John: Hello, I'm John Hilton, editor of the Cochrane Editorial unit. Music therapy is used for a variety of conditions and several Cochrane Reviews examine its effects. A team of music therapists with expertise in the use of music therapy with medical patients updated their review for cancer patients in August 2016 and Joke Bradt from the department of Creative Arts Therapies at Drexel University in Philadelphia, USA tells us what they found in this Evidence Pod. She conducted the review with Cheryl Dileo from Temple University in Philadelphia, Lucanne Magill from Mount Sinai Hospital and New York University in New York, and Aaron Teague, doctoral student in the department of Creative Arts Therapies at Drexel University.

Joke: Patients with cancer can experience intense emotional, physical and social distress. Many of these symptoms and the side effects of treatments impact on their physical well-being and quality of life. In addition, cancer patients often experience grief and depression in response to diagnosis and treatment. Therefore, their care needs to incorporate services that help address symptoms and meet their psychological, social and spiritual needs. Music therapy has been used in different medical fields to this end.
Our review now includes 52 trials with more than 3700 participants with cancer. Seventeen trials included patients who underwent chemotherapy or radiation therapy, 20 trials examined the effects of music during procedures or surgery, and 14 trials included general cancer patients. Almost all the trials were in adults, with only five examining music interventions for pediatric cancer patients.
The use of music in cancer care can be situated along a continuum of care, from music listening initiated by patients, through pre-recorded music offered by medical personnel, to music interventions offered by a trained music therapist. Music therapists are specially trained to select music interventions to offer emotional and spiritual support, facilitate communication and meaningful interactions between patients and their families, offer new coping strategies, and improve symptom management. Therapists may improvise music with the patients, help patients sing familiar and preferred songs, write original songs, or play live music selected by the patients.
We categorized 29 of the studies we found as music medicine studies in which the patient simply listens to pre-recorded music offered by a medical professional. Twenty-three studies were music therapy studies. We have found that both types of intervention may have a beneficial effect on anxiety in people with cancer, which is consistent with our three other Cochrane reviews on the use of music with coronary heart disease patients, mechanically ventilated patients, and for pre-operative anxiety.
The results for cancer patients also indicate that music interventions may reduce depression and fatigue and have a large pain-reducing effect. Furthermore, we found that music interventions may have benefits on heart rate, respiratory rate, and blood pressure. Alongside these findings from meta-analyses, results from single studies suggest that music interventions may reduce the need for anesthetics and analgesics, as well as decreasing recovery time and duration of hospitalization.
We conducted subgroup analyses to examine the impact of type of intervention, as well as music preference. These indicate that music therapy interventions had a moderate effect on quality of life but we found no support for an effect of music medicine interventions for this outcome. We did not find a statistically significant difference between music therapy and music medicine interventions for other outcomes, but the findings of the music medicine studies were highly inconsistent across studies while music therapy interventions produced consistent findings across studies. When examining the impact of music preference on anxiety, we found that it did not seem to matter whether the music was selected by the participant or by the researcher.
In conclusion, we have several research recommendations. Randomised trials are needed
which directly compare the efficacy of music medicine versus music therapy interventions and examine the relationship between frequency and duration of interventions and their effects on a wide range of outcomes. We would also like to see more trials in pediatric cancer. Future research efforts should also aim to enhance understanding of how music therapy and music medicine interventions can be optimized for symptom management, how music interventions can best serve patients along the cancer treatment trajectory, and what unique aspects of music therapy and music medicine interventions contribute to the care of patients. Finally, trials that use listening to pre-recorded music should describe the music selections made available to participants and exercise greater care in selecting music that reflects the patient's true preference. Researchers also need to consider the potential negative impact of using headphones during procedures, because of hampered communication between the patient and medical personnel.

John: To read more about the trial’s in Joke’s review and the range of music interventions that have been tested, visit Cochrane library dot com and run a simple search for ‘music and cancer’.