There is growing evidence that psychosocial interventions can have psychological benefits for people affected by cancer, including improved symptoms of mental health and wellbeing and optimised immune responses. However, despite growing numbers of music interventions, particularly singing, in cancer care, there is less research into their impact. We carried out a multicentre single-arm preliminary study to assess the impact of singing on mood, stress and immune response in three populations affected by cancer: carers (n = 72), bereaved carers (n = 66) and patients (n = 55). Participants were excluded if pregnant or if they were currently being treated with chemotherapy, radiotherapy or oral immunosuppressive drugs. Participants were regular participants in five choirs across South Wales and took part in one hour of group singing. Before and after singing, visual analogue mood scales, stress scales and saliva samples testing for cortisol, beta-endorphin, oxytocin and ten cytokines were taken. Across all five centres and in all four participant groups, singing was associated with significant reductions in negative affect and increases in positive affect (p < .01) alongside significant increases in cytokines including GM-CSF, IL17, IL2, IL4 and sIL-2rα (all p < .01). In addition, singing was associated with reductions in cortisol, beta-endorphin and oxytocin levels. This study provides preliminary evidence that singing improves mood state and modulates components of the immune system. Further work is needed to ascertain how this differs for more specific patient groups and whether repeat exposure could lead to meaningful, longitudinal effects.

Cancer survival rates have improved dramatically over recent years, however, health-related quality of life (HRQoL) for many patients, survivors and their families remains low even after successful treatment. This mixed-methods observational study explored the effects of participation in community choirs on HRQoL in individuals who have had cancer (patients) or have been affected by cancer (non-patients). This included a longitudinal analysis of choristers commencing the Tenovus Cancer Care "Sing with Us" choirs across Wales and a series of semi-structured interviews and focus groups. Participants completed the Short-form 36 and the Hospital Anxiety and Depression Scale on commencement of the choir and 3 and 6 months later. On joining the choir, several domains of the SF36 were lower, indicating worse HRQoL and greater depression in patients than non-patients (p < .05). In patients, choir participation improved vitality, overall mental health and anxiety. In non-patients, choir participation improved anxiety (p < .05). Participants experienced the choirs as both an uplifting musical activity and a supportive community group. The results support the provision of a spectrum of support options to meet the different needs and preferences of people affected by cancer.

This paper discusses the link between community music improvisation and the integration of refugees, asylum seekers and local residents, and proposes a new way of thinking about priority-setting in refugee integration and rehabilitation support schemes. Drawing on observations and interviews with an integrated music group in Wales, we explore the effect of participating in structured musical activities and improvisation in weekly meetings, as well as at public performances in community arts events. We observed that embedding improvisation led to four outcomes. It (i) encouraged individual unscripted performances, instilling confidence in solo performance, (ii) gave individuals who had experienced displacement and marginalisation a chance to lead in a safe, performative space, (iii) gave other participants a chance to follow and accompany this piece instrumentally or vocally, drawing on their own cultural traditions and thus creating innovative cross-cultural pieces; and (iv) provided participants and audience members with a unique and unrepeated, uplifting experience that triggered their imaginations, and prompted questions and further discussion between participants. These findings suggest that the combination of structured musical activity and improvisation may help to foster a sense of wellbeing and social inclusion, shift power dynamics, and create a space for cross-cultural dialogue. These unique outcomes highlight how music can create a community of people from seemingly completely different locations or situations. Furthermore, the well-established Welsh choral traditions and local community arts provided a receptive environment for this diverse group of performers. Therefore, it was not just the musical activities but their connection to the wider local community arts scene that delivered these individual, collective and wider societal benefits.

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Sing With Us is a network of fifteen research-led community choirs run weekly by the cancer charity Tenovus Cancer Care, as a form of support for people affected by cancer in Wales. This article discusses a model created by Tenovus Cancer Care to train and develop their team of eight community Choir Leaders (CLs). It explores the theoretical frameworks and methodology through which a system of continuous quality improvement has been developed for them, and looks specifically at the initial results of a first team assessment. This article will explore the idea that by professionalizing and valuing the roles of the CLs and the work they do, this will create a positive impact in the service that is provided. It will suggest that by implementing a process to ensure a quality leadership in a community choir setting, choristers will be more likely to have a richer experience on which they place high value and will be engaged for longer.