The Impact of Massage Therapy on Osteosarcoma Progression

Osteosarcoma is a malignant bone tumor that primarily affects children and young adults. It arises from primitive mesenchymal cells with the potential to differentiate into various bone-related cells.

The standard treatment for osteosarcoma involves a combination of chemotherapy and surgery. Interestingly, many osteosarcoma patients in the early stages of the disease turn to alternative treatments like massage therapy due to the non-specific nature of their pain. In many Asian countries, including Indonesia, traditional health services like massage are popular. However, previous studies have suggested that massage therapy applied to tumor areas may promote the spread of cancer, making limb salvage surgery more challenging and potentially reducing survival rates. Yet, there is limited research on the effects of massage therapy on osteosarcoma patients.

A study from Faculty of Medicine Universitas Indonesia published in Scientific Reports aims to investigate the impact of massage manipulation therapy on the progression of osteosarcoma, particularly in the context of Indonesian patients who often rely on traditional therapies and may present at advanced stages of the disease.

This research conducted an analytical observational study with both prospective and retrospective cohort designs to investigate the impact of massage therapy on osteosarcoma patients. The study followed 84 patients for one year to assess the occurrence of metastasis.

Prospective data were collected through interviews, while secondary data were obtained from the patients’ medical records. Among the 84 subjects analyzed, 69% had a history of receiving massage therapy. The study found that patients who had undergone massage therapy showed increased levels of LDH (lactate dehydrogenase) and ALP (alkaline phosphatase), with statistical significance .

LDH plays a crucial role in glycolysis in active muscles, while ALP is widely distributed in various tissues and is excreted through the liver and biliary system. Elevated LDH and ALP levels are typically associated with poorer prognosis in osteosarcoma patients.

Furthermore, the median time to metastasis from the baseline was significantly shorter in the massage therapy group (4 months) compared to the non-manipulation group (12 months) .

The research concluded that massage therapy had adverse effects, leading to elevated LDH and ALP levels, an increased likelihood of amputations, a higher risk of metastasis, and lowered survival rates. Patients who had undergone massage therapy experienced metastasis three times faster than those who had not. The study strongly recommends against using massage manipulation therapy in osteosarcoma patients.

This study has limitations, including potential recall bias by patients, lack of subgroup analysis, short follow-up, and limited generalizability. It does not assess long-term survival, and the small sample size limits generalisation.