Contraindications vs Myths: What RMTs Actually Need to Know About Oncology Massage
If you’re an RMT, chances are you were taught a long list of “don’t” when cancer entered the conversation.
Don’t work near tumours.
Don’t use pressure.
Don’t treat during chemotherapy.
Don’t touch lymph nodes.
Somewhere along the way, myths started masquerading as contraindications, and an entire patient population quietly became one of the most avoided in massage therapy.
At Same Stars Academy (SSA), we see this all the time, and we’ll say it clearly:
Most fear around oncology massage is not rooted in current evidence.
Real contraindications still matter, and confusing the two can cause harm.
Let’s break down what RMTs actually need to know.
What a Contraindication Really Is (and Isn’t)
A true contraindication is a situation where massage is unsafe in that moment, in that way, or without modification.
It is not:
A diagnosis on its own
A blanket rule that applies forever
A reason to avoid the patient entirely
They depend on:
Cancer type and location
Current treatment phase
Side effects and medical status
Medications
Skin integrity, blood counts, and bone health
Goals of care (supportive, rehabilitative, palliative)
This is where clinical reasoning replaces fear-based rules.
Common Oncology Myths RMTs Are Still Being Taught
Let’s talk about the big ones, because these myths are still showing up in entry-level education and clinic policies.
Myth 1: Massage Spreads Cancer
This is one of the most persistent, and damaging myths.
There is no evidence that massage spreads cancer through circulation or lymph flow. Metastasis is a complex biological process driven by cancer cell behavior, not external manual pressure.
What does matter:
Avoiding direct pressure over active tumors when indicated
Understanding tissue fragility
Adapting techniques appropriately
Avoiding massage altogether? Not evidence-based.
Myth 2: Oncology Patients Only Need Massage After Surgery
Oncology massage is not limited to post-op care.
Patients may benefit from skilled massage during:
Active chemotherapy or radiation
Long-term survivorship
Hormonal treatment phases
Palliative and end-of-life care
Each phase requires different considerations, not avoidance.
Myth 3: Pressure Must Always Be Feather-Light
Pressure is not the contraindication; tissue tolerance is.
Some patients need:
Gentle, calming work
Others benefits from moderate pressure
Some areas require avoidance or modification
Some areas can be treated normally
The skill lies in assessment, not arbitrary limits.
Myth 4: Lymphedema Means “Hands Off”
Lymphedema requires specialised knowledge, not fear.
While certain techniques may be contraindicated:
Massage is not automatically unsafe
Proper positioning, pressure awareness, and scope clarity matter
Understanding when to refer or collaborate is critical
Avoidance without understanding does not protect patients; it limits care.
Real Contraindications RMTs Do Need to Understand
Here’s where oncology education actually matters.
True contraindications may include (depending on context):
Unstable bone metastases
Severe thrombocytopenia
Acute infection or fever
Fragile or compromised skin
Active radiation burns
Certain vascular complications
Medical instability requiring clearance
Notice the pattern? These are clinical conditions, not cancer itself.
The Real Risk: Under-Treating Instead of Over-Treating
When RMTs rely on myths:
Patients lose access to supportive care
Pain, anxiety, and isolation increase
Therapists lose confidence and competency
The profession reinforces outdated narratives
Oncology patients often need ongoing, long-term care, not avoidance.
What Oncology Massage Education Should Actually Teach
At Same Stars Academy, we focus on:
Clinical reasoning over rigid rules
Assessment-based decision making
Scope-aware, ethical treatment planning
Understanding treatment side effects, not just diagnoses
Collaboration with medical teams
Confidence working with complex presentations
Because oncology massage isn’t about memorising contraindications lists; it’s about knowing when and how to adapt care safely.
Why This Matters for the Future of Massage Therapy
Cancer survivorship is growing. Chronic side effects are common. Patients are living longer and needing care longer.
RMTs who rely on myths will be left behind. RMTs who invest in proper education will become essential providers.
This isn’t about being brave. It’s about being informed.
Ready to Move Beyond Fear-Based Rules?
If you want to:
Treat oncology patients ethically and confidently
Understand real contraindications vs outdated myths
Build referral trust with medical providers
Stop avoiding patients who actually need you
That’s exactly why Same Stars Academy exists.
Because patients deserve care, and therapists deserve better education.
Resources
Curious whether oncology education is right for you? Same Stars Academy has an upcoming Foundations of Oncology Massage Therapy: Level 1 course scheduled in Alberta for April this year. Click here to learn more!
If you ever feel unsure where to start, our team is always here to help. You can call or email us anytime for guidance or support.
