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Supportive Care in Cancer

, Volume 20, Issue 12, pp 3043–3053 | Cite as

Music interventions for psychological and physical outcomes in cancer: a systematic review and meta-analysis

  • Jun-Mei Zhang
  • Pu Wang
  • Jia-xin Yao
  • Lei Zhao
  • Mellar P. Davis
  • Declan Walsh
  • Guang H. YueEmail author
Review Article

Abstract

Purpose

A systematic review and meta-analysis to examine the effect of music interventions on psychological and physical outcome measures in cancer patients.

Methods

We searched six English-language databases and three major Chinese-language databases in March 2011. Nine databases were reviewed from 1966 or the start of the database to March 2011. All randomized controlled trials comparing music intervention with standard care, other interventions, or placebo for psychological and physical outcomes in cancer were included. Study quality was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation Working Group. We then performed a meta-analysis of music interventions for psychological and physical outcomes in cancer.

Results

Of 322 total studies found, 32 randomized trials (3181 participants) met the inclusion criteria. Seven high-quality studies indicated music had positive effects on coping anxiety assessed by the Self-Rating Anxiety Scale. Two moderate-quality studies suggested music reduced anxiety assessed by the Hamilton Anxiety Scale. Eight moderate-quality studies revealed music lowered anxiety assessed by the Spielberger State-Trait Anxiety Inventory. Seven moderate-quality studies demonstrated that music improved depression. Seven moderate-quality studies observed that music had positive effects on pain management. Two moderate-quality studies suggested music worsened fatigue. Four moderate-quality studies indicated music lowered heart rate. Three low-quality studies suggested music could reduce respiratory rate. Two moderate-quality studies indicated that music improved quality of life.

Conclusions

Individual randomized trials suggest that music intervention is accepted by patients and associated with improved psychological outcomes. The effects of music on vital signs especially blood pressure are small. High-quality trials are needed to further determine the effects of music intervention.

Keywords

Cancer Music Outcome Physical Psychological Music medicine Music therapy Music intervention 

Notes

Authors’ disclosures of potential conflicts of interest

The author(s) indicated no potential conflicts of interest.

References

  1. 1.
    Walsh D, Donnelly S, Rybicki L (2000) The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer 8:175–179PubMedCrossRefGoogle Scholar
  2. 2.
    van’t Spijker A, Trijsburg RW, Duivenvoorden HJ (1997) Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med 59:280–293Google Scholar
  3. 3.
    Norton TR, Manne SL, Rubin S et al (2004) Prevalence and predictors of psychological distress among women with ovarian cancer. J Clin Oncol 22:919–926PubMedCrossRefGoogle Scholar
  4. 4.
    Sellick SM, Crooks DL (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology 8:315–333PubMedCrossRefGoogle Scholar
  5. 5.
    Massie MJ (2004) Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57–71PubMedCrossRefGoogle Scholar
  6. 6.
    Parle M, Jones B, Maguire P (1996) Maladaptive coping and affective disorders among cancer patients. Psychol Med 26:735–744PubMedCrossRefGoogle Scholar
  7. 7.
    Raison CL, Miller AH (2003) Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 54:283–94PubMedCrossRefGoogle Scholar
  8. 8.
    Thune-Boyle IC, Myers LB, Newman SP (2006) The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behav Med 32:9–29CrossRefGoogle Scholar
  9. 9.
    Tascilar M, de Jong FA, Verweij J et al (2006) Complementary and alternative medicine during cancer treatment: beyond innocence. Oncologist 11:732–741PubMedCrossRefGoogle Scholar
  10. 10.
    Burns J, Labbé E, Williams K et al (1999) Perceived and physiological indicators of relaxation: as different as Mozart and Alice in chains. Appl Psychophysiol Biofeedback 24:197–202PubMedCrossRefGoogle Scholar
  11. 11.
    Haun M, Mainous RO, Looney SW (2001) Effect of music on anxiety of women awaiting breast biopsy. Behav Med 27:127–132PubMedCrossRefGoogle Scholar
  12. 12.
    Sendelbach SE, Halm MA, Doran KA et al (2006) Effects of music therapy on physiological and psychological outcomes for patients undergoing cardiac surgery. J Cardiovasc Nurs 21:194–200PubMedGoogle Scholar
  13. 13.
    Chikamori F, Kuniyoshi N, Shibuya S et al (2004) Perioperative music therapy with a key-lighting keyboard system in elderly patients undergoing digestive tract surgery. Hepatogastroenterology 51:1384–1386PubMedGoogle Scholar
  14. 14.
    Lin PC, Lin ML, Huang LC et al (2011) Music therapy for patients receiving spine surgery. J Clin Nurs 20:960–968PubMedCrossRefGoogle Scholar
  15. 15.
    Leardi S, Pietroletti R, Angeloni G et al (2007) Randomized clinical trial examining the effect of music therapy in stress response to day surgery. Br J Surg 94:943–947PubMedCrossRefGoogle Scholar
  16. 16.
    Clark M, Isaacks-Downton G, Wells N et al (2006) Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. J Music Ther 43:247–65PubMedGoogle Scholar
  17. 17.
    Ferrer AJ (2007) The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment. J Music Ther 44:242–55PubMedGoogle Scholar
  18. 18.
    Bulfone T, Quattrin R, Zanotti R et al (2009) Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. Holist Nurs Pract 23:238–242PubMedGoogle Scholar
  19. 19.
    Frank JM (1985) The effects of music therapy and guided visual imagery on chemotherapy induced nausea and vomiting. Oncol Nurs Forum 12:47–52PubMedGoogle Scholar
  20. 20.
    Bozcuk H, Artac M, Kara A et al (2006) Does music exposure during chemotherapy improve quality of life in early breast cancer patients? A pilot study. Med Sci Monit 12:200–205Google Scholar
  21. 21.
    Ezzone S, Baker C, Rosselet R et al (1998) Music as an adjunct to antiemetic therapy. Oncol Nurs Forum 25:1551–1556PubMedGoogle Scholar
  22. 22.
    Murrock CJ (2002) The effects of music on the rate of perceived exertion and general mood among coronary artery bypass graft patients enrolled in cardiac rehabilitation phase II. Rehabil Nurs 27:227–231PubMedCrossRefGoogle Scholar
  23. 23.
    Cassileth BR, Vickers AJ, Magill LA (2003) Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation: a randomized controlled trial. Cancer 98:2723–2729PubMedCrossRefGoogle Scholar
  24. 24.
    Sarkamo T, Tervaniemi M, Laitinen S et al (2008) Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 131:866–876PubMedCrossRefGoogle Scholar
  25. 25.
    Barrera ME, Rykov MH, Doyle SL (2002) The effects of interactive music therapy on hospitalized children with cancer: a pilot study. Psychooncology 11:379–388PubMedCrossRefGoogle Scholar
  26. 26.
    Burns DS (2001) The effect of the bonny method of guided imagery and music on the mood and life quality of cancer patients. J Music Ther 38:51–65PubMedGoogle Scholar
  27. 27.
    Bailey LM (1986) Music therapy in pain management. J Pain Symptom Manage 1:25–28PubMedCrossRefGoogle Scholar
  28. 28.
    Beck SL (1991) The therapeutic use of music for cancer-related pain. Oncol Nurs Forum 18:1327–37PubMedGoogle Scholar
  29. 29.
    Cepeda MS, Carr DB, Lau J et al (2006) Music for pain relief. Cochrane Database Syst Rev 2:CD004843PubMedGoogle Scholar
  30. 30.
    Ferguson SL, Voll KV (2004) Burn pain and anxiety: the use of music relaxation during rehabilitation. J Burn Care Rehabil 25:8–14PubMedCrossRefGoogle Scholar
  31. 31.
    Burns SJ, Harbuz MS, Hucklebridge F et al (2001) A pilot study into the therapeutic effects of music therapy at a cancer help center. Altern Ther Health Med 7:48–56PubMedGoogle Scholar
  32. 32.
    Hamai A, Benlalam H, Meslin F et al (2010) Immune surveillance of human cancer: if the cytotoxic T-lymphocytes play the music, does the tumoral system call the tune? Tissue Antigens 75:1–8PubMedCrossRefGoogle Scholar
  33. 33.
    Urakawa K, Yokoyama K (2004) Can relaxation programs with music enhance human immune function? J Altern Complement Med 10:605–606PubMedCrossRefGoogle Scholar
  34. 34.
    Hilliard RE (2003) The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther 40:113–37PubMedGoogle Scholar
  35. 35.
    Dileo C (1999) A classification model for music and medicine. National Association of Music Therapy, Washington, DC, pp. 1–6Google Scholar
  36. 36.
    Dileo C (2006) Effects of music and music therapy on medical patients: a meta-analysis of the research and implications for the future. J Soc Integr Oncol 4:67–70PubMedCrossRefGoogle Scholar
  37. 37.
    Guyatt G, Oxman AD, Akl EA et al (2011) GRADE guidelines: introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64:383–394PubMedCrossRefGoogle Scholar
  38. 38.
    Higgins JPT, Green S (eds) (2006) Cochrane Handbook for Systematic Reviews of Interventions, section 6.7.1., version 4.2.6. [updated Sept 2006]. The Cochrane Library, issue 4. Wiley, Chichester.Google Scholar
  39. 39.
    Review Manager (RevMan) [Computer program] Version 5.0. Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration. 2008. Available at: www.cc-ims.net/RevMan
  40. 40.
    Cai GR, Li PW, Jiao LP (2001) Clinical observation of music therapy combined with anti-tumor drugs in treating 116 cases of tumor patients. Zhongguo Zhong Xi Yi Jie He Za Zhi 21:891–894PubMedGoogle Scholar
  41. 41.
    Li HM, Wang YQ, Yang ZH (2007) Effect of background music on anxiety and depression of patients during thermotherapy of cancer. Nursing Journal of Chinese People’s Liberation Army 24:16–17Google Scholar
  42. 42.
    Liu L, Qu AW, Zeng ZF (2003) The influence of background music for tumour patients’ anxiety when waiting for the surgery. J Clin Nurs 2:56–57Google Scholar
  43. 43.
    Shen S (2006) Music intervention reduce breast tumor patients’ anxiety before outpatient surgery. Henan Journal of Surgery 12:7–8Google Scholar
  44. 44.
    Wang YY (2006) The research of music therapy reduce anxiety and stress of patients with lung cancer before operation. Chinese Journal of Practical Nursing 22:14–15Google Scholar
  45. 45.
    Yang XH (2008) Influence of music therapy on the anxiety and immunity of patients with gastric cancer during chemotherapy. Chinese Journal of Practical Nursing 24:11–13Google Scholar
  46. 46.
    Yang XH, Jing ZP (2008) Music therapy to reduce cancer patients’ discomfort during chemotherapy. Health Vocational Education 26:149–150Google Scholar
  47. 47.
    Zhang WZ, Zhao YL (2010) The influence of music therapy on cancer patients’ emotions during chemotherapy. Nursing Pratice and Research 7:25–26Google Scholar
  48. 48.
    Zhao PT, Liang J, Shao QJ et al (2008) Interventional effects of musical therapy to physiological and psychological conditions in process of radiotherapy for patients with cancer. Chinese Journal of Cancer Prevention and Treatment 15:1097–1099Google Scholar
  49. 49.
    Cao CQ (2007) The effect of music therapy in the course of thermotherapy for cancer patients. J Nurs Adm 7:28Google Scholar
  50. 50.
    Kwekkeboom KL (2003) Music versus distraction for procedural pain and anxiety in patients with cancer. Onc Nurs Forum 30:433–440CrossRefGoogle Scholar
  51. 51.
    Nguyen TN, Nilsson S, Hellström SL et al (2010) Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: a randomized clinical trial. J Pediatr Oncol Nurs 27:146PubMedCrossRefGoogle Scholar
