Episode 18 – Innovative Oncology Massage Research with Jill Cole, MA, LMT, BCTMB
Ep. 18 – Innovative Oncology Massage Research with Jill Cole, MA, LMT, BCTMB
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About This Episode
In this episode of ‘Collaborative Connections,’ hosted by Ericka Clinton and sponsored by the Society for Oncology Massage and the Society for Oncology Esthetics, we feature Jill Cole, a licensed massage therapist and PhD candidate at the University of Kentucky.
Jill shares her journey of becoming a PhD candidate in Rehabilitation and Health Science, focusing on her research in oncology massage, particularly a feasibility study she is conducting at the UK Healthcare Integrative Medicine and Health. She explains the crossover randomized control trial of massage therapy during cancer treatment and discusses the importance and challenges of touch therapy research.
Throughout the conversation, Jill emphasizes the need for more biological and large-scale studies in the field and how empirical evidence can support the growth of the massage therapy profession. She highlights the collaborative nature of research and the critical role of massage therapists in advancing the profession through evidence-based practices.
Topics discussed:
- Innovative oncology massage research
- Understanding the feasibility study framework
- Effects of massage on pain and anxiety
- Benefits of interdisciplinary PhD programs
- Importance of touch therapy research
- Research and growth in massage therapy
Timestamps:
00:00 Introduction
05:18 “Collaborative Connections: Oncology Massage Insights”
08:10 PhD Journey in Rehabilitation Research
12:05 Cancer Patient Care Feasibility Study
16:31 Challenges in Massage Therapy Research
18:38 Massage: Lack of Biological Research
23:03 “Feasibility of Expanding Research”
27:38 Reviving Massage Therapy Research
28:43 Gratitude and Importance of Research
More About Jill Cole, MA, LMT, BCTMB
Jill Cole is a hospital-based oncology massage therapist and the Massage Therapy Coordinator at UK Integrative Medicine & Health. She has worked in the field of massage as a clinician, educator, presenter and researcher for more than two decades.
Cole graduated from the Boulder College of Massage Therapy in Colorado in 1998 and is currently working toward her PhD in rehabilitative science at the University of Kentucky.
To learn more about Society for Oncology Massage, head over to www.s4om.org
Join the S4OM Facebook community at: https://www.facebook.com/s4om.org Or on S4OM’s YouTube channel: https://www.youtube.com/@S4OM
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Ep. 18 – Innovative Oncology Massage Research with Jill Cole, MA, LMT, BCTMB
[00:00:00]
Podcast Introduction
Ericka Clinton: Good day, everyone. Welcome to another episode of collaborative connections, a space for sharing and learning sponsored by the society for oncology massage and the society for oncology aesthetics. My name is Erica Clinton, and I will be your host for this episode. And on today’s podcast, we have Jill Cole.
I’ve known Jill a long time. Jill is a licensed massage therapist in the state of Kentucky since 1998. Jill currently works for the University of Kentucky Healthcare Integrative Medicine and Health as the Massage Therapy Program Coordinator. Jill has been an S40MPP since 2014 and was a board member for three years.
Welcome Jill and thank you for joining us today.
Jill Cole: Erica, thank you for having me. It’s great to sit down with you and have a conversation and talk about some [00:01:00] exciting things that are happening with S4OM and S4OE and, just reconnect with you. It’s great to be here.
Ericka Clinton: Thank you so much for giving us your time.
Really excited that we can talk to you because you are what I call a unicorn in the world of massage. Oh.
Discussion on PhD and Research
Ericka Clinton: You are a very special and unique being because you are actually embarking on getting your PhD.
Jill Cole: Yes, that’s correct. I, Erica, I just feel , extremely lucky to be where I’m at.
And this point in my life and, you know, how things kind of converge and manifest and just present themselves. And I feel like this is what’s happened with me.
Yeah, I’m really excited that at this point in my life after practicing for 28 years I have this opportunity to not only work in the hospital setting and provide hospital based massage Provide oncology massage, but also push [00:02:00] myself to learn and to get a Ph. D. One of the benefits with the University of Kentucky is they do have a tuition assistance program and just very grateful.
I’m in the College of Health Science at the University of Kentucky and within the College of Health Science, I’m in the Rehabilitation and Health Science Ph. D. program. This is such a cool program. It is an interdisciplinary PhD. So what I mean by that is that there are, At least half a dozen or more rehabilitation specialists that are in the program with me, such as athletic trainers, physical therapists, occupational therapists, communication disorder therapists and, nutrition.
