Spa Life Academy RESEARCH

Cancer is the leading cause of death worldwide with more than one in three people in the UK alone developing some form of cancer during their lifetime. Despite the prevalence of the disease, the spa sector has been reluctant to treat consumers with cancer.

Research conducted on behalf of the Spa Life Academy found that all participants interviewed as part of the six month study had faced barri-ers to receiving spa treatments, with some even being turned away from spas and salons at the point of treatment delivery.

It seems incredible that this occurs in the 21st century. And it’s all the more frustrating given the numerous benefits of oncology (cancer) mas-sage, both physical and psychological. Studies have shown that massage may help to reduce pain, fatigue, nausea, anxiety and depression, which explains why oncology massage is available in hospices and treatment centres. But many people would prefer to have a treatment away from a medical environment, perhaps as part of a day spent with family or friends, which can not only alleviate some of their symptoms, but also provide valuable, albeit temporary, escapism from their illness.

Unfortunately, the lack of guidance and education around treating can-cer in a spa environment means the industry has an inconsistent ap-proach to serving this consumer group, creating a situation which is as frustrating for operators as it is upsetting for consumers.

Michelle Hammond, director of education at the Spa Life Academy, initi-ated the research last year after yet another spa operator had voiced concern about offering oncology massage without running the risk of be-ing sued.

“I couldn’t believe we were still talking about this as an industry and not moving forward. Operators want to treat people with cancer, most of us have a guiding desire to want to make people feel better, but there’s no central guidance or consensus about how this should be done safely with Cancer sufferers, so naturally they’re worried about the potential liability issues and of course making someone worse,” she says.

Talking to the industry, it was clear that everyone wanted to overcome the challenge, find the solutions and make lasting change. “So our col-lective goal is to change the way people with cancer are looked after in UK spas. The first logical step to achieving this was to first determine ex-actly what is preventing people with the disease from being treated in our spas,” says Hammond.

We are in an industry that promotes wellness, yet research tells us we are turning people away just when they need us most.

Uncovering the challenges
Michelle appointed Kathryn Dowthwaite-Blay, the new Research Man-ager at Spa Life Academy who conducted the research and was tasked with interviewing people with cancer as well as leading spa operators, product houses, insurers and health experts who shared their insights and experiences.

“Talking to key people in the industry as well as those suffering from cancer, we had overwhelming support for our research, it was clear that this is an issue people are profoundly passionate about,” she says.

“It’s an ongoing challenge for our industry. People with cancer come into our spas every day, whether or not they tell us they have the disease is another matter. If they’ve been turned away before, they’re not likely to always be open to disclose the facts. We are an industry that promotes wellness, yet the research tells us that we are turning people away just when they need us most.”

The research found that there is a widespread assumption in the spa in-dustry that massage can spread cancer via the lymphatic system. How-ever, there is a lack of research to justify this. In fact, lymphatic circu-lation occurs naturally when we move, and while cancer may spread into the lymphatic system, or start in the lymphatic system itself, the circu-lation of lymph, from massage or any other movement, does not cause cancer to spread according to the latest medical research. Although spe-cific training and awareness is needed to ensure a thorough understand-ing and application of the do’s and don’ts.

So where has this general lack of understanding come from? “Most par-ticipants said the problem was rooted in their preliminary training, gov-erning bodies and practice guidelines, which instill fear into therapists to treat any form of ‘contra-indication’, specifically Cancer from the start,” says Dowthwaite-Blay.

” the problem was rooted in training organisations and awarding bodies which insil fear into therapists from the outset”

It seems, not unreasonably, that the spa industry eers on the side of caution when it comes to treating people with ailments, diseases or dis-orders, in the most part teaching includes asking for a doctor’s note for most conditions ‘contra-indicated’ – but this guidance has not been up-dated in decades in many cases and is in desperate need of review. Of course practitioners can also do more for themselves to learn about spe-cific conditions, as often vocational training providers, product houses and employers do not have the funding to spend more time on in-depth knowledge and understanding of contra-indications so it is up to the in-dustry, further training and spas to continuously professionally develop the therapists on key areas such as Cancers.

The education system is not alone in creating barriers for treating people with cancer. According to the research, insurance companies compound the problem by advising operators to follow their training on contraindi-cations, which has already been established as flawed with regards to cancer. They also require consumers to produce a written referral from their GP before undergoing any massage treatment.

