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Effects of live music during chemotherapy in lymphoma patients: a randomized, controlled, multi-center trial

Abstract

Purpose

Chemotherapy is associated with both somatic and psychological side effects. Music might ease these problems. Several randomized controlled trials have investigated the effect of music, but the results are inconclusive. We aimed to examine whether live or pre-recorded music listening decreases anxiety during chemotherapy in newly diagnosed lymphoma patients.

Methods

A total of 143 patients with non-Hodgkin and Hodgkin lymphomas were randomly assigned into three groups receiving either 30 min of patient-preferred live music (n = 47), 30 min of patient-preferred pre-recorded music (n = 47), or standard care (n = 49) during up to five outpatient chemotherapy sessions. The primary endpoint was anxiety measured by the Spielberger’s State Anxiety Inventory. Secondary endpoints included blood pressure, pulse rate, nausea and vomiting, serum catecholamine levels pre- and post-intervention to measure arousal levels, and health-related quality of life. The Musical Ability Test was used to link musical ability to the primary endpoint.

Results

When adjusting for age, sex, diagnosis, number of sessions, and baseline anxiety, the linear mixed model showed a borderline statistically significant reduction in the primary outcome anxiety in the live music group compared to standard care (7% (95% CI, − 14% to 0%, p = 0.05), while the effect of pre-recorded music was non-significant (5% (95% CI, − 12% to + 3%, p = 0.18). No intervention effects were seen in secondary outcomes.

Conclusion

Our findings suggest that patient-preferred live music reduces anxiety among patients with malignant lymphomas undergoing chemotherapy. Musical ability among this group of cancer patients seems not to be a determining factor for effect of music intervention.

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Acknowledgements

The authors wish to thank all the patients who participated in this study as well as project nurses, medical students, and physicians for their valuable contributions to recruitment, planning, data collection, and completion. Further, thanks to all the musicians for offering professional and unique musical moments to the individual cancer patient.

Funding

The Hospital of Southwest Jutland, The Danish National Academy of Music, Region of Southern Denmark, The Danish Cancer Society Research Center, The Danish National Research Foundation (DNRF 117), Familien Hede Nielsens Fond, Karola Joergensens Forskningsfond, Roche.dk, HiFi-Klubben, Juhl-Soerensen A/S, Sønderjyllands Symphony Orchestra, Aarhus Symphony Orchestra, and Copenhagen Phil supported this study.

Author information

Correspondence to Margrethe Langer Bro.

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Conflict of interest

The authors have no financial relationships to disclose. The corresponding author has full control of all data of this article and allows Supportive Care of Cancer to review the data, if requested.

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Appendix 1

Appendix 1

  1. 1)

    What is your favorite musical style(s) for the research project?

    a. Classical, b. Jazz, c. Folk, d. Pop, e. Rock, f. Other

  2. 2)

    List the names of your favorite artists and/or favorite music pieces

  3. 3)

    Which constellation of musicians do you prefer?

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Bro, M.L., Johansen, C., Vuust, P. et al. Effects of live music during chemotherapy in lymphoma patients: a randomized, controlled, multi-center trial. Support Care Cancer 27, 3887–3896 (2019). https://doi.org/10.1007/s00520-019-04666-8

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Keywords

  • Cancer
  • Hodgkin lymphoma
  • Non-Hodgkin lymphoma
  • Chemotherapy
  • Anxiety
  • Music intervention
  • RCT