Clinical question
What is the effect of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer?
Bottom line
Results of 26 trials suggest music therapy and music medicine interventions may have a beneficial effect on anxiety in adults with cancer, with an average anxiety reduction of 7.73 units on the State-Trait Anxiety Inventory scale (score range: 20–80) and -0.76 standardised units on other anxiety scales (considered a moderate to large effect).
Further, 12 studies found music interventions may reduce depression in adults with cancer. The results of a single study suggest music therapy may help adolescents and young adults employ positive coping strategies during stem cell transplant, a high‐risk and high‐intensity treatment. There was no evidence of effect for distress or mood.
The results of 2 studies suggest music interventions may increase hope in adult cancer patients by an average of 3.19 units on the Herth Hope Index (score range: 12–48).
As for the effect of music on physical symptoms in adults, the results of 12 trials suggest music has a moderate pain‐reducing effect of -0.67 standardised units. Music interventions also had a small effect on fatigue (-0.28 standardised units). The results of a single study suggest similar pain‐reducing effects in children. Listening to music may reduce heart rate up to an average of 3–4 beats per minute in adults. However, there was no evidence for an effect of music on other physiological responses, physical functioning or length of hospital stay.
Caveat
Because of the large number of trials at high risk of bias, the findings of this review should be interpreted with caution. Often, blinding of participants is not possible in music studies. For anxiety and quality of life, there were large effects across studies. The trials did not agree on the size of effect, with some reporting much larger beneficial effects than others, resulting in large confidence intervals. For these outcomes, the certainty of the evidence was low and very low, respectively. For pain and mood, the pooled effect sizes were moderate to large, but the evidence was very uncertain. For depression, the pooled effect was small to moderate, but there was very-low‐certainty evidence. The pooled effect for fatigue was small, and the evidence was of low certainty.
Context
Having cancer may result in extensive physical, emotional and psychosocial suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre‐recorded music offered by medical staff.
Cochrane Systematic Review
Bradt J, et al. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database Syst Rev 2021;10:CD006911. This review contains 81 trials with a total of 5576 participants.
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