Chapter 04: Massage and Cancer Patients: A Contemplative Practice

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Chapter 04: Massage and Cancer Patients: A Contemplative Practice

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Ms. Sumler begins this chapter describing how she began to practice massage in 1986 and tells stories to illustrate how "massage is artistic expression." She also notes some myths in the massage community at that time, e.g. that massaging cancer patients would spread their disease through their bodies. Ms. Sumler questioned this belief and decided to know more about massage and cancer. At the same time, family and friends were referring clients with cancer to her for massage. She explains technical aspects of her work with cancer patients. Next, Ms. Sumler explains how she came in contact with Integrative Medicine at MD Anderson. She describes how she felt a "sense of calling" when she was at the institution. She was first invited to come and teach yoga, but that opportunity didn't work out.

Identifier

Sumler,PSS_01_20180501

Publication Date

5-1-2018

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Overview; Overview; Definitions, Explanations, Translations; Joining MD Anderson; Personal Background; Professional Path; Inspirations to Practice Science/Medicine; Influences from People and Life Experiences; Faith; Offering Care, Compassion, Help; Patients; Patients, Treatment, Survivors; Cancer and Disease; Formative Experiences; Faith, Values, Beliefs; Evolution of Career; Professional Practice; The Professional at Work

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey A. Rosolowski, Ph.D.:

Yeah. Now, you mentioned you were teaching, and you said you were a contractor at MD Anderson? So were you already teaching yoga at MD Anderson at this time?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I was not teaching yoga at MD... I wasn’t at MD Anderson at that time.

Tacey A. Rosolowski, Ph.D.:

Okay, so that would’ve been later in the ’90s that you started—

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Mm-hmm.

Tacey A. Rosolowski, Ph.D.:

—there. So where were you teaching at the time, and...?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I was teaching at Yoga Central, so it was—it’s a kundalini yoga center in the Montrose area. And I had taught... I taught some other places in the community, as well. I taught for—in the Spring Branch School District, continuing education, and kind of private classes, and such as that.

Tacey A. Rosolowski, Ph.D.:

Mm-hmm. Did you feel... What was... You had this sense—so much earlier you were interested in the Universe, with a big U, and living a contemplative life. I mean, were you feeling like you were on the path to it, or in the midst of such a life? The purpose question.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I definitely felt like I was on the path, yeah. It was definitely—it felt like it was a journey, that I was on the path. I know that when I had my cancer diagnosis, it was such a shock. I felt like I had been going 300 miles per hour and just, like, crashed into a brick wall. And then as soon as I crashed into that brick wall, I felt like I’ve been [able] to face this because of my yoga practice, and my meditation practice. I felt like, okay, I have the tools to face this. And so I was really very grateful for that, and I just tried to apply what I had to do going forward with that. I was teaching yoga at that time, and I was also practicing massage therapy, so when I first started my massage practice, massage was not licensed in Texas. And there was probably a dozen massage therapists in Houston, (laughs) and so you knew all of them. And I just only practiced massage, like, with family or friends. And so one day my neighbor, who was one of the 12 massage therapists in Houston, called me up and asked me if I would do a massage with her that one of her regular clients wanted a couples massage, and she couldn’t get ahold of anyone else, and she had two tables, and I could bring my then—my youngest daughter was an infant, like a one-year-old. I could bring her over and stay with her nanny, and we could just set up in one room and just do the routine that she did. So I was like, “Sure.” And so I went. We did the massage. So that would’ve been, like, in 1986. And I came home with a hundred-dollar bill in my hand, and I thought, I can do this, and as a stay-at-home mom. And before, when I was an artist, I also did a lot of ceramics work, and I felt like bodywork was kind of like ceramics to me. For me, it was an artistic expression, and a connection, and so it was like an art for me to do, and I did enjoy it.

Tacey A. Rosolowski, Ph.D.:

Tell me about the artistic expression part. Why...? Make that comparison.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

I think, for me, when I was doing artwork, it was really a feeling of a connection with kind of the divine, with that good connection with the self, and to be able to express that, and then working with a human body (laughs) as your medium. For me, it was also like connecting with the self of the other—I’m not going to say “the other” because of this non-dual—trying to realize this non-dual experience of kind of oneness in this expression, but being able to have that—just this time of being completely, 100% there for another person.

Tacey A. Rosolowski, Ph.D.:

And transforming their body through something you’re doing that wouldn’t have happened without that connection.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Yeah.

