The procedure of Intracavitary Brachytherapy (ICBT) involves use of spinal anesthesia and invasive procedure leading to anxiety among the patients. Music therapy (MT) has been established as an excellent measure to alleviate anxiety; however, the role is scarcely employed. This randomized study evaluates the impact of MT on anxiety and distress during the procedure of ICBT in cervical malignancies.
Materials and Methods:
In this single institute, Randomized trial comparing MT versus no MT in patients undergoing ICBT for cervical malignancies, subjective assessment for stress and anxiety was done with use of pre-State-Trait Anxiety Inventory (STAI-S Anxiety) questionnaire and Symptom Distress Thermometer (SDT). Patients under the MT group were counselled for their choice of music prior to the treatment and the non-MT group did not receive any such counselling. After the completion of treatment, both the questionnaires were again repeated and repeated-measures analysis of variance was used to assess treatment effects on STAI and SDT. Correlation between STAI and SDT was also assessed at both time points and by group with Spearman correlation coefficients.
A total of 70 patients with histopathological proven cervical malignancy were enrolled with 35 each in the MT and non-MT group. The median age was 48.5 years and both groups were matched in the treatment and patient characteristics. The overall mean pre- and post-simulation STAI-S scores were 42.3 (range, 22-62) and 37.7 (range, 20-64), respectively. The overall mean pre- and post-simulation SDT scores were 4.6 (range, 0-10) and 3.2 (range, 0-10), respectively. The MT group had mean pre- and post-simulation STAI-S scores of 42.8 and 32.3, respectively (p<0.001) and the mean SDT scores before and after simulation were 4.5 and 1.9, respectively (p<0.001) The no-MT group’s mean pre- and post-simulation STAI-S scores were 41.9 and 39.9, respectively (p=0.54), and the mean SDT scores were 4.7 and 3.9, respectively (p=0.76).
The role of Music therapy as a method to reduce the patient anxiety has been well established in our study. The reduced anxiety in the patient helps the oncologist in performing a better implant which indirectly would lead to better disease control and survival. MT should be incorporated in the Brachytherapy Operating room to help alleviate the patients alleviate their procedure related stress an anxiety.
Dr. Mansi Barthwal –Senior Resident, NCI, AIIMS, New Delhi. I am a proponent of Brachytherapy in times where the art of brachytherapy seems to be in the decline. I have been trained in Interstitial Brachytherapy in Head and Neck, Breast and Sarcoma and and Intracavitary Brachytherapy in Gynecological malignancies and Surface Mold and Intraluminal Brachytherapy