Music interventions for

improving psychological and

physical outcomes in cancer
patients: a Cochrane review
Clinical

Clinical Questions
What are the effects of music therapy or music
medicine interventions on psychological and
physical outcomes in patients with cancer?
Are the effects of music therapy interventions
different than those of music medicine
interventions?

Source: Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving

psychological and physical outcomes in cancer patients. Cochrane Database of
Systematic Reviews 2011, Issue 8. Art. No.: CD006911. DOI:
10.1002/14651858.CD006911.pub2.

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Context
Having cancer can cause extensive
emotional, physical and social suffering.
It is important that the care of cancer patients
incorporates services that help meet their
psychological, social and spiritual needs.
Music interventions have been used to
address such needs and to alleviate
symptoms and treatment side effects in
cancer patients.
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Context
Music therapy and music medicine interventions differ:
Music therapy

Music medicine

The implementation of music interventions

by a trained music therapist

Presence of a therapeutic process

(assessment, treatment and evaluation)

The use of personally tailored music

experiences to meet patients specific
needs:
listening to live or pre-recorded music
performing music on an instrument
improvising music spontaneously using
voice, instruments or both
composing music (e.g. songwriting)

The use of pre-recorded

music by medical
professionals

No process of assessment,
treatment and evaluation

Therapeutic relationship is
not established through
music

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Methods
Searches were carried out in 15 databases including
the Cochrane Central Register of Controlled Trials,
MEDLINE, EMBASE, CINAHL and CancerLit. 15 music
therapy journals were handsearched.
All outcomes were presented as continuous
variables, with standardized mean differences
calculated for outcome measures using results from
different scales. Mean differences (MD) were used
for results using the same scales.
Pooled estimates were calculated with the randomeffects model for meta-analysis.
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PICO(S) to assess eligible

studies

Participants / Population: patients diagnosed with any type

of cancer. Participants undergoing diagnostic procedures were
excluded.
Intervention: standard treatment combined with music
therapy or music medicine interventions.
Comparison: (a) standard care alone; (b) standard care
combined with other therapies; or (c) standard care combined
with placebo.
Primary outcomes:
Psychological outcomes (e.g. depression, anxiety, anger,
hopelessness, helplessness)
Physical symptoms (e.g. fatigue, nausea, pain)
Studies: randomized trials and quasi-randomized trials.
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Description of eligible
30 trials with a total ofstudies
1891 participants (860 females, 617
males):

Type of patients

Number of
Trials

Chemotherapy or radiation therapy

patients

Surgical or procedural patients

General cancer patients

13

Pediatric cancer patients

13 music therapy trials, 17 music medicine trials

Trials were conducted in 7 countries (USA, China, Italy, Iran,
Spain, Taiwan and Vietnam).
Treatment sessions varied greatly in frequency and duration
among the trials.
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Results
Music interventions may have a beneficial effect
on:
anxiety, with a reported anxiety reduction of 11.20 units,
on average, on the STAI-S and 0.61 standardized units on
other anxiety scales
mood (improved by 0.42 standardized units)
pain (reduced by 0.54 standardized units)
quality of life (improved by 1.02 standardized units)
heart rate (4 beats per minute lower) and respiratory
rate (2 breaths per minute lower)
systolic blood pressure (mean drop of 5.95 mmHg) and
diastolic blood pressure (mean drop of 4.28 mmHg)
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Results

No evidence of an effect on depression, fatigue or physical

status, but only a small number of trials investigated these
outcomes.
No conclusions can be drawn on the effects of music
interventions on distress, body image, mean arterial
pressure, oxygen saturation level, immunologic functioning,
spirituality, and communication behaviors because the
results of the studies that included these outcomes could not
be pooled or because only one relevant trial was identified.
Effects of music medicine interventions could not be
compared with those of music therapy interventions because
of the small number of studies reporting the same outcome.

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Conclusions: current
findings

Music interventions had beneficial effects on anxiety, pain,

mood and quality of life in people with cancer.
Music reduced heart rate, respiratory rate and blood
pressure, but the reductions are small and may not be
clinically significant.
The findings of this Cochrane review support the offering of
music interventions as a complementary treatment to
people with cancer.

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Conclusions: future research

More trials are needed to compare music medicine versus music
therapy
Qualitative research and non-randomised studies might help
enhance understanding of a patient's experience and identify
factors that may contribute to, or limit, the benefits of music
therapy or music medicine interventions.
Music medicine trials should select music that reflects the
patient's true preference.
Trials using pre-recorded music should identify the salient musical
elements pertinent to making selections including tempo,
instrumentation, melodic contour and harmonic structure.
More research is needed to examine the relationship between
frequency and duration of music interventions and their effects.
More research is needed for music interventions in children with
cancer.
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Useful links
Cochrane Journal Club discussion
points
Music interventions for improving
psychological and physical outcomes
in cancer patients

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