In the case of an individual diagnosed with cancer, this tendency is even more pronounced with a distinct desire to participate in their own treatment and recovery, and feel empowered to make proactive choices regarding their overall personal well-being.

Cancer, along with the traditional treatments involved, puts a tremendous toll on a patient's body, mind and self-image. Few spa professionals realize the impact they can create when they come in contact with an individual undergoing cancer treatment or with a survivor who is in remission. Medical aestheticians and oncology massage therapists that work directly with oncologists or in cancer clinics interact with cancer patients daily and are extremely familiar with the conditions and side effects associated with the disease. Regrettably, cancer patients and survivors do not always disclose their condition to spa professionals in a non-medical environment and may even sometimes go unnoticed. A concentrated effort in identifying these clients using pre-screening and consultations is often the first step to building a relationship that can positively impact their lives.
Once identified, the challenge for many spa professionals is finding the right modalities to assist their clients on their journey to reclaimed health. Communication about what the client is experiencing is essential to understanding one's role and abilities in providing complementary care. It is equally necessary to open the lines of communication with the client's physician so that a comprehensive modality can be set in place that does not jeopardize current treatment or inadvertently hinder existing sensitivities. Once communication is established, chances are that the use of several presently employed modalities can be offered making only slight adjustments while paying close attention to providing additional quality care.

A Mindful Approach – Using Current Methods
By incorporating existing CAM modalities such as aromatherapy, acupuncture, reflexology, guided imagery, yoga, massage therapy and specialized facial/body treatments into a truly holistic approach that also includes psychological support and safe products, spa professionals have the ability to positively impact the lives of these special clients thereby encouraging their road to recovery. It is important to keep in mind that the primary function of a spa professional when dealing with a cancer patient or survivor is to provide compassionate care in a nurturing environment, remembering to avoid harsh treatments that may harm an already weakened immune system and further affect delicate skin and other sensitivities.
According to a study included in the Journal of Clinical Oncology, the stratum corneum of the epidermis is substantially thinner in patients undergoing cancer therapy. In fact, a large number of cancer patients experience an alteration in their skin's integrity at one point or another during their treatment. Some of the common types of skin problems that many cancer patients experience are xerosis, puritis, palmar-plantar erythrodysesthesia - PPE (also known as hand-foot syndrome), papulopustular rash, radiation recall (which results in skin erosions), inflammation, rashes, redness, and/or burn appearance. Other skin alteration issues that may present themselves are photosensitivity, skin dyspigmentation, hyperpigmentation, nail dystrophies and hair loss (alopecia).

Choosing the Right Products
Due to the extreme skin sensitivities these clients experience, it is important to understand how detrimental many common ingredients can be to a health-challenged person whose immune system is already overtaxed. When treating cancer patients and survivors, products must be completely free from toxins that can damage the skin or contribute further to the person's illness.
Jessica Jüttner, an oncology certified nurse and licensed aesthetician discusses that prevention and management of such cutaneous manifestations as the ones previously mentioned involves restoring and maintaining the skin's natural protective barrier. The trick is to use moisturizers with high Natural Moisturizing Factors (NMFs) and humectants. The healthiest and most effective skin care treatments are often the most natural and simplest in form. Examples include organic plant oils such as jojoba, tamanu nut and rosehip seed. Products containing known toxins that can alter the structure or biological function of the body's tissues and cells over time must be avoided at all costs. There is sufficient peer-reviewed research that indicates exposure to such contaminants over time can lead to liver and endocrine dysfunction, reproductive complications, and ironically enough, cancer. Avoid ingredients such as imidazolidinyl urea, fragrances, parabens, polyethylene glycol and its derivatives (PEGs), sodium lauryl or laureth sulfate, triclosan, triclocarban and triethanolamine (TEA). Products containing ingredients such as lactic, glycolic, alpha hydroxy, and beta hydroxy acids may also be too harsh. Consequently, regardless of whether the client is receiving facial, bodywork, or Ayurvedic treatment, equally important to what is applied to the client's skin, is how the products are applied. This is particularly significant for massage therapists.

A Gentle Touch That Cares
Across the nation and worldwide, massaging cancer patients is becoming a common practice in conjunction with conventional medical treatment. Then again, some people (patients, medical doctors, and even some licensed massage therapists) may still believe that providing this type of complementary therapy to cancer patients is contraindicated due to the elevated sensitivity involved. There is however, no evidence that cancer can be spread or worsen due to therapeutic massage treatment. To the contrary, the National Cancer Institute indicates that about half of their cancer centers offer massage to their patients as a useful addition to their medical treatment. A growing number of health care practitioners are recognizing certain benefits in their patients receiving massages during their fight. Multiple studies have indicated that massaging cancer patients helps to decrease stress, depression, pain and fatigue. The key lies in the level of pressure, the length of the massage, the areas of treatment, and overall sincerity for the patient's care.
"The most important adaptation for diseases like cancer is touch level," says Kathleen Clayton, a licensed massage therapist and spokeswoman for the American Massage Therapy Association. The pressure should generally be lighter than usual. Avoiding deep tissue should be a rule of thumb, remembering to stay away from extra sensitive areas such as open wounds, tumor lesions or lumps. The communication between the patient and the therapist is crucial. A soft touch from a licensed and experienced massage therapist can make all the difference in the world to a person that is going through a cancer treatment. In many cases, that is all they need to feel better and to continue the fight.
Maryuri Velazquez, a licensed massage and bodywork therapist who is also certified in manual lymphatic drainage also emphasizes that communication is key. Requesting permission from the client's doctor and becoming an active participant in the client's treatment is advisable in understanding the patient's needs. She states that massage modalities such as effleurage and manual lymphatic drainage can be effectively applied when the amount of pressure used during treatment is comfortable for the client, and asserts that by massaging the client, "Our intention is not to cure or heal them, but to encourage comfort and touch them with the notion of providing quality of life without causing any harm." She highlights that massage not only reduces the stress the patient is undergoing, but also gives them a sense of protection, which leads to the greatest factor in a cancer patient's road to recovery – compassionate psychological support.

