Music therapy provides valuable support in gynaecologic cancer patients in palliative care in SG

For women with gynaecologic cancer undergoing inpatient palliative care in Singapore, music therapy helps create a comfortable space to disengage from difficult realities, celebrate life, and process grief and other challenging emotions, as shown in a qualitative study.

As such, “music therapy … [is able] to effectively increase focus and attention and reduce symptoms like anxiety and low mood [among patients],” the investigators said. “These outcomes [can] be achieved with just one or two clinical [sessions].”

Interviews with 10 patients who received a single session of music therapy and six patients who received two sessions revealed two major themes: (1) the interpersonal and intermusical experiences and (2) the function of music in music therapy. [Front Psychiatry 2025:16:1577545]

Music therapy was described as a refreshing, spontaneous, soothing, and unhurried experience. The patients felt that music was a means of an escape, promoting a sense of normalcy in their lives and allowing them to express themselves freely.

The music played within the therapy sessions evoked a range of feelings, including calmness, cheer, and emotional connection, according to the patients. They said music offered comfort and pleasure by triggering memories of loved ones, which facilitated an open discussion and the processing of grief.

The patients also stated that the therapy provided them with the opportunity to create artifacts in the form of songs, some of which were sung live or recorded. The artifacts were highly valued by the patients, serving as a way to leave a “piece” of themselves and express their feelings and wishes for their loved ones.

Finally, many noted that the bedside presence of a music therapist, who urged patients to engage in live music, made the experience impactful. The patients mostly highlighted the music therapist’s gentle, soft voice.

“Music therapists are trained to attune and emotionally resonate with the patient through music to provide patients an opportunity for meaningful moments where they can feel heard and explore inner feelings,” the investigators explained.

To that end, music therapists modify the tone and timbre of their voice to suit the hospital environment and the patient’s physical and emotional state, they said.

Music therapy interventions

Two music therapists were involved in providing music therapy sessions separately. Each session was held by the patient’s bedside, lasting 15—90 minutes, and possibly involving more than one music intervention based on the patient’s needs.

Among the 16 patients included in the study, the most frequently used interventions were song choice, music for reminiscence, music for relaxation, and song (lyric) discussion under “Receptive Music Therapy.” Other interventions included active improvisation, emphatic improvisation, and referential improvisation under “Improvisation Music Therapy;” vocal and instrumental under “Re-creative Music Therapy;” and song composition and song stories under “Compositional Music Therapy.”

Song choice involves the music therapist encouraging the patient to choose and listen to their preferred songs and helps build patient–therapist rapport. In music for reminiscence, the music therapist prompts the patient to retrieve memories and recount them in a therapy setting, which in turn facilitates conversation and allows meaningful memories to be discussed. Meanwhile, in music for relaxation, music that is steady and even in rhythm and intensity is played, with the aim of enhancing physical comfort. Music preferences of patients included a range of genres of music, categorized as popular piano (eg, Richard Clayderman), popular classics (eg, Rainbow Connection), classical music, national songs, and hymns (eg, Amazing Grace).

“These ‘Receptive Music Therapy’ methods are most suitable for this population as many of patients are seeking comfort at this stage, and receptive methods do not require them to be physically active to participate actively,” the investigators noted.

However, they stressed that music therapy should be tailored to what the patient is ready for and not for any other agenda, such as the therapist’s agenda to process deep and difficult emotions.

Value in terms of cost

In 2023, Singapore's Ministry of Health committed funding for palliative care patients across hospitals, home settings, and hospice day care. And the investigators emphasized that the present study strengthens the case for integrating music therapy into standard palliative care. [https://www.moh.gov.sg/news-highlights/details/launch-of-the-2023-national-strategy-for-palliative-care]

“Music therapy is an inexpensive intervention that uses a patient-centred approach to care for patients… A sustainable view in cost can consider how a shared musical experience may help expedite the building of rapport between patient and therapist, [which is crucial] to having positive outcomes in therapy,” the investigators said. [BMC Psychol 2019;7:91; Curr Med Chem 2024;doi:10.2174/0109298673307490240614053104]

The fact that most patients included in the study were able to benefit greatly within only one or two sessions indicates that with music therapy, significant results can be achieved even with limited sessions, they added.

While acknowledging the lack of any cost savings data in the study, the investigators stressed that their research is a step toward gaining a deeper understanding of the value of music therapy as defined by the recipients themselves. “This can help shape future research measuring value using the value-based healthcare model.”