Efficacy of swedish massage therapy on cancer-related fatigue in cancer survivors

描述(由申请人提供)：仅在美国就有大约1200万癌症幸存者，人们越来越关注癌症治疗后的生活质量。癌症相关性疲劳(CRF)是癌症患者最普遍和最虚弱的症状之一。在癌症治疗完成后，它可能会持续数月或数年，并对所有功能领域产生负面影响。CRF有意义的循证治疗选择极其有限，迫切需要找到安全、廉价和有效的干预措施来管理这一令人痛苦的症状。对神经免疫相互作用的基础研究表明，促炎细胞因子可以导致行为的有效变化，包括活动减少、疲劳和社交行为减少。此外，过去十年的研究表明，更多的CRF衰弱水平与促炎细胞因子水平的增加有关。因此，研究在慢性肾功能衰竭时降低促炎性细胞因子、降低hsCRP和增加抗炎性细胞因子的治疗方法是一个合理的干预目标。推拿疗法是发展最快的替代疗法之一，在癌症患者中对症状管理的接受率很高。在对癌症患者进行的较小规模的研究中，按摩被证明可以调节免疫系统。此外，按摩已被证明能显著降低正常受试者的促炎细胞因子。目前还没有公开发表的随机对照试验来检验按摩作为主要治疗慢性肾功能衰竭的干预措施的作用，也没有研究其抗炎作用作为其假想改善慢性肾功能衰竭的机制。这项建议调查了推拿疗法对乳腺癌幸存者同种人群中慢性肾衰的影响。我们的主要假设是，瑞典按摩疗法(SMT)与轻度触摸条件和等待名单对照相比，将减少CRF。我们的第二个假设是SMT将通过降低促炎细胞因子水平、降低hsCRP和增加抗炎细胞因子来改善CRF。我们的主要探索性假设是，CRF的减少将提高癌症幸存者的生活质量。

DESCRIPTION (provided by applicant): With approximately 12 million cancer survivors today in the United States alone, increased attention is being given to quality of life after cancer treatment. Cancer-related fatigue (CRF) is one of the most prevalent and debilitating symptoms experienced by people with cancer. It can persist for months or years after cancer therapy is completed and has a negative impact on all areas of function. Meaningful evidence-based treatment options for CRF are extremely limited and finding safe, inexpensive, and effective interventions for managing this distressing symptom are urgently needed. Basic research on neural-immune interactions has shown that pro-inflammatory cytokines can cause potent changes in behavior including reduced activity, fatigue, and decreased social behavior. Furthermore, research over the last decade has correlated more debilitating levels of CRF with increased levels of pro-inflammatory cytokines. Thus, investigation of therapeutic modalities that may decrease pro-inflammatory cytokines, decrease hsCRP, and increase anti-inflammatory cytokines in the setting of CRF represents a plausible target for intervention. Massage therapy is one of the fastest growing alternative therapies and has a high rate of acceptance for symptom management among cancer patients. Massage has been shown in smaller studies with cancer patients to modulate the immune system. Moreover, massage has been demonstrated to significantly decrease pro-inflammatory cytokines in normal subjects. There are no published randomized controlled trials examining either the role of massage as an intervention primarily for CRF or investigating its anti-inflammatory effects as a mechanism for its hypothesized improvement in CRF. This proposal investigates the effects of massage therapy on CRF among a homogenous group of breast cancer survivors. Our primary hypothesis is that Swedish Massage Therapy (SMT) will decrease CRF compared to a light touch condition and wait list control. Our secondary hypothesis is that SMT will ameliorate CRF by decreasing levels of pro-inflammatory cytokines, decrease hsCRP, and increasing anti-inflammatory cytokines. Our main exploratory hypothesis is that a decrease in CRF will increase quality of life among cancer survivors.