Integrative Medicine for Pain Management in Oncology

Publication Date: September 18, 2022
Last Updated: September 19, 2022

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)
1534123

Recommendation 1.2

Yoga may be offered to patients experiencing aromatase inhibitor-related joint pain in breast cancer (Quality - