Cancer patients with sickle cell disease report reduction in pain and anxiety in response to music therapy

A new study from University Hospitals (UH) Connor Whole Health found patients with cancer and patients with sickle cell disease (SCD) treated at an academic cancer center reported clinically significant reductions in pain and anxiety in response to music therapy. Furthermore, patients with SCD who received music therapy reported significantly higher pain and anxiety at baseline than patients with hematologic and/or oncologic conditions excluding SCD. The findings from this study were recently published in the journal, Integrative Cancer Therapies, a leading journal focusing on understanding the science of integrative cancer treatments.

In this retrospective study conducted between January 2017 and July 2020, music therapists at UH Connor Whole Health provided 4,002 music therapy sessions to 1,152 patients across 2,400 encounters at UH Seidman Cancer Center, making this the largest investigation of the real-world effectiveness of music therapy within hematology and oncology to date. This study builds upon a history of seminal music therapy studies funded by the Kulas Foundation, the country's leading foundation for funding scientific research in music therapy, that have investigated the efficacy of music therapy in palliative care, surgery, and sickle cell disease at UH.

The music therapy programming provided at Seidman Cancer Center offers a unique and effective means of symptom management for patients and family members throughout their cancer journey. In particular, music therapy services are fully integrated throughout both inpatient and outpatient units to provide continuity of care through transitional periods of treatment."

Seneca Block, The Lauren Rich-Fine Endowed Director of Expressive Therapies, UH Connor Whole Health

UH Connor Whole Health manages the largest health system-based music therapy program in the U.S. Board-certified music therapists collaborate with providers across the system to help patients and their families manage the physical and emotional toll of an illness or hospitalization. Additionally, UH Connor Whole Health provides a diverse offering of integrative health and medicine modalities, including acupuncture, chiropractic, and integrative medicine consults, that are centered on patients' entire well-being.

In "Clinical Delivery and Effectiveness of Music Therapy in Hematology and Oncology: An EMMPIRE Retrospective Study," researchers examined the clinical delivery and effectiveness of music therapy at UH Seidman Cancer Center and compared the effectiveness of music therapy on pain, anxiety, and fatigue between adult patients with SCD as compared to adult patients with hematologic and/or oncologic conditions excluding SCD (the HemOnc group).

Music therapists provided interventions including live music listening, active music making, and songwriting to address patients' needs including coping, pain management, anxiety reduction, and self-expression. As part of clinical care, the music therapists assessed patients' self-reported pain, anxiety, and fatigue on a 0 to 10 scale at the beginning and end of each session and documented their sessions in the electronic health record.

"What makes this research unique is our ability to collect all our data within the electronic health record and then extract and analyze it to understand the real-world impact of music therapy," said Sam Rodgers-Melnick, a music therapist, first author of the study, and a co-investigator on the EMMPIRE project (Effectiveness of Medical Music Therapy Practice: Integrative Research using the Electronic Health Record) examining the effectiveness of music therapy throughout the UH Health System. "This research highlights the increased symptom burden that adults with SCD face in the hospital and the significant impact that a single session of music therapy can have on their pain and anxiety." The present study was a 3-year grant funded from the Kulas Foundation to Jeffery A. Dusek PhD, Director of Research, UH Connor Whole Health, Block and Rodgers-Melnick.

Rodgers-Melnick served as the principal investigator for the first systematic research on the use of music therapy for individuals with SCD and has led multiple studies funded by the Kulas Foundation on the topic since 2014. These studies support the benefits of music therapy for managing acute pain, improving self-efficacy and quality of life, and improving sickle cell disease knowledge in adolescents and young adults transitioning from pediatric to adult care.

Results of the recent study showed that in the combined sample of patients in the SCD and HemOnc groups, statistically significant reductions in pain (1.48 units), anxiety (2.58 units), and fatigue (0.84 units) were observed, with changes in pain and anxiety exceeding clinically significant thresholds. Music therapy sessions differed between the two groups, with interventions including active music making, songwriting, and song recording being much more prevalent in the SCD group than the HemOnc group. Furthermore, in an analysis of patients' comments about music therapy, patients expressed themes including enjoyment, gratitude, and improvements in mood, pain, and anxiety.

"It helps me release the everyday pressure and stress that is going on," said one patient featured in the study's qualitative analysis. "I've had a lot of hard times, but this really gives me courage. You gave me a way to articulate my feelings." Responses from patients highlight the importance of music therapists' expertise in addressing patients' needs. As Rodgers-Melnick states, "Our work goes beyond providing tailored receptive music interventions to address symptoms. The ways in which we build therapeutic relationships with patients and actively engage them in the musical process are essential for helping patients to express their thoughts and feelings and cope with extended series of treatments at the cancer center."

"Integrative Oncology utilizes complementary therapies, such as music therapy discussed in this study, to improve well-being for those affected by cancer. Using an evidence-based approach and building off research allows us to confidently build a program around supporting patients with integrative modalities as part of a strategy to manage symptoms that they may encounter through therapies or from cancer," explained Santosh Rao, MD, a board-certified medical oncologist and integrative medicine provider and Medical Director of Integrative Oncology at UH Connor Whole Health.