There has been two music therapists, and I’m the first, but not the last, massage therapist to go through the program. And essentially, we’re learning how to do research. That’s what a PhD is all [00:03:00] about, really, to learn how can we effectively and ethically and responsibly do research in our field of study, which for us it’s massage therapy.
So I’m just just really excited and lucky. This is my fourth year and I will be finished with classes next semester. And so in May, I’ll start to take what’s called the qualifying exams. So there are four qualifying exams to be able to be what is called a PhD candidate. Everything but the dissertation.
So so that’s, really exciting. I’m, in the process now of writing my IRB to get approval to have my dissertation study at UK. So, yeah, it’s really exciting. Anybody and everybody could, I mean, well, I just get excited. I really would encourage anyone that is [00:04:00] interested in a PhD, reach out to me.
I’ll provide my email address. Thank you, Erica for, the folks listening and would just love to talk to anybody.
Ericka Clinton: That’s awesome. And thank you because I think research is such an amazing category. And for years, like as massage therapist, we didn’t know if we really had a place in research. But so much research has been done, I would say in the last 20 years.
that it really qualifies that touch therapy is something that should be studied and can be studied. So, you know it’s, also exciting to know that you can actually do a PhD in the area of focus or the thing that is your passion, which could be massage. And Obviously, huge bonus working at a university, that has this type of, program.
I hope you get a lot of support at your job [00:05:00] as well, being a PhD candidate. I do, I really do. So, obviously, you’re writing your IRB, which means you’ve decided on the topic for your dissertation.
Jill Cole: Absolutely.
Feasibility Study Details
Jill Cole: for my dissertation, I’m really focusing, it’s going to be a feasibility study.
So, that’s just a little bit different. We will have outcomes of pain and anxiety pre post post pandemic. Massage and the other two groups that will have the patients in but I really wanted to focus on if we were to do a larger scale study with this design and the design I’m, going to do it’s referred to as a crossover randomized control trial.
So crossover means there’s either two or more groups of patients or subjects that we’re going to study. So I’m going to have three groups in. My, a dissertation study. Of course, the first group will get a massage and this, the setting of the study is going to [00:06:00] be in an infusion center at UK. So in our Marquis Cancer Center, so it’s going to be a patient with cancer receiving massage, during their infusion, whether that be chemotherapy, whether that be blood, immunotherapy, whatever they need.
And The second group, so the first group will get massage, and we’ll do measurements pre post. The second group will get what’s called patient education, so just talking to the patient about their pain and their anxiety doing similar, measurements with them as we did in the massage group.
And then the third group, They will just get standard of care, which is nothing. it’ll be interesting to see what data that we gather and we can, you know, cross over the data between groups and, see if we have any correlation at all, if massage has any effect at all. And that’s, all well and good.
However, the main thing we want to look at in, in a feasibility study, so we’ll get some data and [00:07:00] that’ll be good and we might be able to. You know, draw out some more direction with the data. But the main thing in a feasibility study is to really look at, the implementation of it. Can we implement this on a larger scale?
What are some roadblocks that we’ve hit? Will the patients be receptive to what we’re doing and why? The acceptability. Do the patients accept this? Do the staff accept this? That’s a huge part of a feasibility study. Practicality, is it practical to, conduct the study in a really busy infusion center or how can we be as minimal as possible?
If we’re doing a larger scale study, is that going to be impactful in patient care? And then adaptation. How can we adapt what we’re doing? to patient care beyond our research. And so that’s really, that’s the goals of [00:08:00] the dissertation study, the goals of the, of writing the IRB, to really set this up and say, hey, can we do this?
And, this is why we want to look at it, which is really important. And we’re going to, we’re going to use 20 patients, and they’re going to, Those same 20 patients will be in all three groups and the assessor, the person that is going to do the measurements pre post, it won’t be me, it will be a, an assessor that’s what’s called blinded.
So that person won’t know if that patient just had a massage, if they had just had patient care or just, they just had standard of care, which is not really nothing. You know, and so that will also minimize some bias in measurements and, so forth. So, and then we will start every patient off as they are, that, that will be their first, we’ll follow them with their first chemo session.
So there’ll be a new patient going into chemo for the first time. So everybody’s on the [00:09:00] same, excuse me, Wavelengths, and then we’ll gather data, three more consecutive times with them.
