluntary signed informed consent from all participants.</li>
</ol>
3. Exclusion criteria
<ol>
	<li>Exclude individuals with recurrent depression or anxiety disorder defined as &#8805; 2 documented episodes in the past 2 years or any prior episode requiring hospitalization &#8805; 7 days; who received massage therapy intended to regulate mental state within the past 6 months; with primary psychotic disorders, bipolar disorder, severe personality disorder, or other major psychiatric illnesses requiring specialized treatment; with concomitant central nervous system lesions; currently participating in other clinical trials; with skin cancer; with significantly abnormal coagulation function or apparent skin lesions in the massage area; taking medications that may affect emotions (e.g., systemic corticosteroids, anabolic steroids, lithium, valproate, benzodiazepines); meeting criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for disorders other than depression or anxiety unless the disorder is clearly secondary to cancer and HAMD/HAMA scores remain above inclusion thresholds; deemed unsuitable by specialist doctors, including but not limited to uncontrolled hypertension, severe osteoporosis, cardiovascular instability, cancer-related fragility, thrombocytopenia, or other conditions that may increase the risk of massage therapy.</li>
</ol>
NOTE: Include patients with advanced-stage cancer only if clinically stable and assessed as able to tolerate manual therapy.
4. Treatment protocol
NOTE: Refer to Figure 1B-D and Figure 2B-D for operational procedures.
<ol>
	<li>Select bilateral acupoints: Taiyang (EX-HN5), Neiguan (PC6), Shenmen (HT7), Taichong (LR3), Xinshu (BL15), Ganshu (BL18), and Pishu (BL20).</li>
	<li>Position the patient supine or sitting for anterior/limb points; position the patient prone or sitting for posterior/back points as appropriate.</li>
	<li>Apply massage to Taiyang, Neiguan, Shenmen, and Taichong bilaterally for 2 min per acupoint using standardized techniques (6&#8211;10 N, 120&#8211;160 times per min).</li>
	<li>Position the patient prone or sitting and apply kneading massage to Xinshu, Ganshu, and Pishu bilaterally for 2 min per acupoint.</li>
</ol>
NOTE: Maintain a total operation time of approximately 15&#8211;20 min per session. Deliver treatments once every other day, three times per week, for 4 weeks. Conduct all sessions during morning clinical hours at a consistent time of day.
CAUTION: Massage therapy in elderly cancer patients should be performed cautiously. Adjust pressure according to patient tolerance and discontinue immediately if pain, dizziness, or other adverse symptoms occur.
5. Observation period
<ol>
	<li>Observe participants for a total of 8 weeks: 4 weeks of treatment (weeks 1&#8211;4) and 4 weeks of follow-up (weeks 5&#8211;8).</li>
</ol>
6. Outcome assessment
<ol>
	<li>Assess HAMD-17, HAMA, and FACT-G at baseline (day 1), end of treatment (week 4), and end of follow-up (week 8).</li>
	<li>Record changes in primary tumor status at week 4 and week 8.</li>
	<li>Record any changes to anticancer therapy during treatment and follow-up periods.</li>
</ol>
NOTE: Record anticancer treatment changes as &#8220;no change&#8221; or &#8220;change,&#8221; defined as any modification, interruption, or discontinuation documented in the medical record.
7. Adverse event recording
<ol>
	<li>Record all adverse events related to massage operations, including skin damage, pain, and subcutaneous congestion.</li>
	<li>Grade adverse events by severity (mild, moderate, severe) and relatedness to the intervention (definite, probable, possible, unlikely, or unrelated). Define these grades as follows: Mild: transient symptoms not requiring treatment; Moderate: symptoms requiring observation or minor intervention; Severe: symptoms requiring treatment, discontinuation, or hospitalization.</li>
	<li>Report serious adverse events to the principal investigator and relevant authorities.</li>
</ol>
8. Concomitant therapy recording
<ol>
	<li>Document clinically indicated pharmacotherapy, including drug, dose, and duration.</li>
	<li>Termination criteria</li>
	<li>Terminate participation in cases of withdrawal or loss to follow-up.</li>
	<li>Terminate participation if adverse reactions render continuation unsafe.</li>
	<li>Terminate participation if disease progression prevents continuation.</li>
	<li>Terminate participation if medications affecting the emotional state become necessary.</li>
</ol>
9. Quality control
<ol>
	<li>Train and certify all therapists in acupoint localization, manipulation techniques, and treatment rhythm.</li>
	<li>Provide standardized operation manuals and instructional materials.</li>
	<li>Conduct periodic supervision and fidelity checks.</li>
</ol>

The authors have no conflicts of interest to disclose.

