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

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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

Authors and Affiliations

  1. The Danish National Academy of Music, Odense, Denmark

    Margrethe Langer Bro

  2. Institute of Regional Health Science, University of Southern Denmark, J. B. Winsløws Vej 19, 5000, Odense, Denmark

    Margrethe Langer Bro

  3. Unit of Survivorship, Danish Cancer Society Research Center, Copenhagen, Denmark

    Christoffer Johansen

  4. Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Christoffer Johansen

  5. Center for Music in the Brain, Institute of Clinical Medicine, Aarhus University and The Royal Academy of Music, Aarhus/Aalborg, Denmark

    Peter Vuust

  6. Department of Haematology, Herlev Hospital, Herlev, Denmark

    Lisbeth Enggaard

  7. Department of Haematology, Roskilde Hospital, Roskilde, Denmark

    Bodil Himmelstrup

  8. Department of Haematology, Hospital of Southwest Denmark, Esbjerg, Denmark

    Torben Mourits-Andersen

  9. Department of Haematology, Rigshospitalet, Copenhagen, Denmark

    Peter Brown

  10. Department of Haematology, Aarhus University Hospital, Aarhus, Denmark

    Francesco d’Amore

  11. Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark

    Elisabeth Anne Wreford Andersen

  12. Department of Haematology, Odense University Hospital, Odense, Denmark

    Niels Abildgaard

  13. Quality of Life Research OUH, Odense University Hospital, Odense, Denmark

    Niels Abildgaard

  14. Academy of Geriatric Cancer Research, Odense University Hospital, Odense, Denmark

    Niels Abildgaard

  15. Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Jutland, Denmark

    Jeppe Gram

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  1. Margrethe Langer Bro
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Correspondence to Margrethe Langer Bro.

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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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  • DOI: https://doi.org/10.1007/s00520-019-04666-8

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