Hot Stone Massage in Oncology Practice for Cancer Patients & Survivors

Hot Stone Massage in Oncology Practice for Cancer Patients & Survivors

Hot stone massage has been normally contraindicated for past oncology clients; however, as oncology treatments have improved, our hot stone massage treatment options have as well.

According to the National Cancer Institute, it is estimated that there are more than 16.9 million cancer survivors alive in the U.S. today and that number will grow to more than 22.1 million by 2030. Additional statistics show that almost half of men and one-third of women in the US will receive a cancer diagnosis in their lifetime. Because our oncology population continues to grow, most massage therapists will find themselves working with both cancer patients and survivors at some point in their careers.  

This increasing oncology populace is due, in part, to the advances in oncology treatments that are used to prolong life and fight cancer. And while cancer is not a general bodywork contraindication, some oncology treatments are, especially with the application of hot stone massage. 

Luckily, today we have better academic recognition of how hot stone massage can and cannot be applied with several oncology treatments. After all, fighting cancer should not end all possibilities of enjoying a hot stone massage for those who love it or just want to try it. Instead, oncology practitioners should review how a hot stone massage service can be provided or modified with various oncology treatments for this vulnerable and rising population.  

And with full disclaimer, this article specifically speaks to the application of hot stone massage with three popular forms of oncology treatments. This article does not speak to working with oncology or massage as a whole. 

Primary Oncology Treatments 

The three primary forms of oncology treatments used to fight cancer today are surgery, radiation, and chemotherapy. Most will receive at least one or a combination of the three to combat their cancer diagnosis. Let’s look at how these three oncology treatments affect hot stone massage practice. 

Oncology Surgery 

Surgery creates an acute medical situation. In simplified terms, tissues are cut, inflamed, and then heal, in most circumstances. After healing, the surgical site scar may be sensitive and is prone to further damage. Placement and working stones should never be applied directly over a dermal scar.  

Nervous system innervation can be cut or pierced during oncology surgery. And in some surgeries, major nerves can be briefly retracted from a surgical site, which could cause a temporary, delayed or permanent dysfunction of sensory abilities. 

Aside from the immediate surgical site, most cancer survivors should be able to receive hot stone massage after oncology surgery without adverse effect, minus a few exceptions, such as nervous system damage or additional oncology treatments. 

Oncology Radiation 

Healthy tissues, including nervous system innervation, are often destroyed alongside cancer cells in radiation treatments. Survivors who received external radiation decades ago have likely lost some or all sensation in the treated area. Areas that have had been treated with internal or external radiation can be severely damaged and are a permanent local contraindication for hot stone massage. Do not ever place or move hot stones over radiated tissues.  

Modern day oncology radiation recipients may have less damage due to incredible technological advances; however, all radiated tissue is susceptible to a lifetime potential of greater injury, regardless of when the radiation was administered.  

Some radiation clients will have tiny dot tattoos that show where their external radiation was focused. Practitioners can work around a radiated tissue if they are 100% certain they are able to avoid all of it. Consider using a cooler stone bath for these clients. 

Oncology Chemotherapy  

An oncology client who has received a recent dose of chemotherapy is not a good candidate for hot stone massage. Practitioners should not promote thermal therapy manual circulation during the tissue metabolism of chemotherapy without specific approval from the prescribing oncologist.  

An active chemotherapy cancer patient may also have a port or another external device affixed to their body.  All externally affixed body devices are a local contraindication for both placement and working stones. 

A cancer survivor who has completed their chemotherapy treatments may be a great fit for hot stone massage. However, there are a few caveats.  For example, those who have lost nervous sensation. Chemotherapy can damage nerve cells throughout the body, which can result in neuropathies and more. 

Hot Stone Massage and the Nervous System 

All hot stone massage recipients must be able to feel the heat of a stone to help avoid the potential of being burned by it. Hence, their nervous system’s sensory capabilities must be intact and fully functioning. Practitioners should avoid areas that have lost sensation as a local contraindication and not administer any hot stone massage at all if the entire body’s nervous sensation is impaired.  

Chilling with Oncology Treatments 

Many oncology treatments can leave a client feeling cold. The thermal therapy effects of hot stone massage can be remedial for a chilled client, once all other bodywork considerations have been addressed.  

Other hot stone massage considerations for oncology surgery, radiation and chemotherapy treatments include: 

 Lymph Nodes and Swelling  

Oncology treatments often focus on lymph nodes because they are a common area for metastatic cancer. Lymph node cancer treatments can create swelling in the localized treatment area. Do not apply hot stones or massage therapy to any areas of swelling.  

 Fatigue and Frailty 

Oncology treatments can cause extreme fatigue. These treatments can also cause a deterioration of skin, muscle, bone or any combination of the three.

If an oncology client seems excessively frail or in need of a colossal doze, consider switching the hot stone service to a bodywork that does not require frequent verbal communication and solely uses the hands instead of the harder surface of a stone. Frail and fatigued oncology clients will normally benefit from some adequate rest and doubly so with the correct massage. 

• Additional Side Effects 

Almost all cancer survivors will have a lifelong impact from their oncology treatment(s). However, survivors are usually better candidates for hot stone massage than those who are actively fighting cancer. 

Active oncology treatment recipients have an extensive list of possible side effects, such as mouth sores, lowered immunity or hand-foot syndrome, which all create additional oncology bodywork considerations. Sometimes, these side effects can last longer than the oncology treatment that caused them, but the severity does lessen for most survivors over time. 

Modifying Hot Stone Massage for Oncology Treatments 

In review, we have shown that these three primary oncology treatments chiefly create local contraindication sites more than full-body or total service contraindications for hot stone massage. As such, think about how hot stone massage can be adapted for local contraindications. For example, the arms and legs make up over half of the human body’s surface area.

Applying hot stone massage to an oncology client’s extremities is a great modification to work the majority of the body when the head, chest or organ areas have local contraindication(s). Even with a modified application, the thermal therapy effects of hot stone massage may be a wonderful relief for oncology clients who have pain, feel cold, or just want a special volcanic retreat from their everyday life. 

Still, because there are so many medical considerations with oncology treatments, partial or full body hot stone massage should only be provided on a case-by-case basis for multiple reasons beyond any single list that can be conceived here or anywhere. Keep in mind that all general hot stone and oncology bodywork contraindications, such as fever, active vomiting, infection and more, are still applicable. 

Consultation and Training in Oncology and Hot Stone Massage  

Unfortunately, like many bodywork subspecialties, we have very little research with oncology hot stone massage. Until we do, it is safest and best practice to consult with the client’s oncologist prior to administering hot stone massage for individual concerns and needs.  

While we have addressed hot stone application with three different oncology treatments here, general oncology bodywork and hot stone massage education is another matter. Specific oncology and hot stone massage CE classes should be sought prior to practicing either. Training in both should help provide knowledge of the adaptations, precautions and contraindications necessary to practice hot stone massage with cancer patients and survivors.  

CE Institute LLC Oncology & Hot Stone Massage Instructor Selena Belisle will share some ideas of how hot stone massage could be applied for cancer patients and survivors in this brief 18-minute video.

For comprehensive hot stone massage training please visit and register at:

For more comprehensive oncology and hot stone bodywork training please visit and register at:

To review this oncology hot stone massage article on Massage Magazine, please visit:

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