Going Beyond Physical Treatment
Have you not noticed that nowadays when people need to talk to someone or release some stress, they go to their massage therapist, aesthetician, hair dresser or manicurist? Emphasizing on communication, Velazquez affirms that "Sometimes my clients have come to me to talk and share a problem with me during a massage ... sometimes that is truly what they are here for." Lisa Corbin, M.D., medical director of Integrative Medicine at the University of Colorado Hospital cited that depression has been estimated to be four times more common in cancer patients than compared with the general population. She further explains that due to undertreated psychological symptoms such as anxiety, patients' perception of their physical symptoms may worsen, leading them to not follow through with treatment recommendations or report a higher severity of physical symptoms. The magazine publication, Psychology Today, pointed out how psychology can play an important role in cancer patients' treatment due to its effects on reducing emotional distress, minimizing treatment side effects, and improving quality of life. Supportive communication, positive encouragement, and listening to cancer patients during a spa treatment can be an added value to their fight and resistance to the effects of cancer treatment.

Education That Satisfies Demand
There is no such thing as knowing it all once you are done with school. Whether you are a doctor, an engineer, an aesthetician, or a massage therapist, education does not stop. Our basic studies provide us with certain fundamentals and a basic understanding of our career path overall. Even though cancer is not something new, the growing number of people suffering from the disease has increased the demand for education and training in all areas encompassing care and treatment, including those involved with aesthetics, massage and bodywork. In order to get comfortable with treating cancer patients and survivors and to be successful at it, spa professionals must continue their education by attending seminars, acquiring certifications, researching, reading articles and studies from reputable sources, and gaining experience within the field.
The National Cancer Institute states that about one in three Americans will be diagnosed with cancer. Studies have reported that a cancer diagnosis or the completion of treatment acts as "a catalyst to stimulate increased health behaviors, including diet and exercise." With the ever increasing rate of people experiencing the disease, it is highly recommended that spa professionals assist all of their clients in developing holistic lifestyles where meditation, relaxation, good nutrition, and regular exercise are part of the norm. The fact of the matter is that a person is likely to increase their chances of getting cancer by not adopting a more holistic lifestyle.
It goes without saying that because cancer patients are a vulnerable population, spa professionals must use every tool available to them to employ modalities that not only encourage their clients' road to recovery but also provide supportive, compassionate care in a truly comforting environment. By becoming proactive in identifying cancer victims, communicating with them, and providing the essential needs of these clients, more and more survivors and individuals suffering from the disease can empower themselves and others to make positive and long-lasting changes in their lives. Some might even argue that there is no greater purpose.

References:
Albanell, Joan, et al. "Pharmacodynamic Studies of the Epidermal Growth Factor Receptor Inhibitor ZD1839 in Skin From Cancer Patients: Histopathologic and Molecular Consequences of Receptor Inhibition." Journal of Clinical Oncology. 20.1 (2002): 110–124. Print
Bray, Freddie, PhD, et al. "Global cancer transitions according to the Human Development Index (2008-2030): a population-based study." The Lancet Oncology, Jun 2012 (Article in Press DOI: 10.1016/S1470-2045(12)70211-5)
Corbin, Lisa M.D. "Safety and Efficacy of Massage Therapy for Patients with Cancer." Cancer Control. (Jul 2005). 12.3: 158-164. http://moffitt.usf.edu/CCJRoot/v12n3/PDF/158.pdf Accessed on May 26.2012
Deng G, Cassileth BR. "Integrative oncology: complementary therapies for pain, anxiety, and mood disturbance." CA Cancer J Clin. 2005;55:109-116
Juttner Jessica, RN, BSN, OCN, Licensed Esthetician, "Skin Care and Oncology Patient" powerpoint presentation. The Puget Sound Chapter of the Oncology Nursing Society. http://psons.org/wp-content/uploads/2011/03/7_Juttner-Skin-Care-final.pdf Accessed on May 26.2012
Książek J, et al. "Psychological support of a cancer patient based on nursing care process records." Advances in Medical Sciences · Volume 52 (2007). Print
Moore, Susan, RN, MSN, ANP-BC, AOCN, and Pamela Hallquist, RN, MS, CS, ANP, AOCNP. "Dermatologic Effects of Cancer Therapy." Manage CRC and Menius Educational Institute. (Apr 2011) http://www.managecrc.com/cefiles/cearticle-25/Dermatologic_Effects_of_Cancer_Therapy.pdf
Strauss-Blasche G., et al. "Cancer inpatient rehabilitation and spa therapy for breast cancer patients: effects on quality of life and CA 15-3." Cancer Nursing. 28.5: 390-8
The American Cancer Society, "Cancer Facts and Figures 2012." http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf Accessed on May 26.2012
The American Cancer Society, Find Support and Treatments: Massage http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/massage Accessed on May 28.2012