Tacey A. Rosolowski, Ph.D.:

That’s a very beautiful, intersubjective thing to be happening. Yeah.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

So then I started kind of a small massage practice, just really word-of-mouth. I worked out of my home, or I went to people’s houses. And then, when I was diagnosed with cancer, what happened was my—that same friend of mine, she had also had the same surgery for scoliosis, and we used to trade back massages pretty regularly. And so at some point—I didn’t get massaged for quite a while after my diagnosis, because you were just in that getting tests all the time, and all of the cancer things. And then one day I told her, I said, “Hey, look, let’s schedule a trade and do some back massage,” because my back was really hurting. And she said, “Oh, you know, I can’t massage you.” And I was like, “Why not?” And she goes, “You know, the cancer. Like, massage will spread your cancer, so I can’t touch you.” And then at that time massage therapists were taught in school to never touch anyone who’s ever had cancer in their whole life, because if you do you’ll spread the cancer, even if they haven’t had cancer for 20 years or whatever. And so really, for me, to manage my back—because one of the side effects I had from my back surgery is muscle rigidity in my back, and so kind of I used yoga, meditation, massage, and walking, and they were all equally important. And so when she said that, I just said to her, I said, “You know, if I can’t have massage I’m really not interested in having cancer. That’s just not going to work for me.” (laughter) And so I said, “I’ve got to find out. I’ve got to find out about this massage thing, because it just doesn’t make sense to me.” And so that’s when I started just really speaking with my oncologist, and trying to find out everything I needed to know about massage and cancer, and really what was true and what was just a myth. And simultaneously—

Tacey A. Rosolowski, Ph.D.:

Was there a lot of information available at the time?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

There was really almost nothing available at the time, except really to have a conversation with my doctor, and to try to learn about cancer, and... But there wasn’t really anything on... Oncology massages didn’t really exist. If there were, there were, maybe somebody else like me in a couple other places in the world. And so kind of simultaneously people just started referring their family and friends who were being diagnosed with cancer to me, and—as a massage therapist. And so—

Tacey A. Rosolowski, Ph.D.:

So how...? Because this is something I wanted to ask you about later, but appropriate now. So tell me about how you work with a cancer patient as a massage therapist. What’s that practice like?

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

So really, with massage, there’s—I forget—there’s over a hundred modalities of massage. And so oncology massage is really not about a modality. It’s really about education on what is cancer, what about cancer treatment, and what do we need to do to be safe. And also, what are—what practice do we have that’s evidence-based? Because massage has a lot of—comes—has had a lot of myth involved with it in the past. I think that’s changing now.

Tacey A. Rosolowski, Ph.D.:

Yeah, witness the massage will spread your cancer.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

Right, exactly, starting—

Tacey A. Rosolowski, Ph.D.:

Crazy.

Pamela Austin Sat Siri Sumler, LMT, BCTMB, CLT, E-RYT:

—just starting with that one. And so, really, for me, working with someone who’s been diagnosed with cancer, it’s really a contemplative practice to begin with. So really just taking all the dogma about massage and kind of throwing it out. And so, for instance, massage dogmas that during the massage you don’t talk. You encourage the massage—your client to not talk, or they should just be experiencing the massage. Well, sometimes when massage—what goes hand-in-hand with massage is trust, right? You’re usually naked, and a stranger or someone is touching you while you’re relaxing, so there’s a lot of trust there. And often for people you might be the person they trust to share what’s going on with them. And so I’ve had countless people tell me “I’ve never told anyone this. I haven’t told my husband this.” Or just taking their wig off. “No one’s seen me without my wig. Even my husband hasn’t seen me without my wig.” And so those kind of dogmas, like everyone needs to just experience the massage and not talk, doesn’t work with oncology massage. Another one is whatever you do on one side of the body, you’re going to do it just the same on the other side of the body. Well, what’s going on with somebody who’s had cancer or cancer treatment on one side of the body, the other side of the body might not be there, or it may have precautions that you need to take that you need to do something differently. So, for instance, the risk of lymphedema. If we remove lymph nodes, if somebody’s had a mastectomy or melanoma or something, and they’ve had lymph nodes removed, and they’re at risk for developing lymphedema. Massage can trigger lymphedema in someone who’s at risk in that region. So we modify how we do the massage, the pressure we use, the direction that we massage, kind of the rate, the tempo of the massage, to help be supportive of collateral flow. So we’re not treating lymphedema, but we’re just supporting the lymph to flow in a collateral way. We’re still able to give touch, so it’s not just contraindicated and I can’t touch you there. We can still incorporate it into the massage, but not trigger lymphedema. Well, somebody might just want regular massage (laughs) on the other arm, on the other side of the body. They might not want it to be the same. And so, really, it has to do with modifying different ways of positioning a patient, the level of touch we use. So in oncology massage there’s two different scales of massage pressure, and the one that we use here is called the Walton Scale of massage pressures, and it has five different pressure levels. Well, when you’re in massage school, you don’t learn different pressure levels. And so when you practice massage, in general, you’re not just using the strength of your hands. You use the strength of your hands, but you also use your bodyweight. So you have the table. The person is lower than you, where you can lean and apply pressure into them. And so, for instance, in the first two levels of the lighter pressure in the Walton Scale, we don’t use any bodyweight. So we’re not contouring our hands, but our hand is flat, and it’s matching the contours of the body, so we’re not changing the contours of the body, so it’s a very light practice. And we’re looking at what are the patient’s blood levels; are they at risk for bruising or bleeding; what medications are they taking; are their medications affecting the integrity of their tissue, or also putting them more at risk for bleeding. We’re looking for medical devices, what medical devices do we need to avoid; tumor involvement; is there bone involvement, are they at risk for fracturing; things like that.

Chapter 04: Massage and Cancer Patients: A Contemplative Practice

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