  52. 52.
    Wan YH, Mao ZF, Qiu YR (2009) Influence of music therapy on anxiety, depression and pain of cancer patients. Can J Nurs Res 5:1172–1175Google Scholar
  53. 53.
    Liu AM, Jia T, Liu XM et al (2006) Music relaxing therapy on psychological status of the patients with malignant tumors subject to radiofrequency heat therapy. Journal of Nursing Science 21:60–61Google Scholar
  54. 54.
    Lu ZQ, Hu Y (2010) The effect of music relaxation therapy on the adverse reactions induced by chemotherapy in patients with breast cancer. Chinese Journal of Nursing 5:405–408Google Scholar
  55. 55.
    Zhang YW (2010) Effect of music and mood relaxation training for anxiety reduction in patients with breast tumor before operation. Cancer Research and Clinic 22:692–694Google Scholar
  56. 56.
    Xu LT, Han JH, Le YQ et al (2008) The impact of music therapy on cancer patients’ pain and depression. Chinese Journal of Practical Nursing 24(Supplement 2):2Google Scholar
  57. 57.
    Zhou KN, Li XM (2010) The effectiveness of music therapy reduces breast cancer patients’ depression and time of hosptalization after eradicative operation. Chinese Journal of Practical Nursing 26:55–57Google Scholar
  58. 58.
    Bi XQ, Li JP, Zhao FR et al (2007) Music therapy to release pains for patients with maxillofacial cancer. Chinese Journal of Practical Nursing 23:38–40Google Scholar
  59. 59.
    Fan YY, Hu W, Xiao CQ et al (2008) Application of music therapy in patients with nasopharyngeal carcinoma during radiotherapy. Chinese Journal of Practical Nursing 24:3Google Scholar
  60. 60.
    Wu YF (2009) The influence of background music on the psychological status of patients with breast cancer during operation. Hei Longjiang Medical Journal 9:709–710Google Scholar
  61. 61.
    Zhou KN, Li XM (2010) Effect of music therapy on pain of breast cancer patients after radical mastectomy. Chinese Journal of Nursing 12:1086–1088Google Scholar
  62. 62.
    Huang ST, Good M, Zauszniewski JA (2010) The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial. Int J Nurs Stud 47:1354–1362PubMedCrossRefGoogle Scholar
  63. 63.
    Hanser SB, Wu SB, Kubicek L et al (2006) Effects of a music therapy intervention on quality of life and distress in women with metastatic breast cancer. J Soc Integr Oncol 4:116PubMedCrossRefGoogle Scholar
  64. 64.
    Xie Z, Huang G (2001) The influence of music therapy plus relaxation method on the quality of life of cancer patients during chemotherapy. Chinese Mental Health Journal 15:176–178Google Scholar
  65. 65.
    Lai HL, Good M (2002) The overview of music therapy. The Journal of Nursing 49:80–84Google Scholar
  66. 66.
    Chlan LL (1998) Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilatory assistance. Heart Lung 27:169–176PubMedCrossRefGoogle Scholar
  67. 67.
    Chlan LL (2000) Music therapy as a nursing intervention for patient supported by mechanical ventilation. American Association of Critical Care Nurse 11:128–138Google Scholar
  68. 68.
    Chin CC, Good M (1994) The effect of western music on postoperative pain in Taiwan. Kaohsiung Journal of Medical Science 14:94–103Google Scholar
  69. 69.
    Lai HL (2004) Music preference and relaxation in Taiwanese elderly people. Journal of Geriatric Nursing 25:286–291CrossRefGoogle Scholar
  70. 70.
    Vanderark SD, Ely D (1993) Cortisol, biochemical and galvanic skin responses to music stimuli of different preference values by college students in biology and music. Perceptual and Motor Skill 77:227–234CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jun-Mei Zhang
    • 1
    • 6
  • Pu Wang
    • 2
  • Jia-xin Yao
    • 3
  • Lei Zhao
    • 4
  • Mellar P. Davis
    • 5
  • Declan Walsh
    • 5
  • Guang H. Yue
    • 6
    • 7
    Email author
  1. 1.Department of Sports, Wuhan University of TechnologyWuhanChina
  2. 2.Department of Physical Medicine and RehabilitationZhongnan Hospital of Wuhan UniversityWuhanChina
  3. 3.Tianjin Sport UniversityTianjinChina
  4. 4.State Key Lab of VirologyWuhan UniversityWuhanChina
  5. 5.The Harry R. Horvitz Center for Palliative Medicine, Section of Palliative Medicine and Supportive OncologyCleveland Clinic, Taussig Cancer InstituteClevelandUSA
  6. 6.Department of Biomedical Engineering/ND20Cleveland ClinicClevelandUSA
  7. 7.Physical Medicine and RehabilitationCleveland ClinicClevelandUSA

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