How Music Therapy Can Reduce Anxiety, Pain and Cancer Treatment Side Effects

Research shows music therapy can reduce anxiety and pain, improve concentration and mood, and more.

Have you ever played a favorite song to improve your mood, help you concentrate or give you energy during a workout? If you have, then you know the power of music to change how you feel and function.

Music therapy is an evidence-based practice, facilitated by a trained music therapist, that harnesses this power to support patients physically and emotionally.

“Most everyone understands that music can be therapeutic,” says David Cote, a board-certified music therapist and neurologic music therapist at the Survivorship and Supportive Care Institute at Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System. “However, when experiencing something as overwhelming as a cancer journey, many forget that music is one of the most basic and innate modalities for healing and expression that we have.”

Cote provides music therapy as supportive care to cancer survivors at Sylvester. He notes that studies show music therapy can help patients manage nausea, pain, anxiety, depression, sleep problems, memory, cognitive functioning and stress. Managing these effects can improve both the effectiveness of cancer treatment and a patient’s quality of life.

What is music therapy?

Music therapy includes a wide range of techniques, both receptive (such as simply listening) and active: singing, songwriting, guided imagery with music, moving with music, and playing or learning to play an instrument. Therapists use those experiences to address specific symptoms and non-musical goals with people of all ages and abilities.

“In an oncology setting, music therapy sessions can range from fun and playful to deep and reflective —from emotional and cathartic to feeling accomplished and uplifted, and sometimes all in the same hour,” Cote says.  “Every session is unique and tailored to the patient’s mood, energy and goals.”

How does music therapy work?

Music acts on the brain and body in a variety of ways. At its heart, music is an organized sound wave. It travels through the air and reaches your ear, where it is converted into structured signals that the brain can interpret. To the brain, music is more than just sound. It can activate systems involved in attention, memory, emotion, breathing, movement, stress responses, heart rate, pain and reward. For example, music can stimulate the production of dopamine, endorphins, and serotonin, which are chemicals that promote positive feelings and relaxation.

Music can affect attention, memory, emotion, breathing, movement, stress hormones, heart rate, pain pathways and reward signals.

The brain naturally tends to follow the patterns in music. Rhythms can help with focus, faster music can raise your energy level, and music you enjoy can stimulate motivation, goal-directed behavior and improved self-esteem. Music can also compete with pain for the brain’s attention, helping it feel less intense or disruptive.

In the body, heart rate and breathing may sync to the rhythm, tempo or vibration of external beats, especially if you like the music or it’s familiar. Music therapy takes advantage of this mechanism to help shift the body toward a calmer state.

For example, certain music might lead your autonomic nervous system to slow your heart rate, deepen your breathing and improve blood flow to your brain. These changes can reduce feelings of stress, lower inflammation and improve immune function.

Which music therapy techniques are used in cancer care?

Music therapists select approaches based on each patient’s symptoms, needs and goals. These may include:

Mindfulness-based music therapy (MBMT)

Delivered in person or online, this approach to music therapy combines specific music with guided mindfulness practices, such as focusing on sounds from a single instrument. Research shows it can reduce stress, fatigue, brain fog and other symptoms associated with cancer treatment.

Music-Assisted Relaxation (MAR)

Combining music with spoken guidance, breathing exercises or imagery, this is one of the most widely studied music therapies. Research has shown that it reduces vomiting and nausea during chemotherapy, helps patients relax, reduces stress and supports the improvement or maintenance of cognitive and fine motor skills.

Brainwave entrainment

This technique uses repeated sounds or beats intended to encourage the brain to sync its electrical activity with the sound pattern. It may be used to change energy level and mood.

Neurologic music therapy

Through very specific uses of music, this type of therapy builds new connections or reinforces existing connections in the brain. For example, a patient might engage in songwriting or playing an instrument to improve executive functioning and attention skills. It may benefit speech, motor skills and cognitive function.

Playing (or learning to play) a musical instrument

Playing an instrument can engage attention, memory, coordination and wordless emotional expression. Research has shown that it can improve the cognitive side effects of chemotherapy, such as memory lapses, difficulty concentrating and motor-skill problems.

Group singing and dancing

Singing and dancing with others can add positive social connections to the other benefits of music. It may stimulate the release of oxytocin, helping patients feel less isolated and more supported during cancer care.

Singing

Singing, which combines breath and the voice to create music, encourages a deeper, slower rate of respiration and can improve mood and reduce anxiety. Memorizing and singing lyrics can help improve memory and cognitive abilities that may have been affected by chemotherapy. And, singing can strengthen the lungs and muscles that may have been weakened by radiation or other treatments.

As an active therapy, singing can be cathartic or expressive, whether it’s a song you write yourself or one whose lyrics capture what you’re feeling. It’s a more socially acceptable way to let out some of the same feelings you might express with a scream.

Humming

Humming can have some of the same benefits as singing, using vibration, breath and sound to calm anxiety and focus the mind. It also increases levels of nitric oxide in the nasal area, which leads to immune benefits.

“You can use humming to augment the benefits of deep breathing,” Cote says. “The next time you take a deep breath, try some humming. Inhale through your nose, and exhale with your lips closed as you let your vocal folds vibrate together. You can do this anywhere, with no training, preparation or tools.”

Songwriting

Therapeutic songwriting is a guided process that can include writing lyrics, choosing melodies, or even adapting an existing song. It aims to help patients with meaning-making by telling their story and giving shape to their fear, grief, hope or gratitude in a form that can be repeated and shared.

The future of music therapy

Researchers at Sylvester are studying which music therapy techniques may be most helpful for specific cancer-related symptoms. One study looks at how specific mindfulness-based music therapy techniques impact stress, anxiety, depression and treatment-related side effects. The study is funded by a federal grant and led by Frank J. Penedo, Ph.D., Sylvester associate director for population sciences and director of SSCI, and Teresa L. Lesiuk, Ph.D., director and associate professor of music therapy at the University of Miami Frost School of Music.

“This study is examining whether specific music therapy techniques can be linked to specific patient outcomes,” Dr. Penedo explains. “We’re looking at whether music can improve symptom burden and quality of life, and mapping the underlying biological mechanisms via which these favorable outcomes may occur.”

The research aims to at make music therapy even more precise. But Cote says its foundation is already familiar and accessible.

“We are humans, with bodies, ears and voices. You don’t have to have any training to benefit from music therapy,” Cote says. “It’s an opportunity to have some control, make decisions, express yourself and find catharsis, and it can have direct positive effects on your brain and body.”

Music and singing can affect:

• Breathing
• Heart rate
• Muscle tension
• Stress hormones
• Reward signals in the brain
• Pain pathways
• Stress responses
• Attention
• Emotion
• Memory
• Mood

Learn more about music therapy at Sylvester Survivorship and Supportive Care Institute by calling 305-243-4129 or asking your provider for a referral.

Written by Rochelle Broder-Singer. Medically reviewed by David Cote, a board-certified music therapist and neurologic music therapist at Sylvester Comprehensive Cancer Center.

Tags: cancer survivorship, David Cote, Dr. Frank Penedo, Mindfulness Therapy, Music Therapy, Survivorship and Supportive Care Institute, Sylvester Comprehensive Cancer Center