“This is obviously an issue, because few, if any, clients would know they need a doctor’s note to have a massage, so would turn up without one. And even if they were pre-warned, some participants said that having to pay for a referral as well as a massage would be enough to deter them having a treatment altogether given that many already face financial pressures because of the illness, which prevent them from working full-time or at all,” says Dowthwaite-Blay.

The research demonstrated a bouncing of responsibility between the in-surance companies, therapists and medical professionals. Whilst some medical professionals hold massage and complimentary treatments in great esteem other GPs do not know of any of the benefits and may not feel informed enough to write a doctors. Combine this with a reluctance from medical practitioners, not always in approving the patient for treatment, but in approving the ‘practitioner’ to deliver treatments. Many medical practitioners are concerned that practitioners training and expe-rience can vary so greatly, with beauty and massage qualifications being possible to obtain in as short as a 2 day course through to more ad-vanced accreditation, with no legal responsibility to stay up to date or compliant in the form / method of their practice.

What happens now?
Having uncovered a lack of understanding across the industry about the treatment of cancer, the products to use, training and insurance, the re-search highlighted areas for improvement.

The first of these was the need for specific training for therapists treating people with cancer. Specialists agree that most treatments can be adapted to suit the needs of the individual consumer. But therapists do require education to learn how to modify massages and services, gain an understanding of cancer treatments and their side effects as well as knowledge of the products they can use during a massage.

“All we initially wanted to do was find out what was preventing people with cancer being treated in our spas & clubs, but already we are coming up with solutions”

The research found that the qualities of those performing the massage were as important as the treatment itself. Many participants felt that therapists should be mature, rather than school leavers, experienced and sensitive with an awareness of the disease. Indeed, many believed that the entire spa journey – from reception to cuisine to treatments – needed to be addressed to meet the needs of customers with cancer.

One employer who had invested in staff training in this area said it had boosted staff morale. Treating customers with cancer was rewarding and had given staff a sense of satisfaction and fulfilment, while helping them to work better as a team.

Encouragingly, the research discovered that there is a wealth of knowledge available across varying industries about how to treat people with cancer in a spa / wellness environment. The problem is that the in-formation is fragmented and people just don’t know how and where to access it.

“A massage may seem insignificant when dealing with the fight against cancer, but what this research has shown is that massage has substantial benefits for people suffering the disease. As an industry, it’s time to col-laborate, share and make changes to meet the needs of so many of our customers.”

The industry wants clear guidelines, for treating individuals with Cancer considerately and professionally, so we can all treat spa consumers with cancer in our spas and stop discriminating and become educated to meet our client’s needs.

Making changes
Enthusiastically received, the research has spurned the industry into change. Now that the barriers to treating people with cancer have been identified, developing a system that meets the approval of spa opera-tors, medical professionals and insurers is the crucial next step in provid-ing a universal approach to serving these consumers.

“Our goal now is to develop online education about cancer and make it available to the industry, so that everyone can learn about treating peo-ple with the disease,” says Hammond, who is proposing a collaboration between Spa Life Academy and the non-profit organisation ‘Wellness for Cancer’ by providing all spa employees the opportunity to achieve a ‘cancer awareness’ badge once they have successfully undergone the training, which demonstrates that they do welcome and can treat con-sumers with the disease.

“It’s a simple approach, but both the insurers and medical professionals I have spoken to have said they would be happy to work with such a badge system, that makes it easy to recognise basic and advance level understanding and a commitment to continuous training as a benchmark throughout spas properties and individual practitioners” she says.

Exactly what this education should look like and how it should be funded is another question, and one that is being addressed early this year when the industry gets together at a cancer roundtable organised and hosted by Spa Life Academy.

The wheels are in motion, says Hammond. “All we wanted to do was find out what was preventing people with cancer being treated in our spas, but because of the high volume of support to address this we are al-ready finding solutions. People are amazing when they come together. We’re now in a position, collectively, to help get all UK spas completely behind this cause so that people with cancer aren’t turned away from our facilities in the future. And if there is a way we can finance this to ensure every single UK property and practitioner has the opportunity to complete the online introductory level for free throughout 2015 – then we are very keen to explore this and make that happen”

Vicky Kiernander, Health Editor, body LIFE UK.

For further information about the research by Spa Life Academy contact Michelle Hammond,