The paucity of geriatric-focused clinical trials has hindered comprehensive understanding of cancer-related psychosocial morbidity and therapeutic needs in older adults with malignancies19,20,21. Clinically, affective disorders such as anxiety and depression in this population are frequently misattributed to neoplastic pathophysiology alone, neglecting synergistic interactions with age-specific vulnerabilities. Diagnostic oversi...

The progression of malignancies is inextricably linked to biological aging, a key driver of oncogenesis1. Population research demonstrates that seniors (&#8805; 65 years) represent 54% of incident malignancies globally and contribute disproportionately to 70% of cancer deaths2,3. Elderly cancer cohorts present distinctive clinical dilemmas. Relative to younger counterparts, these patients frequently manifest atypical symptom onset, heightened multimorbidity prevalence, and deficient psychosocial safety nets4,5,6. A salient issue involves the elevated incidence of concurrent psychiatric conditions, wherein anxiety (23%) and depressive disorders (26%) surpass population norms by substantial margins7,8.
Psychological distress in elderly cancer patients is multifactorial, involving biological, psychological, and social mechanisms. Age-related neuroendocrine dysregulation, chronic inflammation, and hypothalamic&#8211;pituitary&#8211;adrenal (HPA) axis dysfunction contributes to increased vulnerability to depression and anxiety. In addition, cancer-related symptoms such as pain, fatigue, and sleep disturbance further exacerbate psychological distress. Social factors, including functional decline, reduced independence, and diminished social support, also contribute to emotional vulnerability in geriatric oncology populations. These interconnected mechanisms highlight the complexity of psychological distress in elderly cancer patients and underscore the need for integrative therapeutic approaches.
Psychological comorbidities in malignancy patients propagate multifaceted consequences: they degrade life satisfaction, undermine therapeutic compliance, attenuate clinical response rates, and amplify mortality hazards9,10. Although pharmacotherapy and psychotherapy are considered standard treatments for psychological distress in cancer patients, their application in elderly populations presents specific challenges. Antidepressants and anxiolytics may increase the risk of adverse effects such as sedation, falls, drug-drug interactions, and cognitive impairment, particularly in patients with multimorbidity and polypharmacy. Psychotherapy, including cognitive behavioral therapy, may be limited by cognitive decline, reduced physical endurance, and accessibility barriers in older adults.
In Traditional Chinese Medicine theory, psychological distress in elderly cancer patients is often attributed to disharmony of Qi and blood, deficiency of vital energy, and imbalance of the heart-liver-spleen systems. Aging and malignancy are believed to weaken vital Qi, leading to emotional disturbances such as anxiety and depression. Traditional Chinese medical massage (Tui Na) is a Chinese medical therapy that applies manipulation to points or body areas for disease treatment and prevention, as well as promoting health. It has been shown to regulate qi (The intangible, high-mobility nutritive substance that maintains vital activities) and blood circulation, as well as adjust the upper warmer. It also helps regulate and calm the mind. Its non-invasive therapeutic profile and evidence-based efficacy have been substantiated by multiple randomized controlled trials (RCTs)11,12,13,14. Emerging research suggests Tui Na interventions may ameliorate cancer-related psychosomatic disorders by modulating autonomic nervous system activity and mitigating affective disturbances15,16. Despite growing interest in personalized cancer care, there is still a lack of focused studies and treatment guidelines specifically designed to address the unique biological and physiological needs of elderly cancer patients.
Previous systematic reviews and meta-analyses show that massage therapy significantly improves anxiety, quality of life, and pain in cancer patients. For example, a 2024 meta-analysis of 36 RCTs involving 3,671 patients reported notable benefits for anxiety and quality of life17, and another review focusing on post-surgical breast cancer patients (7 studies) demonstrated reductions in both pain and anxiety18. However, there remains a lack of focused studies specifically targeting elderly cancer patients with clinically diagnosed depression and anxiety. This study applies the Hamilton Depression scale-17 (HAMD), Hamilton Anxiety scale (HAMA), and Functional Assessment of Cancer Therapy-General (FACT-G) to evaluate psychological outcomes in this population.

