Music therapy and cancer

Dr Simon Procter, Director of Music Services at Nordoff Robbins, describes how we work with young people facing cancer.

We all know about cancer – many of us have experienced it, if not ourselves, then certainly in relation to a close friend or family member. As a diagnosis, it’s the last thing we expect: we all know it’s common but feel it surely can’t affect us. When it arrives in our lives, usually out of the blue, people are often afraid, or angry, or disbelieving. For some people, just coming to terms with the diagnosis can be a massive hurdle in itself, and all the more so when the person receiving the diagnosis is young.

But many young people are diagnosed with various forms of cancer all the time: and many of them find themselves having to leave their lives and families behind to be admitted as inpatients to specialist hospital wards. This is bad enough for anyone at any time of life, but all the more so for someone in their teens, at the very stage of life when identity is being forged and when friends and family are so important. Teenage cancer wards are simultaneously places of fear and loss of identity, but also places where new relationships can be forged, where people can support and learn from each other, and where new experiences are needed to substitute for the everyday experiences of hope, exploration, experimentation and self-discovery that have had to be left behind.

Of course, the primary reason for being admitted to such a ward as an inpatient is to receive cutting-edge hi-tech medical treatment. It is extraordinary how much progress has been made in recent years in combatting aggressive forms of cancer using drug therapies and other interventions. But to fight such aggressive disease, the treatment has to be aggressive too: being treated for cancer can be a gruelling experience. Chemotherapy can lead to hair falling out, drugs can make people chronically sick, surgery can leave people with impaired movement or even paralysed. And all of this at the very time of life when identity and self-image are at their most important.

And that’s why medical treatment alone is not enough. Most wards offer some kind of talking therapy – opportunities for people to talk about their feelings with a therapist or psychologist – but for many people this isn’t straightforward.

Music is central to the identities of many teenagers and young people when they’re not in hospital, so why not when they are inpatients too? Why should people diagnosed with cancer be denied the usual access to this very particular means of creating, negotiating and expressing their identity at the very time when they need it most? And shouldn’t that access also include opportunities to acknowledge and address the situation they find themselves in – a situation that for others can be very hard to understand?

Visiting a ward recently, I was struck by the noisiness and exuberance of a music therapy group. All the patients are young people facing an uncertain future: a lot of the time there is a sort of quiet nervousness to the ward as people engage with demanding and sometimes gruelling treatments. I ask a nurse if music therapy isn’t too noisy for the ward: “No, not at all – it’s great they can be noisy sometimes!”. Nurses worry about patients who become isolated or inexpressive: medical treatment works at a physical level but teenagers need personal care and suitable opportunities for continuing development too.

Viv (not her real name) tells me how friends back home treat her differently when they hear she has cancer: they probably just don’t know what to say or how to react. And, she adds, being in hospital, even though the staff are “awesome”, means you can’t help thinking about it all the time. But in music you get taken out of yourself – you’re not restricted by your diagnosis or your treatment or the medication. It’s time to forget yourself, to lose yourself in something bigger and more joined up. She’s made friends here and these friendships are forged in music-making, songwriting and “having a laugh”.

Ben (also not his real name) tells me how an operation on a brain tumour has left him partially paralysed on one side. Previously a sporty seventeen-year-old, he now can’t do any of the things he took for granted less than a year ago – running, dancing, playing football. And the cancer isn’t beaten yet either. Cancer makes him feel small, helpless and fearful – exactly the opposite of what he was feeling before cancer came along, and not what most young men are comfortable talking about. Ben has written and recorded songs with his music therapist about his experience, and he is proud of these, perhaps not so much because of the open-hearted words which I find so powerful as because he’s genuinely proud of the musical product, which he is eager to share with me and with friends back home.

And it’s not just the patients who comment on this. A mother, visiting her daughter, pulls me aside. Nodding at the raucous music therapy group in progress, she says “It’s not what I expected here. It makes such a difference”. It is indeed unexpected, and it clearly does make such a difference.