Ericka Clinton: so in the study, you said you’re going to have 20 patients in the infusion. The assessor will be blinded, so they won’t know which.
Intervention, let’s say that the, client or patient received and will they get the same intervention each time over the three times that you follow them? So if they got massaged the first time, they’ll be getting massaged subsequently after that as well.
Jill Cole: You know, that’s a great question, Erica, they, because it’s a crossover design, they will be randomly put in.
So if the first group got a massage, then they’ll be randomly put in either in standard of care or patient care, patient education rather, and vice versa. So if, so say for example, we’re in the, We volunteer and we’re in the study. You might be in the massage group first. I might be in the patient education group [00:10:00] first.
And then when we come in the next session, we’ll be randomized to another group.
Ericka Clinton: that’s really, interesting because obviously, like the randomized control. Trial is like the gold standard, right? Of research. But some of the challenge with massage therapy is, can you really have a control group?
You know, can you really blind it as best as possible? So it sounds like you guys are working through some of those challenges by having this crossover type of study. Because then, particularly with a blind assessment person, you can really collect data that might show that when people get massage, they have different outcomes than when they get standard of care or patient education.
And I guess the patient education part also helps you look at the impact of just having another human being interact with you, right? During, treatment, and the impact of that. So that’s really [00:11:00] interesting. And sounds like, I’ll, be very interested to kind of see what the outcomes are.
And I think infusion is an interesting space to think about. Doing research because the sessions, particularly the massage sessions are so short, right? So that’s going to be very, interesting. in terms of the research you’re doing, it seems like. it is going to give us interesting information and what I love is it is also something that can be recreated with more numbers which is kind of always what you need, right, in terms of actually having research impact standard of care.
Challenges in Touch Research
Ericka Clinton: but in what you’ve been looking at over the last few years as a PhD student, what do you think is missing from touch research?
Jill Cole: So, really from touch research, we know anecdotally. that, that massage has some effect on the body because we work with clients, patients week to week and we, you know, they [00:12:00] self report and you know, they let us know about any changes in their condition and so forth and that’s all well and good and that’s amazing.
However, we don’t have enough research in how massage affects the systems of the body. So we don’t have a we have a lot of research that is more observational, that’s self reported. We don’t have as much biological research, and what I mean by that is that we don’t have enough research that we can look at a system, or we can look at the blood, or we can look at the blood pressure and, especially the blood.
Part is very interesting to me that we can maybe look at inflammatory markers and say, gosh, they were here before the massage. And then after the massage, they were here. I’m just purporting this. I’m, this is not, hasn’t been validated in research, but that’s kind of, that’s what I mean is that. We have [00:13:00] established a wonderful foundation of research, like you were talking about, over the last 20, 30 years, and I feel that massages, research and touch therapy is at a point in which we can take it further.
We can look at how. And our measurements have gotten a little bit, we’ve had some really creative technological measurements that have come out that are validated that we didn’t have 20 years ago. So we can look at pressure levels with touch, we can have algometers with, you know, measuring pain pre and post, we have von, what’s called von Frey filaments.
And these are just little tiny filaments that, you know, You can apply to the skin to have a marker of sensitivity and then a marker of, pain level that doesn’t cause discomfort, which is really interesting to me, even though we’re measuring pain. So, I think that’s the biggest thing. And then larger scale studies, [00:14:00] it’s really challenging, like you were talking about the gold standard, the randomized control trial, and, With the study that I’m proposing for my dissertation, it, 20, 20 patients is a very low sample and We kept it low because we’re really just looking at the feasibility and also it is my dissertation study.
So I’m, I didn’t want to like, yeah, I had to be reined in by my advisor, but we are lacking, you know, larger scale studies with a lot of sample sizes. And, you know, there’s different challenges with that. But yeah it’s, interesting to see how we can be creative to, you know, Research touch therapy and to see how we can overcome some of the, I hate to say barrier, but some of the longstanding beliefs around research and massage.
Ericka Clinton: Yeah, because I think that’s what also keeps people from doing it is they feel like we can’t. play in that sandbox, [00:15:00] so to speak, like we’re not those kind of scientists or practitioners. And I’m like, right, but I think we can value what we do. And we can really honor that we need some kind of concrete data to show the impact of touch.
