Jason Kiernan knows the value of music. After studying piano, he developed a taste for bluegrass in his 20s. Now he plays banjo in a six-piece bluegrass band. In addition to picking the banjo, he's an assistant professor in the College of Nursing at Michigan State University.
A few years ago, when he was finishing his doctorate in nursing and looking around for a dissertation project, he noticed something interesting about patients receiving chemotherapy in the infusion clinic: They were, quite often, listening to music on headphones while they received their treatments.
When he asked why they were listening to music rather than streaming a TV show or surfing YouTube, most replied that the Wi-Fi at the hospital wasn't great. It was just easier to listen to music. Still, Kiernan wondered if there might be a benefit to those tunes.
Music Therapy for Nausea
Kiernan was aware of the evidence that music can help reduce pain, but there is much less evidence for music's effect on chemotherapy-induced nausea. According to the National Cancer Institute, around 80 percent of patients develop chemotherapy-related nausea. Even with medications, almost 50 percent still suffer nausea, Kiernan says.
"Anti-nausea meds are expensive. I work in a big urban center where insurance is an issue, and there are people who can't afford those medications. As a nurse practitioner, I'm always interested in interventions that are low cost and easily accessible to my patients." He'd found the perfect research topic.
After hold-ups due to the pandemic — "they were not letting any unnecessary personnel anywhere near the hospital," says Kiernan — he was finally able to put together a small pilot study. Over a period of five days, 12 patients listened to their favorite music for 30 minutes each time they took their nausea medication. The patients experienced a reduction in the severity of nausea as well as in ratings of how much the nausea bothered them. Kiernan and co-author April Hazard Vallerand published their research this February.
How Does Music Reduce Nausea?
But how does music reduce nausea? Nausea, explains Kiernan, is a neurological phenomenon. Even though you perceive nausea in your stomach, it doesn't start there. The brain creates nausea. And that's why music therapy — a noninvasive, non-pharmacological approach — is effective.
"When we listen to music, we gain access to the brain via the auditory nerve," says Kiernan. "You're using a neurologic intervention (music) to influence a neurologic phenomenon (nausea)."
Serotonin is the prime neurotransmitter behind chemotherapy-induced nausea. Anti-nausea medications taken by cancer patients work by blocking the release of serotonin. Kiernan had seen earlier research that found that when people listen to music they like, there is less release of serotonin. So it was a natural next step to see if music would prove useful for treating chemotherapy-induced nausea.
Challenges in Measuring Effectiveness
In Kiernan's study, in addition to grooving to their favorite tunes, the patients were also taking anti-nausea medicine. It would be unethical, Kiernan points out, to take away medicines known to be effective in order to test treatments that may or may not help.
But that made it difficult for the researchers to distinguish the effect of the music from the effect of the medications. However, Kiernan found a clever way around this problem. He started the music just when the patients took their anti-nausea medications before the meds had time to take full effect. The music lasted for 30 minutes, after which time the medicines would have been fully effective.
In an upcoming study, Kiernan plans to cut the time of the music intervention to two or three minutes to further reduce the chances of medication muddying the study's results. Meanwhile, he points out that music therapy is inexpensive, and you don't need a doctor's prescription to give it a try.
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