Oncology · Medical Literature
The Effect of Music During Chemotherapy Treatment on Depression, Anxiety, Stress Levels and Chemotherapy Symptoms: A Randomized Controlled Trial.
Abstract
This study aimed to determine the effect of listening to music during chemotherapy sessions on depression, anxiety, stress, and treatment-related symptoms. A randomised controlled trial was conducted between June and September 2023 with stable, non-metastatic patients receiving outpatient chemotherapy at a university hospital oncology unit. Sixty-three eligible patients were randomised to the intervention or control group, and 49 participants completed the study (intervention n = 24; control n = 25). Both groups received routine care, while the intervention group additionally listened to music during chemotherapy sessions for 4 weeks. Depression, anxiety, stress, and chemotherapy-related symptoms were assessed before and after the intervention using validated measurement tools. The study was reported according to the CONSORT guidelines. Participants who listened to music showed significant reductions in depression, anxiety, and stress, together with improvements in treatment-related symptoms, including pain, fatigue, nausea, sadness, worry, insomnia, appetite loss, well-being, and shortness of breath. Listening to music during chemotherapy may improve psychological well-being and alleviate treatment-related symptoms. As a simple, non-invasive, low-cost intervention, music can be incorporated into routine nursing care as a complementary therapeutic approach. ClinicalTrials.gov identifier: NCT06180629.
Clinical relevance
Does listening to music during outpatient chemotherapy sessions reduce depression, anxiety, and stress, and improve treatment-related symptoms in stable, non-metastatic cancer patients compared with routine care alone? __SNAPSHOT__ {"studyDesign":"Randomized controlled trial (reported per CONSORT guidelines)","setting":"University hospital oncology outpatient unit; country not explicitly stated in abstract (author names suggest Turkey)","sampleSize":"n=49 completed (intervention: n=24; control: n=25); 63 patients randomized (14 did not complete the study)","population":"Stable, non-metastatic adult cancer patients receiving outpatient chemotherapy; specific cancer types, age range, performance status criteria, and prior treatment history not reported in abstract","intervention":"Music listening during chemotherapy sessions for 4 weeks (music genre, delivery method, session duration, and whether music was self-selected or pre-specified are not reported in abstract)","comparator":"Routine care alone (no music)","primaryOutcome":"Not formally designated as a single primary endpoint in the abstract; outcomes assessed include depression, anxiety, stress (via validated measurement tools, instruments not named in abstract), and chemotherapy-related symptoms (pain, fatigue, nausea, sadness, worry, insomnia, appetite loss, well-being, shortness of breath)","followUp":"4 weeks (pre- to post-intervention assessment); longer-term durability not assessed","fundingSource":"Not reported"}
Key findings
The abstract reports that the music-listening group showed statistically significant reductions in depression, anxiety, and stress, as well as improvements across multiple treatment-related symptom domains including pain, fatigue, nausea, sadness, worry, insomnia, appetite loss, subjective well-being, and shortness of breath, compared with the routine care control group. No specific effect sizes, mean differences, standard deviations, confidence intervals, p-values, or NNT/NNH values are reported in the abstract. The direction and magnitude of effect across the nine symptom domains cannot be independently assessed from the available text. Adverse events related to the intervention are not reported. Attrition was 22% (14/63 randomized did not complete; intervention: not broken out by group in abstract), which may have affected balance between arms and introduces a potential risk of attrition bias.
Practice implications
This RCT provides preliminary evidence that a simple, low-cost, nurse-administered music-listening intervention during outpatient chemotherapy may reduce psychological distress and improve subjective symptom burden in stable, non-metastatic cancer patients over a 4-week period. However, several key limitations restrict the strength of this inference: (1) this summary is based solely on the abstract — full statistical data, instrument names, allocation concealment details, and blinding procedures are not available for appraisal; (2) the sample is small (n=49 completers), limiting statistical power for the broad range of outcomes assessed; (3) blinding of participants to a music intervention is inherently impossible, introducing performance and detection bias risk; (4) the primary endpoint was not pre-specified as a single outcome, raising concern about multiplicity of testing across nine symptom domains; (5) cancer type heterogeneity, chemotherapy regimen diversity, and baseline severity of symptoms are not described, limiting the generalizability of findings; and (6) the 4-week follow-up window does not address durability of benefit. The findings are consistent with the broader literature supporting music interventions in oncology settings but require confirmation in larger, methodologically rigorous trials before they can justify formal integration into clinical protocols. __LIMITATIONS__ Small sample size (n=49 completers); underpowered to reliably detect effects across nine distinct symptom outcomes without substantial risk of false-positive findings.,22% attrition rate (14/63); reasons for non-completion and differential dropout between arms not described in abstract, introducing attrition bias risk.,No single pre-specified primary endpoint; testing across multiple symptom domains without correction for multiplicity inflates Type I error risk.,Participant blinding is impossible by nature of the intervention; detection bias and performance bias are unavoidable without objective outcomes or blinded assessors.,Instruments used to measure depression, anxiety, stress, and symptom burden are not named in the abstract; psychometric properties and clinical thresholds cannot be evaluated.,Music type, volume, delivery mode, session duration, and patient self-selection of music are not described, limiting reproducibility.,Cancer type, stage distribution, and chemotherapy regimens are not reported; population heterogeneity limits generalizability.,Short follow-up (4 weeks) — durability of benefit beyond the active intervention period is unknown.,Funding source not reported; potential conflicts of interest cannot be assessed.,Abstract-only availability: full methodological details (randomization sequence, allocation concealment, intention-to-treat analysis, protocol registration) cannot be independently verified. __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ This small RCT (n=49) suggests that music listening during outpatient chemotherapy may reduce depression, anxiety, stress, and a broad range of treatment-related symptoms over 4 weeks, consistent with prior literature. However, the abstract reports no quantitative effect sizes, the study is significantly underpowered for its breadth of outcomes, and inherent blinding limitations introduce bias risk. These findings are hypothesis-generating and practice-informing at the level of a low-harm adjunct, but are insufficient to mandate protocol-level adoption without confirmation in larger, adequately powered trials with pre-registered primary endpoints and longer follow-up.