<table><tbody><tr><td>Biohazard waste bags (yellow)</td><td>Lixinyun Plastic Industry Co., Ltd.</td><td>HJ421-2008</td><td></td></tr><tr><td>Disposable sterile gloves</td><td>Shanghai Kebag Medical Latex Equipment Co., Ltd.</td><td>22010739</td><td></td></tr><tr><td>Iodine (povidone-iodine) cotton swabs</td><td>Shandog Lircon Medical Technology Co., Ltd.</td><td>LEK-DMQ-1</td><td></td></tr><tr><td>Opaque sealed envelopes (for randomization)</td><td>Nanjig Kogdu Printing Co., Ltd.</td><td>201701</td><td></td></tr><tr><td>Statistical analysis software (SPSS)</td><td>IBM</td><td>SPSS Statistics 22</td><td></td></tr><tr><td>Sterile dry cotton balls</td><td>Zhende Medical Co., Ltd.</td><td>202203121B</td><td></td></tr><tr><td>Tuina manipulation parameter measurement system (ZTC-II)</td><td>Shanghai Yilin Medical Instrument Development Co., Ltd.</td><td>032030</td><td></td></tr></tbody></table>

therapeutic massage for psychological well-being in geriatric oncology

Therapeutic Massage for Psychological Well-being in Geriatric Oncology

Psychological distress, particularly depression and anxiety, is highly prevalent among elderly cancer patients. Such psychological distress has been shown to significantly affect quality of life, treatment adherence, and overall prognosis. Although pharmacological treatments are available, they may increase the risk of adverse effects and drug interactions in older adults. Therefore, safe and effective non-pharmacological interventions tailored to geriatric oncology populations are urgently needed. Traditional Chinese massage (Tui Na), which has historically been used to harmonize the body and mind, may alleviate cancer-related psychosomatic disorders by modulating autonomic nervous system activity and mitigating affective disturbances. This study presents a standardized therapeutic massage protocol applied in elderly cancer patients with clinically diagnosed anxiety and/or depression. The primary outcomes were changes in depression and anxiety, and quality of life was assessed as a secondary outcome. Adverse events were monitored to evaluate safety.
This study demonstrates the application of therapeutic massage as a complementary, non-pharmacological intervention for psychological distress in elderly cancer patients. The findings support the integration of massage therapy into comprehensive geriatric oncology care and suggest a safe and feasible approach to improving mental well-being in this vulnerable population.

To verify the practical feasibility and procedural fidelity of the intervention protocol, 13 participants undergoing therapeutic massage were included for representative procedural evaluation during the implementation phase. This intervention involves standardized acupoint manipulation and operator–participant interaction as defined in the protocol. The detailed operational workflow, therapist positioning, acupoint sequence, and manipulation procedures are illustrated in Figure 1 </s...

This study presents a therapeutic massage protocol to address psychological problems such as depression and anxiety in elderly cancer patients, aiming to support the integration of complementary therapies into comprehensive geriatric oncology care.

Psychological distress, particularly depression and anxiety, is highly prevalent among elderly cancer patients. Such psychological distress has been shown ...

