Impact of Sound and Music on Cancer Cell Viability—Current Evidence and Mechanistic Insights

Music therapy is established in oncology as a supportive intervention to reduce anxiety, pain, distress and treatment-related symptom burden. Beyond these clinical effects, emerging experimental evidence suggests that audible sound and music may also exert direct biological effects on non-auditory cells, including cancer cells. This review summarizes current evidence on the effects of audible sound, music and acoustic stimulation on cancer-cell viability and related cellular processes. Sound represents a mechanical pressure wave that may interact with cells through mechanotransductive processes involving the plasma membrane, cytoskeleton, integrins, focal adhesions and mechanosensitive ion channels. Since cancer cells frequently display altered stiffness, cytoskeletal organization, membrane dynamics and mechanosensitivity, they may respond differently to acoustic or vibrational stimulation than non-malignant cells. Available in vitro studies report associations among audible sound, music, acoustic stimulation and cancer-cell viability, proliferation, migration, apoptosis-related signalling, gene expression and extracellular vesicle secretion. These effects have been demonstrated in breast, gastric, prostate, glioblastoma, colon, ovarian and neuroblastoma cell models, but findings appear highly cell-type-specific and dependent on exposure parameters. Proposed mechanisms include intracellular calcium signalling, cytoskeletal remodelling, mitochondrial dysfunction, reactive oxygen species generation and pathways involving PIEZO1, integrins, focal adhesion kinase and YAP/TAZ; however, causal mechanisms are not shown. Much of the mechanistic framework derives from ultrasound-based research and cannot be extrapolated to audible sound or music. Overall, the reported findings of in vitro experiments on the effect of sound on cancer cells remain preliminary, methodologically heterogeneous and do not establish reproducible, causal or cancer-selective effects. Standardized studies are required before these observations can be translated into mechanistically defined or therapeutically relevant concepts in oncology.