Music may be a tool in reducing anxiety, pain, and improving mood among patients with cancer in active treatment. However, methodological limitations in the studies conducted so far prevent firm conclusions.

Chemotherapy is associated with both somatic and psychological side effects. Music might ease these problems. Several randomized controlled trials have investigated the effect of music, but the results are inconclusive. We aimed to examine whether live or pre-recorded music listening decrease anxiety during chemotherapy in newly diagnosed lymphoma patients. Methods: A total of 143 patients with non-Hodgkin and Hodgkin lymphomas were randomly assigned into three groups receiving either 30 minutes of patient-preferred live music (n=47), 30 minutes of patient-preferred pre-recorded music (n=47) or standard care (n=49) during up to five outpatient chemotherapy sessions. The primary end-point was anxiety measured by the Spielberger´s State Anxiety Inventory. Secondary end-points included blood pressure, pulse rate, nausea and vomiting, serum catecholamine levels pre-and post-intervention to measure arousal levels, and healthrelated quality of life. The Musical Ability Test was used to link musical ability to the primary endpoint. Results: When adjusting for age, sex, diagnosis, number of sessions and baseline anxiety the linear mixed model, showed a borderline statistically significant reduction in the primary outcome anxiety in the live music group compared to standard care (7% (95% CI,-14% to 0%, p=0.05), while the effect of pre-recorded music was non-significant (5% (95% CI,-12% to +3%, p=0.18). No intervention effects were seen in secondary outcomes. Conclusion: Our findings suggest that patient-preferred live music reduces anxiety among patients with malignant lymphomas undergoing chemotherapy. Musical ability among this group of cancer patients seems not to be a determining factor for effect of music intervention.