October 2009: Interview with Dr. Barrie Cassileth, MS, PhD

Laurance S. Rockefeller Chair in Integrative Medicine
Chief Integrative Medicine Service
Memorial Sloan-Kettering Cancer Center

Music has long been associated with health and healing in many cultures. Apollo, the Greek god of music, was also the god of healing. Today’s efforts in many settings that attend to seriously ill patients reflect this belief. We have a major music therapy effort in the Integrative Medicine program at Sloan Kettering, involving two senior music therapists plus graduate student interns who work primarily with inpatients.

Music therapy is like psychotherapy. It applies music instead of words to reach similar goals. In some situations, for example when patients are facing end of life, become non-communicative or withdrawn, music may be the only way to reach them. We receive many requests from the hospital for music therapy, because there are many seriously ill patients who respond to little else. It is quite magical to see what music can do.

We recently produced a tape that teaches patients self- hypnosis, a deeper form of meditation, and we did it with our two senior music therapists. So the music is an essential part of the meditation training. Patients who learn self-hypnosis can use it to relax prior to stressful situations such as before surgery, prior to difficult tests or procedures, or for sleep problems. It is a tool with which they can help themselves.

Our music therapists provide one-on-one care. But we also have volunteer musicians from several music schools as well as professional musician volunteers who come to us on their own or through Musicians on Call, a wonderful organization. These volunteers perform in larger areas of the hospital such as waiting rooms.

We have a collection of small percussion and other instruments that our music therapists carry around to give patients an opportunity to participate. These therapists approach music therapy exactly as how any cancer patient is treated at MSKCC- the intervention must be individualized and specific to that patient. Music therapists are adroit at recognizing what each patient requires. What works for one is not necessarily appropriate for another. Working with our inpatients, who typically are critically ill, means working with a family, as family members tend to be present. Often one can see amazing results, the patient lifting out of despair or pain.

We are also heavily into research, which is very challenging in music therapy. We conducted a randomized controlled trial of patients awaiting bone marrow transplantation. These patients endure many weeks of isolation in preparation for the transplant, a very difficult time. This study was published in the journal CANCER some years ago. Patients were randomized to usual care or to receive music therapy. Gowned and masked, the music therapist went into the isolation area and worked with the patient. Patients who received music therapy did much better in terms of their mood, their levels of depression and anxiety.

We know intuitively, but also because of this and other studies, that music therapy is useful and beneficial. When I help leaders of hospitals or other groups set up Integrative Medicine or Integrative Oncology programs, I routinely recommend that they start with music therapy. I see it is that important. Music accesses a primitive, pre-language part of the brain. It is possible to accomplish with music what often cannot be accomplished with words.