Massage to Enhance Quality of Life in ASCT Patients

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DESCRIPTION (provided by applicant) Patients with cancer undergoing autologous stem cell transplantation (ASCT) endure stressors and symptoms throughout treatment, resulting in greatly impaired quality of life (QoL). Despite advances in conventional symptom management, patients often experience significant emotional distress (anxiety, stress, and depressive symptoms), pain, fatigue, nausea, and vomiting prior to and following ASCT. Psychosocial interventions that alleviate stress and induce relaxation can reduce treatment-related symptoms and improve QoL in many patients with cancer. However, some patients are not responsive to these approaches, and more passive therapies may be preferred by patients with impaired concentration and/or fatigue. This revised exploratory application proposes a novel seven-week massage therapy intervention that potentially could reduce symptoms and improve QoL. The study will utilize a prospective, randomized two-group design. Thirty-two patients with cancer (ages >= 18) scheduled to receive ASCT at the University of Virginia Cancer Center will be recruited, evaluated with baseline measures, and randomly assigned to receive either: (1) standard medical care alone (SMC); or (2) SMC plus seven weeks of massage therapy. Patients will complete weekly questionnaires (QoL, symptoms) during the intervention period. The primary aims of the study are to explore: 1) the feasibility of the study design and massage intervention protocol; and 2) the estimation of the changes in QoL and symptoms over time in each group (massage and SMC). The stressors and symptoms of ASCT could potentially reduce cardiac vagal tone, and massage has been demonstrated to stimulate parasympathetic outflow. Thus, the investigators propose a secondary aim to explore the use of power spectral analysis of short-term heart rate variability (HRV) in obtaining preliminary estimates of immediate and/or cumulative changes in parasympathetic tone (high frequency component of HRV) after either massage (treatment group) or rest (SMC group). These analyses will provide the foundation for designing a large multi-site RCT (R01) that will examine the effects and mechanisms of massage therapy for patients with cancer undergoing ASCT