***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To examine the short-term effects of light pressure effleurage on circulating lymphocytes by study ing the number and activity of peripheral blood natural killer ( NK ) cells in patients with breast cancer compared to a control group . Furthermore , the effect of light pressure effleurage on salivary cortisol levels , heart rate and blood pressure was studied . DESIGN Single centre , prospect i ve , r and omized and controlled study . METHODS Thirty women , aged 50 to 75 years ( mean 61 sd=7.2 ) with breast cancer undergoing radiation therapy in a hospital in southwestern Sweden were enrolled in the study . They were allocated to either receive massage in the form of a full-body light pressure effleurage treatment , or a control visit where they were given an equal amount of attention .  Blood sample s , saliva , notation of heart rate and blood pressure were collected before and after massage/control visit . Differences in change over time between groups were analyzed by Student 's t-test . RESULTS Light pressure effleurage massage decreased the deterioration of NK cell activity occurring during radiation therapy . Furthermore it lowered heart rate and systolic blood pressure . No effects were demonstrated on cortisol and diastolic pressure . CONCLUSIONS A single full-body light pressure effleurage massage has a short-term effect on NK cell activity , systolic blood pressure and heart rate in patients with breast cancer . However , the long-term clinical importance of these findings needs to be further investigated A r and omised controlled pilot study was carried out to examine the effects of adjunctive aromatherapy massage on mood , quality of life and physical symptoms in patients with cancer attending a specialist unit . Participants were r and omised  to conventional day care alone or day care plus weekly aromatherapy massage using a st and ardised blend of oils for four weeks . At baseline and at weekly intervals , patients rated their mood , quality of life and the intensity and bother of two symptoms most important to them . Forty-six patients were recruited to the study . Due to a large number of withdrawals , only 11 of 23 ( 48 % ) patients in the aromatherapy group and 18 of 23 ( 78 % ) in the control group completed all four weeks . Mood , physical symptoms and quality of life improved in both groups . There was no statistically significant difference between groups in any of the outcome measures . Despite a lack of measurable benefit , all patients were satisfied with the aromatherapy and wished to continue . Whilst this pilot study has shown that a r and omised controlled trial of complementary therapy is feasible , it has also identified several areas that would require further consideration when design ing future studies , e.g. , the recruitment and retention of appropriate numbers of patients and the outcome measures used BACKGROUND Patients with colorectal cancer are usually treated with chemotherapy , which reduces the number of blood cells , especially white blood cells , and consequently increases the risk of infections . Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by , for example , increasing the numbers of natural killer cells and peripheral blood lymphocytes . However , there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer . The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer , who have received chemotherapy , can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects . MATERIAL S AND METHODS Sixty-six patients with colorectal cancer in Phichit Hospital , Thail and , were enrolled in a single-blind , r and omised-controlled trial . The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period . The control group received st and ard supportive care only . Assessment s were conducted at pre- assessment and at the end of one week of massage or st and ard care . Changes from pre- assessment to the end of treatment were measured in terms of white blood cells , neutrophils , lymphocytes , CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores . RESULTS The main finding was that after adjusting for pre- assessment values the mean lymphocyte count at the post- assessment was significantly higher ( P=0.04 ) in the treatment group than in the controls . The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11 % . The secondary outcomes were that at the post assessment the symptom severity scores for fatigue , presenting symptom , pain and stress were significantly lower in the massage group than in the st and ard care controls . CONCLUSIONS Aromatherapy with light Thai massage can be beneficial for the immune systems of cancer patients who are undergoing chemotherapy by increasing the number of lymphocytes and can help to reduce the severity of common symptoms AIM To test whether reflexology was inferior to aromatherapy massage for ameliorating self-selected problems or concerns . DESIGN Non-blinded , r and omised study with a 1:1 allocation . Adult