Music as an Alternative

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Music therapy as an alternative and complimentary method to manage cancer pain in adult patients

Introduction

The purpose of this article was to explore the effectiveness of using music therapy as an alternative method in managing pain in cancer patients. There is an increase in the prevalence of patients diagnosed with cancer every year with an estimated 12 million new diagnosis yearly worldwide.1 A patient’s perception of pain can be affected by various attributes such as the patients age, sex, race, psychological state, previous pain experiences, etc., which makes it extremely difficult to find one universal solution to manage pain in all patients. Despite advances in pain neurophysiology, assessment, and treatment, the burden of cancer pain is significant and one of the most common and distressing symptoms in patients diagnosed with cancer.1 An article in the journal Practical Pain Management states that, pain continues to be the most important undertreated symptom in end-stage cancer patients, with 50% to 90% of patients experiencing cancer-related pain.2 Cancer pain is a complex problem which needs priority intervention from health care providers. Unfortunately, current management of cancer pain is solely focused on biomedical issues, with primary emphasis on pharmacological interventions. The current method of pain management has been shown to be an ineffective intervention in managing the symptoms of pain. In adjunct to pharmacologic measures, non-pharmacological methods may be used to help control pain in cancer patients. Evidence based practice must be used in order to find a definite solution to this on-going problem. Evaluation of the effect music has on cancer pain is essential to recognize breaches within the current procedure. This will eventually allow health care providers and organizations to promote or dissuade music as an alternative method in managing cancer pain. The implication of music an alternative method of pain management can be helpful to both patients and organizations alike because it can be used as an inexpensive, nontoxic, noninvasive and easy to apply method that can be individualized to the patients liking.

Findings

For the purpose of this study, various papers were examined in order to find a definite answer to what effect music therapy will have on cancer pain. Many studies have shown that music therapy can make a difference in the way patients cope with and feel about their disease. Unlike Music, music therapy requires specialization in the field. Music therapy may be implemented by a music therapist who may use various instruments and modify the session based on the particular patient. A study conducted by Malgorzata Monica Stanczyk showed that there are two types of music therapy, active (interactive) and receptive (passive).3 In the active form of patients are musically engaged and encouraged to create or describe their experiences with music. Receptive forms of music therapy involve the patient simply listening to either live or recorded music. She concluded that passive/receptive form of therapy can be easily integrated into clinical situation where music can be used as a distraction method to keep patients mind away from the therapy which will help them cope with high levels of stress, pain, and fear associated with the disease process. Music therapy may be defined in multiple ways, however, the purpose of it does not change.4 The main idea of practicing music therapy is to benefit from therapeutic aspects of music. According to the American Music Therapy Association, Music Therapy uses music to address physical, emotional, cognitive, and social needs of patients of all ages and abilities.4 Music therapy interventions can be designed to promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication, and promote physical rehabilitation. Another study conducted by AnnMarie Keenan and Joyce Keithley confirmed that patients reported a decrease in pain that was twice as great for music in comparison to patients that did not receive music therapy and that patients that received music therapy requested less analgesics and opioids on average.1

Nursing Implications

Many studies have shown that music therapy can be successful in pain management with cancer patients. Nurses can advocate for their patients and recommend alternative methods such as music therapy which can help patients immensely on their road to recovery. Therapies such as this can change cancer pain management so that patients aren’t reliant on opioids as their first line of treatment.5 Although many studies have shown the effectiveness of music therapy and other nonpharmacological interventions, more studies are needed to get a more comprehensive understanding of the matter. Nurse researchers should continue to evaluate the potentials of using music in various setups to relieve cancer pain in order to come up with a more informed conclusion.

Conclusion

Pain is one of the most dreadful cancer related symptom. With the increased rate of unrelieved cancer pain, it is time to investigate alternative methods to alleviate patients from this awful symptom. Many studies were conducted, and they all concluded that music therapy is an effective method to help alleviate cancer pain. This method works mainly by acting as a distraction method to help patients get their mind away from the pain associated with the disease. Music therapy can be a breakthrough in managing cancer pain because it is a simple nontoxic, noninvasive, and cost-efficient method that is readily available.6 Establishing the usefulness of alternative therapies such as music therapy should be a priority in the field of oncology. A greater understanding of the area will allow healthcare providers to offer patients with chronic cancer pain a nonpharmacological evidence-based intervention to manage pain.

References

  1. Keenan A, Keithley JK. Integrated review: effect of music on cancer pain in adults. Oncology Nursing forum. 2015; 42(6): 368-375. doi:10.1188/15.ONF.E368-E375
  2. Zahid S, Koa J, Goldstein L. Managing cancer-related pain: A look at alternative approaches. Practical Pain management. 2017: 17(3): 8-10. https://www.practicalpainmanagement.com/pain/cancer/managing-cancer-related-pain-look-alternative-approaches?page=0,1 Accessed 11/4/2018
  3. Stanczyk MM. Music therapy in supportive cancer care. Report of Practical Oncology and Radiotherapy. 2011; 16(5):170-172. doi:10.1016/j.rpor.2011.04.005.
  4. American Music Therapy Association. What is music therapy 2018. https://www.musictherapy.org/about/musictherapy/. Assessed November 3, 2018.
  5. Hui D, Bruera E. A personalized approach to assessing and managing pain in patients with cancer. Journal of Clinical Oncology. 2014;32(16):1640-1646. doi:10.1200/jco.2013.52.2508.
  6. Eaton LH, Brant JM, McLeod K, Yeh C. Nonpharmacologic pain interventions. Clinical Journal of Oncology Nursing. 2017; 21(3): 54-79. doi:10.1188/17.CJON.S3.54-70.
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About Author

Mary Cibil, RN, BSN, OCN

Mary Cibil is currently a Clinical Nurse at Tampa General Hospital

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