Progressive muscle relaxation is one of the simple, low-cost, and feasible interventions in psycho-oncology that can be used to moderate patients' anxiety before starting chemotherapy. Waiting to receive medication, entering the treatment environment, experiencing possible complications, and worrying about the effectiveness of the treatment can increase the patient's psychological and physiological arousal. This condition is sometimes associated with muscle tension, heart palpitations, restlessness, worrying thoughts, and increased sensitivity to physical symptoms. Progressive muscle relaxation with training to identify and gradually reduce muscle tension helps the patient better recognize the relationship between physical tension and anxiety and develop a calmer response to the therapeutic situation.
The main basis of this technique is controlled contraction and then release of different muscle groups. During the exercise, the patient directly experiences the difference between tension and relaxation and gradually increases the ability to detect the initial symptoms of physical arousal. From a psycho-oncological point of view, this process is particularly important because anxiety before chemotherapy is not just a mental experience and can be associated with activation of the autonomic nervous system and increased physical tension. Therefore, an intervention that affects the physical and psychological component of anxiety at the same time can play a supportive role in the management of this condition.
One of the important uses of progressive muscle relaxation is to reduce anticipatory anxiety or anticipatory anxiety, that is, anxiety that forms before the chemotherapy process and based on the patient's expectations of it. Some patients experience an increase in anxiety even before entering the treatment department, observing the hospital environment, smelling disinfectants, or approaching the time of injection. Repetition of this reaction can create a conditional association between environmental symptoms and feelings of fear. Practicing relaxation in the interval before treatment can help the patient have a more controlled physiological response to these stimuli.
On the other hand, this technique can also have an indirect effect on the cognitive cycle of anxiety. When a person is in a state of intense tension, the likelihood of selective attention to threatening signs, anticipating negative consequences, and catastrophically interpreting the symptoms increases. Step-by-step focus on muscle groups shifts the patient's attention resources from threat-oriented thoughts to a controllable experience of the body. This shift in focus can provide a good opportunity to reduce rumination and increase feelings of psychological control.
The application of this intervention in psycho-oncology is not limited to reducing anxiety, but can also be part of the patient's psychological preparation process for treatment. Training the technique before the first session of chemotherapy gives the patient a transferable self-regulation skill that can be used in subsequent sessions as well. Such an experience may increase the sense of self-efficacy because the patient has a specific tool to manage some of their reactions rather than passively experiencing anxiety.
The implementation of the technique should be tailored to the patient's physical and mental condition. Short and simple sessions, gradual training, and a focus on the muscles that the patient is able to control can make the technique easier to use. In patients with pain, severe weakness, neuropathy, or movement limitation, muscle contraction should be performed with caution and a modified, non-contraction-based version should be used if necessary. Therefore, the intervention should be individual-centered and not implemented as a fixed instruction for all patients.
From a therapeutic perspective, progressive muscle relaxation can be combined with psychoeducation, emotional support, calming breathing, and cognitive-behavioral interventions and can be part of a comprehensive pre-chemotherapy anxiety management program. Its effectiveness should not only be measured based on the reduction of subjective anxiety, but also changes in muscle tension, physiological symptoms, sleep quality, sense of control, and the degree of patient cooperation with the treatment process.
Progressive muscle relaxation can be considered as a practical and accessible intervention in psycho-oncology that aims to reduce physiological arousal, modulate predictive anxiety, and increase patient self-regulation prior to chemotherapy. The main value of this method lies in its simplicity, educability, and the possibility of independent use by the patient. However, it should not be considered as a substitute for medical treatment or specialized psychological interventions in cases of severe anxiety, but rather as part of supportive and integrated cancer care.