Music Calms Anxiety, Boosts Mood for Cancer Patients

By Emily P. Walker, Washington Correspondent | MedPage Today | Published: August 10, 2011 | Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Action Points

Note that this study reviews the literature to determine whether there is evidence of benefit in music medicine interventions.

Point out that this review did find evidence of a beneficial effect on anxiety, pain, mood, and quality of life.

Listening to music reduced anxiety and pain in cancer patients and helped improve their mood and quality of life, according to a systematic review.

However, incorporating music into the treatment of cancer patients had no effect alleviating depression, according to the study published this week in the Cochrane Database of Systematic Reviews

The field of incorporating music into medicine has grown over the past two decades, and music therapy has now been linked to decreasing anxiety and distress of patients on mechanical ventilators; decreasing anxiety of heart disease patients; decreasing tension during chemotherapy or radiation; improving mood and quality of life; and improving immune system functioning.

For the current study, a team of music therapists led by Joke Bradt, PhD, of the Department of Creative Arts Therapies at Drexel University in Philadelphia, performed a literature review of 30 trials with a total of 1,891 cancer patients who underwent music therapy interventions as part of their treatment.

The researchers reviewed 17 trials that involved a medical professional merely playing pre-recorded music for the patient, which is referred to as “music medicine,” and 13 trials that involved “music therapy” in which trained music therapists actively engaged the patient in a personally-tailored music and therapy experience, which may have included listening to live music or playing an instrument.

They found that both music interventions appeared to be more effective at reducing anxiety than no music or white noise or nature sounds delivered through headphones.

Patients in seven trials that tested music’s ability to alleviate anxiety achieved average reductions of 11.20 units on a widely-used scale that measures anxiety (95% CI -19.59 to -2.82, P=0.009).

Music had a positive impact on mood (95% CI 0.03 to 0.81, P=0.03) as well as small reductions in heart rate, respiratory rate, and blood pressure.

Patients who were exposed to music medicine or music therapy were also less were also slightly more likely to report that they felt less pain during a cancer-related procedure than those who didn’t listen to music (95% CI -0.92 to -0.27, P=0.0003).

In addition, pooled results from two trials indicated music therapy has a positive effect on patients’ quality of life (P=0.0001).

“Evidence of the trials included in this review suggest that music interventions may be offered as a complementary treatment to people with cancer,” the authors concluded.

What music didn’t appear to help was depression.

Five studies all showed that incorporating music into the treatment of cancer patients did nothing to help with their depression. Depression occurs more often in cancer patients than in the general public, and may increase a patient’s likelihood of dying of cancer, a 2009 meta-analysis suggested.

Bradt and colleagues said there wasn’t enough data to draw any conclusions on the effect of music interventions on distress, body image, oxygen saturation level, immunologic functioning, spirituality, or communication outcomes.

Nor were they able to tease out differences in effect between the two types of music interventions — simply having music played or active intervention of music therapists who “carefully select music interventions to offer emotional and spiritual support, support communication with loved ones, enhance sense of control, and improve physical well-being in patients with cancer.”

They did note, however, that one study uncovered the fact that many patients didn’t like listening to music via headphones during a procedure, because they couldn’t hear what the doctor was saying, which causes anxiety and could actually increase the perception of pain.

Researchers should “carefully consider the potential negative impact of the use of headphones during procedures …” the authors wrote.

They also called for more research to test music interventions that take into account the patient’s musical preference; test frequency and duration of music and its effect; and test music therapy in children with cancer.

The authors reported no financial conflicts of interest.

Primary source: Cochrane Database of Systematic Reviews
Source reference:
Bradt J, et al “Music interventions for improving psychological and physical outcomes in cancer patients” Cochrane Database Syst Rev 2011; DOI: 10.1002/14651858.CD006911.pub2.