This study presents a therapeutic massage protocol to address psychological problems in elderly cancer patients. Current methods carry the risk of the adverse effects or limited accessibility, highlighting the need for integrative approaches like Tui Na.To begin, enroll patients with a confirmed cancer diagnosis for the procedure. Select the bilateral acupoints, Tai Yang, Nei Guan, Shen Men, Tai Chong, Shenshu, Ganshu, and Pishu.Position the patient supine or seated for anterior and limb acupoints and prone or seated for posterior and back acupoints as appropriate. Then, apply massage to Tai Yang, Nei Guan, Shen Men, Tai Chong bilaterally for two minutes per acupoint using standardized techniques. Next, position the patient in a prone or sitting posture and apply kneading massage to Shenshu, Ganshu, and Pishu bilaterally for two minutes per acupoint.Observe participants for a total duration of eight weeks, including four weeks of treatment and four weeks of follow-up. Assess Hamilton Depression Scale 17 or HAM-D17, Hamilton Anxiety Scale or HAM-A, and Functional Assessment of Cancer Therapy or FACT-G at baseline, end of treatment, and end of follow-up at week eight. Record changes in primary tumor status at weeks four and eight.Record any changes to anti-cancer therapy during the treatment and follow-up periods. Record all adverse events related to the massage operations, including skin damage, pain, and subcutaneous congestion. Grade each adverse event by severity and relatedness.Define the grades as presented here. Report serious adverse events to the principal investigator and relevant authorities. Document clinically indicated pharmacotherapy, including the drug, dose and duration.Terminate participation in cases of withdrawal, loss to follow up, unsafe adverse reactions, disease progression, or the need for medications that affect emotional state. Train and certify all therapists in acupoint localization, manipulation techniques, and treatment rhythm. Provide standardized operation manuals and instructional materials.Conduct periodic supervision and fidelity checks. The mean HAMA score decreased from baseline to week four, and then slightly increased at week eight. The mean HAMD score declined from baseline to week four, and then increased at week eight.The FACT score increased from baseline to week four and then decreased at week eight. The most important challenge is the accuracy and the repeatability of the massage operation. Future work may incorporate objective biomechanical measurements such as pressure sensors or machine tracking to further refine intervention standardization.

therapeutic-massage-for-psychological-well-being-in-geriatric-oncology

Research

JoVE Journal

Medicine

Here we describe the protocols for applying defined mechanical loads to mouse calves and for monitoring the concomitant intramuscular pressure changes. The experimental systems that we have developed can be useful for investigating the mechanism behind the beneficial effects of physical exercise and massage.

Application of Consistent Massage-Like Perturbations on Mouse Calves and Monitoring the Resulting Intramuscular Pressure Changes

The present article presents the details pertaining to the application of resistance training associated to vascular occlusion in IBM patients.

Vascular Occlusion Training for Inclusion Body Myositis: A Novel Therapeutic Approach

Fluorescence imaging is a promising innovative modality for image-guided surgery in surgical oncology. In this video we describe the technical procedure for detection of the sentinel lymph node using fluorescence imaging as showcased in gynecologic oncologicy. A multispectral fluorescence camera system, together with the fluorescent agent indocyanine green, is applied.

Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology

A thoracic oncology database was developed to serve as a comprehensive repository for clinical and laboratory data for the purposes of translational research. The database will serve translational cancer researchers within the Thoracic Oncology Research Program. This database is adaptable to other cancer models, as well as other human diseases.

Generation of Comprehensive Thoracic Oncology Database - Tool for Translational Research

This article describes a protocol for inducing psychological stress in participants, which enables researchers to measure psychological, physiological and neuroendocrine responses to stress within single participants or between groups.

The Trier Social Stress Test Protocol for Inducing Psychological Stress

We describe a simple approach for diagnosis of halitosis in dogs as well as a dietary approach for its management. This protocol may be extended to the management of halitosis in humans in the near future.

Therapeutic Effectiveness of a Dietary Supplement for Management of Halitosis in Dogs

This video demonstrates the technique of percutaneous muscle biopsy of the human vastus lateralis using the Weil-Blakesley conchotome.

Human Vastus Lateralis Skeletal Muscle Biopsy Using the Weil-Blakesley Conchotome

During development of drugs for pulmonary delivery, it is necessary to evaluate pharmacokinetics and efficacy in an animal model. We present a method to build a disposable aerosol dispersion system from of-the-shelf components that can be used to administer intrapulmonary dry powder aerosol to rodents.

Disposable Dosators for Pulmonary Insufflation of Therapeutic Agents to Small Animals

Clinical linear accelerators can be used to determine biologic effects of a wide range of dose rates on cancer cells. We discuss how to set up a linear accelerator for cell-based assays and assays for cancer stem-like cells grown as tumorspheres in suspension and cell lines grown as adherent cultures.

Use of a Linear Accelerator for Conducting In Vitro Radiobiology Experiments

Here, a critical hindlimb ischemia experimental model is presented followed by a battery of functional, histologic and molecular tests to assess the effectiveness of angiogenic...

Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia

Learn a standardized Tui Na massage protocol for reducing anxiety and depression in elderly cancer patients. This method improves quality of life and offers a safe, non-pharmacological approach.

Therapeutic Massage for Psychological Well-being in Geriatric Oncology

Explore More Videos