out patients recruited from a UK cancer centre , r and omised by the minimisation method to either four aromatherapy massage or four reflexology sessions . OUTCOME MEASURES MYCaW scores at baseline and completion ; VAS ( relaxation ) pre and post-sessions . ANALYSIS Unpaired t-test for the primary outcome ; analysis of variance tests for repeated measures for VAS ( relaxation ) ; descriptive statistics ( means and 95 % confidence intervals ) and content analysis for patient comments . RESULTS 115 subjects ( 58 aromatherapy massage , 57 reflexology ) recruited . Reflexology was found to be no less effective than aromatherapy massage for MYCaW first concerns ( p = 0.046 ) . There was no statistical difference between groups for MYCaW second concerns or overall well-being scores , proportions of patients gaining clinical benefit , VAS scores over time ( p = 0.489 ) or between groups ( p = 0.408 ) or in the written responses Women diagnosed with breast cancer received massage therapy or practice d progressive muscle relaxation ( PMR ) for 30-min sessions 3 times a week for 5 weeks or received st and ard treatment . The massage therapy and relaxation groups reported less depressed mood , anxiety , and pain immediately after their first and last sessions . By the end of the study , however , only the massage therapy group reported being less depressed and less angry and having more vigor . Dopamine levels , Natural Killer cells , and lymphocytes also increased from the first to the last day of the study for the massage therapy group . These findings highlight the benefit of these complementary therapies , most particularly massage therapy , for women with breast cancer OBJECTIVES massage can help relieve pain , although empirical evidence is scarce and contradictory . This study aims to assess the effectiveness of a massage protocol in relieving pain in children hospitalized with cancer . METHODS a r and omized , controlled , and single-blind trial was performed in a sample of 52 children aged between 10 and 18 years who were hospitalized in a pediatric cancer ward . The intervention consisted of the implementation of a massage protocol with three sessions of 20 to 30minutes on alternate days over a one-week period . The effectiveness of the protocol was evaluated by assessing pain using the Brief Pain Inventory ( BPI ) , while the effectiveness of each massage session was measured using the Visual Analogue Scale ( VAS ) . RESULTS the massage protocol was only effective in reducing the interference of pain in walking ( p<0.05 ) , although it also contributed to relieve pain and its impact on the children 's activities . After each massage session , the intensity of the pain experienced by the child decreased ( p<0.001 ) . CONCLUSIONS despite the small sample size , massage therapy appears to be a useful intervention in reducing pain in children with cancer . However , there are still questions regarding the effectiveness of this massage protocol . The authors recommend its use due to its contribution to the promotion of the child 's well-being and quality of life The objective of this study was to assess the impact of a Swedish massage intervention on oncology patients '  perceived level of distress . Each patient 's distress level was measured using 4 distinct dimensions : pain , physical discomfort , emotional discomfort , and fatigue . A total of 251 oncology patients volunteered to participate in this nonr and omized single-group pre- and post design study for over a 3-year period at a university hospital setting in southeastern Georgia . The analysis found a statistically significant reduction in patient-reported distress for all 4 measures : pain ( F = 638.208 , P = .000 ) , physical discomfort ( F = 742.575 , P = .000 ) , emotional discomfort ( F = 512.000 , P = .000 ) , and fatigue ( F = 597.976 , P = .000 ) . This reduction in patient distress was observed regardless of gender , age , ethnicity , or cancer type . These results lend support for the inclusion of a complementary massage therapy program for hospitalized oncology patients as a means of enhancing their course of treatment Research suggests that patients with cancer , particularly in the palliative care setting , are increasingly using aromatherapy and massage . There is good evidence that these therapies may be helpful for anxiety reduction for short periods , but few studies have looked at the longer term effects . This study was design ed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer . Forty-two patients were r and omly allocated to receive weekly massages with lavender essential oil and an inert carrier oil ( aromatherapy group ) , an inert carrier oil only ( massage group ) or no intervention . Outcome measures included a Visual Analogue Scale ( VAS ) of pain intensity , the Verran and Snyder-Halpern ( VSH ) sleep scale , the Hospital Anxiety and Depression ( HAD ) scale and the Rotterdam Symptom Checklist ( RSCL ) . We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control , anxiety or quality of life . However , sleep scores improved significantly in both the massage and the combined massage ( aromatherapy and massage ) groups . There were also statistically significant reductions in depression scores in the massage group . In this study of patients with advanced cancer , the addition of lavender essential oil did not appear to increase the beneficial effects of massage . Our results do suggest , however , that patients with high levels of psychological distress  respond best to these therapies PURPOSE The aim of this feasibility study was to examine the use of reflexology lymphatic drainage ( RLD ) in the treatment of breast-cancer related lymphoedema ( BCRL ) with a view to further research . METHODS An uncontrolled trial was conducted with 26 women who had developed lymphoedema in one arm following treatment for breast cancer . Changes in upper-limb volumes and in participant concerns and wellbeing were measured . Qualitative data were also collected . RESULTS A significant reduction in the volume of the affected arm was identified at follow-up compared to baseline . This reduction in volume appeared to be maintained for more than six months . Participant concerns were significantly reduced and their wellbeing significantly increased . No serious adverse effects were reported . CONCLUSIONS RLD may be a useful intervention for BCRL although the results could not be attributed to the reflexology intervention because of research design limitations . The main conclusion was , however , that there was sufficient evidence for further research using a r and omized controlled trial Purpose Cancer patients frequently suffer from psychological comorbidities such as depression and elevated stress . Previous studies could demonstrate that cancer patients benefit from massage therapy on the physical and psychological level . This pilot study investigates the effects of massage on depression , mood , perceived stress , and the Th1/Th2 ratio in breast cancer patients . Methods Thirty-four breast cancer patients were r and omly assigned to a massage group ( n = 17 ) and a control group ( n = 17 ) . Patients of the massage group received two 30-min classical massages per week for 5 weeks . At baseline , at the end of the intervention period , and 6 weeks after the end of intervention , patients of both groups completed the  Perceived Stress Question naire ( PSQ ) , the  Patient Health Question naire ( PHQ ) , and the  Berlin Mood Question naire ( BFS ) and blood was withdrawn for determining cytokine concentrations and the Th1/Th2 ratio . Results Twenty-nine patients were included in the statistical analysis . Depression ( PHQ ) and anxious depression ( BSF ) were significantly reduced immediately after massage compared to the control group . Stress ( PSQ ) and elevated mood ( BSF ) did not show significant alterations after massage therapy .  Changes of cytokine concentrations and Th1/Th2 ratio were insignificant as well , although there was a slight shift towards Th1 in the massage group over time . Conclusions Massage therapy is an efficient treatment for reducing depression in breast cancer patients . Insignificant results concerning immunological parameters , stress , and mood indicate that further research is needed to determine psychological and immunological changes under massage therapy OBJECTIVES The aim of the present study was to examine the effect of massage on nausea , anxiety , and depression in patients with breast cancer undergoing chemotherapy . DESIGN This work was a single-center , prospect i ve , r and omized , controlled trial . SETTING S/LOCATION This study was conducted in an oncology clinic , in a hospital in southwestern Sweden . SUBJECTS Thirty-nine ( 39 ) women ( mean age = 51.8 ) with breast cancer undergoing chemotherapy were enrolled . INTERVENTIONS The patients were r and omly assigned to a massage therapy group ( 20 minutes of massage on five occasions ) or a control group ( five 20-minute visits ) . OUTCOME MEASURES All patients recorded nausea and anxiety on the Visual Analogue Scale before and after each intervention . They also completed the Hospital Anxiety and Depression 
    Output:
    
Furthermore , this review demonstrated no differences in effects of massage on depression , mood disturbance , psychological distress , nausea , fatigue , physical symptom distress , or quality of life when compared with no massage .
There was some indication of benefit in the aromatherapy-massage group but this benefit is unlikely to translate into clinical benefit .
Massage with aromatherapy versus massage without aromatherapy groupsFrom the limited evidence available , we were unable to assess the effect of adding aromatherapy to massage on the relief of pain , psychological symptoms including anxiety and depression , physical symptom distress , or quality of life .
AUTHORS ' CONCLUSIONS There was a lack of evidence on the clinical effectiveness of massage for symptom relief in people with cancer .