About the Author: Dr Arkanil Gain is a junior resident in the Department of Onco-Anaesthesia and Palliative Medicine at AIIMS, New Delhi.
Apart from being a doctor, Dr Gain celebrates his life and living through making music and trying to make the world a better place for everyone he meets. He believes that, “No person on this earth can be devoid of tragedies and distress, we will all have our share of pain and heartbreaks, but at the end of the day, the clock ticks and, The show must go on!”.
Cancer is one of the most feared and stigmatized diagnosis prevailing in this world. It disrupts various aspects of one’s life starting from the physical, social, psychological aberrations and their interpersonal relationships. The journey for a cancer patient and their caregiver begins right from the day they noticed their first symptoms. The apprehension of being diagnosed with cancer forces them to navigate a series of diagnostic tests. While awaiting the results of their diagnostic tests, they become detached and burst out of their comfort bubble.
If diagnosed, before the acceptance of the diagnosis, they are made to undergo a process of chemotherapy, radiotherapy or a surgical intervention, either separately or concurrently. As the concurrent aggressive therapies focus on the cure of the disease, the person carrying the disease tends to often lose themselves over time. The financial burden, the physical pain, the worsening relationships with their loved ones, the anguish of losing one’s own self, contributes towards making these patients nothing less than a struggling soul.
It is during this journey that music therapy can play a big role in reducing one’s suffering and helping one to revive their lost happiness and peace.
Music therapy has been one of the latest introductions in the supportive management options of cancer. The bio-psycho-social model of pain highlights that pain is not limited to only a mere physical and subjective sensation, but it is instead a conglomeration of various psychological, social and physical aspects. Music therapy offers an effective form of supporting cancer care for patients during the treatment process and may also form the basis for planning effective rehabilitation programs to promote wellness and improve physical and emotional well-being.
Music therapy can be of two types, passive and active.
The passive therapy involves the patient enjoying and cherishing music as a listener (pre recorded music) or as a spectator (live music session) within the comfort of their own home or while they are in a hospital ward. This therapy is easy to organise and deliver and helps improve the mental and emotional status of a patient or their caregiver if implemented in an organised manner. One must however exercise caution to ensure that the chosen music aligns with the preferences of the listener and that it does not disturb the other patients in the ward. A failure of being mindful of the mentioned may actually make the process unbearable for patients and their caregivers.
Active music therapy is the process in which the patient or their caregiver themselves sing or play an instrument. This activity provides immense pleasure to the individual as they feel that they are able to still create something special thereby improving their feeling of well being. This activity also becomes a huge moral boost for these patients and their caregivers, and tremendously improves one’s quality of life as more often than not, these patients have usually lost their self-confidence and self-belief in their battle with cancer.
Music therapy cancer treatment program also consists of relaxation techniques with music (progressive muscle relaxation, imagery techniques). Relaxation techniques for these cancer patients help to also ease the side effects from their treatment. Learning how to relax as they undergo a battery of hard-to-tolerate cancer treatments, helps them cope with symptoms such as tension, anxiety, depression, nausea and pain.
Akash (name changed), was a 29 year old software engineer and a radiologically proven case of CA stomach. He visited the palliative medicine ward at AIIMS New Delhi, with complaints of excruciating pain over his epigastric region. The battle of living and spending each moment on this earth seemed to be a difficult task for the young lad. Neither could he take food orally nor could he sleep peacefully and pain-free at night. He had only recently accepted that his days were numbered and that he couldn’t get his old self back. We learnt that Akash was a musician and that he used to play the guitar. While admitted in our ward, we noticed that he listened to his own recorded songs on earphones every day. As Akash’s disease was advanced with no curative options available, he was discharged once his symptoms were under control. Upon returning home, Akash was once again reunited with this own guitar, which meant he could escape from this scary world for a few moments. His parents shared that he played his guitar every evening and that each time he played guitar, they saw him glowing with happiness after he had faced such a harrowing ordeal. Akash passed away a few months ago. His parents also shared with us that they found their “old Akash” during those evenings when he played his guitar even after the dreadful cancer had set in, and that having the “old Akash” even if for a few minutes was like a miracle to them. Music therapy for Akash played a key role in reducing all the factors attributing to pain as per the biopsychosocial model of pain.
It is interesting to note that music therapy not only improves the depressive symptoms and psychological aspects of pain, but it also helps create a healthy relationship between the patient and the therapist and improve compliance and adherence to treatment. It makes the patient and their caregivers also enthusiastic towards the treatment and care, as the caregivers witness a positive change in their loved ones. One of the prime intentions of provisioning music therapies is for its sonic features to elicit particular emotional responses, such us calm, excitement, alleviation, cheerfulness, etc.. The other important issue is the interconnection between the psycho-acoustic phenomena and the emotional responses related to the communication and evocation of emotions through music.
In conclusion, I would like to share that music provides an escape to everyone from their daily mundane life. In the case of those cancer patients who are struggling in their every moment music only exemplifies this effect and makes their journey less painful and more bearable. It surely does work as an adjuvant to all the therapies that the person is going through.
- This article is a republication from the Indian Association of Palliative Care’s monthly newsletter: September edition.
- The Indian Association of Palliative Care collaborates with the Shankar Mahadevan Academy – Nirvana, to present the palliative care community in India with a series of free virtual evening of harmonies known as ‘Singing for the Stars’. Click here to know how you can join us and for further information about this.