Last updated September 19, 2022

Integrative Medicine for Pain Management in Oncology

Pain Management

The following set of recommendations are for adults with cancer. There is insufficient or inconclusive evidence to make recommendations for pediatric patients with cancer.

Aromatase Inhibitor-Related Joint Pain

Recommendation 1.1

Acupuncture should be offered to patients experiencing aromatase inhibitor-related joint pain in breast cancer. (EB, B, I, M)
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Recommendation 1.2

Yoga may be offered to patients experiencing aromatase inhibitor-related joint pain in breast cancer (Quality - Low). (EB, B, , W)
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General Cancer Pain or Musculoskeletal Pain

Recommendation 1.3

Acupuncture may be offered to patients experiencing general pain or musculoskeletal pain from cancer. (EB, B, I, M)
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Recommendation 1.4

Reflexology or acupressure may be offered to patients experiencing pain during systemic therapy for cancer treatment. (EB, B, I, M)
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Recommendation 1.5

Massage may be offered to patients experiencing chronic pain following breast cancer treatment. (Quality - Low) (EB, B, , M)
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Recommendation 1.6

Hatha yoga may be offered to patients experiencing pain after treatment for breast or head and neck cancers. (Quality - Low) (EB, B, , W)
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Recommendation 1.7

Guided imagery with progressive muscle relaxation may be offered to patients experiencing general pain from cancer treatment. (Quality - Low) (EB, U, , W)
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Chemotherapy-Induced Peripheral Neuropathy

Recommendation 1.8

Acupuncture may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment. (Type - EB/IC, Quality - Low) (EB, B, , W)
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Recommendation 1.9

Reflexology or acupressure may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment. (Quality - Low) (EB, B, , W)
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Procedural or Surgical Pain

Recommendation 1.10

Hypnosis may be offered to patients experiencing procedural pain in cancer treatment or diagnostic workups. (EB, B, I, M)
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Recommendation 1.11

Acupuncture or acupressure may be offered to patients undergoing cancer surgery or other cancer-related procedures such as bone marrow biopsy. (Type - EB/IC, Quality - Low) (EB, B, , W)
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Recommendation 1.12

Music therapy may be offered to patients experiencing surgical pain from cancer surgery. (Quality - Low) (EB, B, , W)
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Pain During Palliative Care

Recommendation 1.13

Massage may be offered to patients experiencing pain during palliative and hospice care. (EB, B, I, M)
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Although many of the recommendations are weak and based on low quality evidence, the interventions do have clinical relevance, with a favorable benefit to harm ratio, and this is the basis for making the recommendations.

Recommendation Grading

Overview

Title

Integrative Medicine for Pain Management in Oncology

Authoring Organizations

Publication Month/Year

September 19, 2022

Document Type

Guideline

Country of Publication

US

Target Patient Population

Adult patients with cancer

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Home health, Hospice, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Counseling, Management

Diseases/Conditions (MeSH)

D000072716 - Cancer Pain, D010166 - Palliative Care, D065126 - Palliative Medicine, D055048 - Integrative Medicine, D026881 - Acupuncture, D008405 - Massage, D019050 - Acupressure, D009147 - Music Therapy, D006990 - Hypnosis

Keywords

integrative medicine, acupuncture, neuropathy, cancer pain, Integrative Therapies, acupressure, massage, music therapy, reflexology, guided imagery, hypnosis

Source Citation

Mao JJ, Ismaila N, Bao T, et al. Integrative Medicine for Pain Management in Oncology: SIO-ASCO Guideline. J. Clin Oncol. 2022 Sept 19. doi:10.1200/JCO.22.01357.