I mean, we have, you know, all doctors and neurologists who’ve studied it. So we clearly know there’s an impact, but to really measure that in a way where people could say, well, the blood pressure did go down or this person’s pain was diminished and not just that they reported it was diminished. We actually saw that there was this change.
In a, more biological way, let’s say. So I, think that’s a great approach. And yes, feasibility for us is also the challenge. You know, you’re doing it as part of your dissertation, but if it was to get [00:16:00] bigger. You know, is this going to be something the university would support? Or do you need the National Institute of Health to come to the, you know, to come to your aid to provide the funds to run something like that?
Ericka Clinton: So I love what you’re doing. And I can’t again. I can’t wait to see the results just from the small sample that you do have. But it also gives me a lot of hope that this could be something that could be done on a much bigger scale at a later time. So I guess my last question is something that I hope you’ll find easy to answer.
Future of Touch Research and Profession
Ericka Clinton: but how do you think touch research can support growth in the massage therapy profession?
Jill Cole: At its foundation, touch therapy research is about that word expanding patient care and accessibility for work for massage therapists. So in this last. part of [00:17:00] my career, so to speak. I’m hoping to be at this another 15 years, maybe 20.
But my goals are to broaden the profession with touch research with empirical evidence with, and this is not just me, this is all of us working together. I recognize that research is such a collective collaboration. Go back to the podcast name. It’s larger than me, it’s larger than any of us.
And really having those pieces to say, this is worth it. It helps with reimbursement. It helps with job placement. It helps with integration and whole health integration in, hospital systems and other medical systems. It helps in our private practice. It helps if we’re working in a group practice. Helps with spas.
It helps in any myriad of places where massage therapy is offered. And so I just feel like. And we have some really [00:18:00] interesting and exciting opportunities to move forward. And to go back to anecdotal evidence, that is where all research starts and it’s so important. So I’m just going to do a plug here for the Massage Therapy Foundation right now.
They have brought back their case, their practitioner case report contest, and that is such a cool contest. It’s such a cool experience to go through. So I was able to participate in that a few, I don’t know, many years ago, I should say. And I had a client at the time that had peripheral neuropathy from diabetes.
And we did a protocol and, The hypothesis was, but he was also in a clinical trial with Lyrica. So it was found confounding, but it was just really a wonderful experience to go through and, find articles and write the paper. And I worked [00:19:00] with Dr. Nikki Monk on that and it was just really, it sparked, I think that was a big spark for me.
Ericka Clinton: And that’s a very unique opportunity, but also one that I think really allows massage therapists to show. What they do as impactful is to really look at, you know, one person’s experience and, really trace that over time, as well as do some research to really integrate all of that information to found, find out how you can best help them.
And then to be honored by your profession, how awesome, you know, and the massage therapy research foundation, they do so much. Yeah. For our profession. And. I was at a convention a year ago, two years ago where you know, they were displaying a lot of posters [00:20:00] from people who had won grants from the Massage Therapy Research Foundation.
And the stuff that people were studying and reporting on was so amazing. You know, from everything from injury prevention to massage therapists, to the impact of touch therapy, to improve the suckling reflex of a newborn. And it was just so fascinating. So I’m really excited that they’re bringing that back.
I hope more people participate in it because as you said it’s, a great learning experience as well for those of us who are thinking about maybe studying more or doing research or participating in research because at the end of the day for folks like you, who are going to write these dissertations and, provide a construct, they’re going to be a lot of therapists who are going to be needed to do the work.
To actually help [00:21:00] facilitate the project. So, there’s a lot of opportunity for everybody. Absolutely,
Closing Remarks
Ericka Clinton: Thank you so much, Jill. I really appreciate. Having this conversation and just connecting with you again and figuring it out, all the stuff you’re doing, which I think is so exciting. And I think our listeners who have clearly identified for S4OM that they want more on research will really enjoy hearing about what you’re doing and thinking about the opportunities.
And I love what you just said in terms of. you know, providing accessibility. And I think for client or patient populations, as well as for massage therapists to have longevity in the field, research could really give everybody what they need. So it’s something we should not be afraid of, and definitely be open [00:22:00] to and engage in more.
So thank you. Thank you again so much.
Jill Cole: Absolutely. Erica. Thank you so much for having me. And I, have a special place in my heart for S4OM and I just am really have been so excited to see how, see the growth with S4OM and just keep moving, keep at it.
Ericka Clinton: Absolutely. Absolutely. All right, collaborators have a great day and I hope you enjoyed today’s podcast.