illustration by Medical Art Group
Study investigates music’s ability to soothe
Can the soothing sounds of classical music or the upbeat rhythm of rock and roll ease the symptoms associated with radiation therapy for cancer patients undergoing treatment? That is what research from the Vanderbilt University School of Nursing and the Vanderbilt-Ingram Cancer Center has sought to uncover for the last several years.
The study involved 63 cancer patients undergoing daily radiation therapy at the Cancer Center who agreed to participate in music therapy intervention during the course of their treatment. Patients first met with a music therapist, during which time the patient could choose the music to be played during the intervention. Patients were then told they could use the music as often as they wanted over the course of their radiation, using a tape cassette provided as part of the study.
“A few previous studies have looked at this using music as a background in the radiation department, but we wanted to be more specific in this study and allow patients to select the music,” said Nancy Wells, D.N.S.c., R.N., director of Nursing Research at VUMC and research professor of Nursing. Music therapy experts say allowing patients to listen to music they prefer has been shown to provide more positive outcomes.
Wells partnered with Carol Eck, M.B.A., R.N., administrative director of the Cancer Patient Care Center, Sheryl Redlin-Frazier, R.N., staff nurse educator in Obstetrics, Gloria Isaacs-Downton, a certified music therapist, and Michael Clark, director of music therapy at Tennessee Tech University and primary investigator on the study.
Patients were reviewed at the beginning, middle, and again at the end of treatment for effects the music intervention might have had on anxiety, depression, distress, fatigue and pain over the course of their radiation therapy.
“Patients who did listen to the music more often reported a greater decline in distress over time,” said Wells. “Distress declined and remained steady.” Wells noted that anxiety levels also declined over time, but surprisingly, she said there was no impact on pain. “We found no significant effect on pain, which contradicts the previous literature in this area, and could be due to our small sample size,” Wells said. Depression and fatigue also did not appear to be impacted by listening to music in this study.
Isaacks-Downton said many patients chose to listen to popular styles of music like country or gospel, some chose jazz music, and a few chose classical. “It really varied. Some people asked me for classic rock and a few asked for music in the style of Metallica,” which she said was surprising. Although this study did not look at whether the type of music that was selected had an impact on the patients' symptoms, Isaacks-Downton said 60 beats per minute is the optimal choice for healing.
“Your body adjusts to the tempo of the music. So, generally speaking, if you want the heart rate to be at 60, you want to adjust the music to that pace.” She said listening to non-vocal music has also been shown to help people relax more, and the optimal choice among music therapists is to perform the music live, rather than recorded. “Because the music therapist can change what they are playing to reflect the changing mood of the patient,” said Isaacks-Downton.
Because of constraints involved with radiation therapy, patients were not able to listen to the music by headset during their actual radiation treatment. However, they were able to listen to the music immediately before or after treatment, in the car on the way to their clinic appointment, or during other times of stress or heightened emotions related to their cancer treatment. “Using music not only helps to relax patients, but it provides a distraction before and after treatment. While in this study the patients could not use the headsets during the actual treatment, I frequently see patients receiving chemotherapy listening to music during their treatment,” said Eck.
Redlin-Frazier said she's sees a place for music and other alternative or complimentary options for patients at VUMC. “There are other ways to calm, relax, and minimize side effects that don't involve an expensive shot or introducing another chemical to the human body,” said Redlin-Frazier. “Music is very individualized and offers a variety of choices. That simple act of focusing on something else might be enough to beneficially improve the outcome of someone's disease treatment,” she added.
Clark said in the future he hopes more research will uncover the direct physiological effects music is believed to have on the brain. “Much basic research has already identified rhythm as, perhaps, the most influential component of music. It's much more than soothing,” Clark said. “The rhythm of music is known to be able to 'prime' motor areas of the brain, and to drive the coordination required for complex motor activities. The emotional component of music also facilitates brain functioning because of the influence of 'emotion networks' in the brain on other areas,” he added.
Patients also noted that they used other relaxation techniques during the course of their treatment, including deep breathing, imagery, and muscle relaxing exercises. Funding for the study was provided by the American Music Therapy Association (Arthur Flagler Fultz Research Fund), Sigma Theta Tau's Iota Chapter, and the Joint Center for Nursing Research.