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

描述（由申请人提供）：今天仅在美国就有大约1200万癌症幸存者，越来越多的关注被给予癌症治疗后的生活质量。癌症相关性疲劳（CRF）是癌症患者经历的最普遍和最令人衰弱的症状之一。它可以在癌症治疗完成后持续数月或数年，并对所有功能领域产生负面影响。针对CRF的有意义的循证治疗选择非常有限，迫切需要找到安全，廉价和有效的干预措施来管理这种令人痛苦的症状。对神经免疫相互作用的基础研究表明，促炎细胞因子可引起行为的强烈变化，包括活动减少、疲劳和社交行为减少。此外，过去十年的研究已经将CRF的更多衰弱水平与促炎细胞因子水平的增加相关联。因此，在CRF的情况下，对可能降低促炎细胞因子、降低hsCRP和增加抗炎细胞因子的治疗方式的研究代表了合理的干预目标。按摩疗法是发展最快的替代疗法之一，在癌症患者中具有很高的接受率。按摩已被证明在较小的研究与癌症患者调节免疫系统。此外，按摩已被证明可以显着降低正常受试者的促炎细胞因子。目前还没有发表的随机对照试验研究按摩作为CRF主要干预措施的作用，或研究其抗炎作用作为CRF假设改善的机制。本研究旨在调查按摩疗法对同种乳腺癌幸存者CRF的影响。我们的主要假设是，瑞典按摩疗法（SMT）将减少CRF相比，轻触摸条件和等待名单控制。我们的次要假设是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.