Questão 42 - AFA 2020

Directions: Read the text below and answer question according to it.

TEXT

Music therapy with cancer patients

    Cancer is the second leading cause of death in the
United States, in Germany and in many other
industrialized countries. In 2007, about 12 million
people were diagnosed with cancer worldwide with a
[5] mortality rate of 7.6 million (American Cancer Society,
2007). In the industrial countries, the most commonly
diagnosed cancers in men are prostate cancer, lung
cancer and colorectal cancer. Women are most
commonly diagnosed with breast cancer, gastric
[10] cancer and lung cancer.
    The symptoms of cancer depend on the type of the
disease, but there are common symptoms caused by
cancer and/or by its medical treatment (e.g.,
chemotherapy and radiation). Common physical
[15] symptoms are pain, fatigue, sleep disturbances, loss of
appetite, nausea (feeling sick, vomiting), dizziness,
limited physical activity, hair loss, a sore mouth/throat
and bowel problems. Cancer also often causes
psychological problems such as depression, anxiety,
[20] mood disturbances, stress, insecurity, grief and
decreased self-esteem. This, in turn, can implicate
social consequences. Social isolation can occur due to
physical or psychological symptoms (for example,
feeling too tired to meet friends, cutting oneself off due

[25] to depressive complaints).
    Besides conventional pharmacological treatments
of cancer, there are treatments to meet psychological
and physical needs of the patient. Psychological
consequences of cancer, such as depression, anxiety
[30] or loss of control, can be counteracted by
psychotherapy. For example, within cognitive therapy
cancer patients may develop coping strategies to
handle the disease. Research indicates that music
therapy, which is a form of psychotherapy, can have
[35] positive effects on both physiological and psychological
symptoms of cancer patients as well as in acute or
palliative situations.
    There are several definitions of music therapy.
According to the World Federation of Music Therapy
[40] (WFMT, 1996), music therapy is: “the use of music
and/or its music elements (sound, rhythm, melody and
harmony) by a qualified music therapist, with a client or
group, in a process designed to facilitate and promote
communication, relationship, learning, mobilization,
[45]expression, organization, and other relevant
therapeutic objectives, in order to meet physical,
emotional, mental, social and cognitive needs”.
    The Dutch Music Therapy Association (NVCT,
1999) defines music therapy as “a methodological form
[50] of assistance in which musical means are used within a
therapeutic relation to manage changes,
developments, stabilisation or acceptance on the
emotional, behavioural, cognitive, social or on the
physical field”.
[55]    The assumption is that the patient's musical
behaviour conforms to their general behaviour. The
starting points are the features of the patient's specific
disorder or disease pattern. There is an analogy
between psychological problems and musical
[60] behaviour, which means that emotions can be
expressed musically. For patients who have difficulties
in expressing emotions, music therapy can be a useful
medium. Music therapy might be a useful intervention
for breast cancer patients in order to facilitate and
[65] enhance their emotional expressivity. Besides analogy,
there are further qualities of music that can be
beneficial within therapeutic treatment. One of these

qualities is symbolism: music can symbolize persons,
objects, incidents, experiences or memories of daily
[70] life. Therefore, music is a reality, which represents
another reality. The symbolism of the musical reality
enables the patient to deal safely with the other reality
for it evokes memories about persons, objects or
incidents. These associations can be perceived as
[75] positive or negative, so they release emotions in the
patient.
    Music therapy both addresses physical and
psychological needs of the patient. Numerous studies
indicate that music therapy can be beneficial to both
[80] acute cancer patients and palliative cancer patients in
the final stage of disease.
    Most research with acute cancer patients receiving
chemotherapy, surgery or stem cell transplantation
examined the effectiveness of receptive music therapy.
[85] Listening to music during chemotherapy, either played
live by the music therapist or from tape has a positive
effect on pain perception, relaxation, anxiety and mood.
There was also found a decrease in diastolic blood
pressure or heart rate and an improvement in fatigue;
[90] insomnia and appetite loss could be significantly
decreased in patients older than 45 years. Further
improvements by receptive music therapy were found
for physical comfort, vitality, dizziness and tolerability of
the chemotherapy. A study with patients undergoing
[95] surgery found that receptive music therapy led to
decreased anxiety, stress and relaxation levels before,
during and after surgery. Music therapy can also be
applied in palliative situations, for example to patients
with terminal cancer who live in hospices.
[100]    Studies indicate that music therapy may be
beneficial for cancer patients in acute and palliative
situations, but the benefits of music therapy for
convalescing cancer patients remain unclear. Whereas
music therapy interventions for acute and palliative
[105] patients often focus on physiological and
psychosomatic symptoms, such as pain perception and
reducing medical side-effects, music therapy with post

hospital curative treatment could have its main focus
on psychological aspects. A cancer patient is not free
[110] from cancer until five years after the tumour ablation.
The patient fears that the cancer has not been
defeated. In this stage of the disease, patients
frequently feel insecure, depressive and are
emotionally unstable. How to handle irksome and
[115] negative emotions is an important issue for many
oncology patients. After the difficult period of the
medical treatment, which they often have overcome in
a prosaic way by masking emotions, patients often
express the wish to become aware of themselves
[120] again. They may wish to grapple with negative
emotions due to their disease. Other patients wish to
experience positive feelings, such as enjoyment and
vitality.
    The results indicate that music therapy can also
[125] have positive influences on well-being of cancer
patients in the post-hospital curative stage as well as
they offer valuable information about patients' needs in
this state of treatment and how effects can be dealt
with properly.

(Adapted from https://essay.utwente.nl/59115/1/scriptie_F_Teiwes.pdf - Access on 25/02/19) 

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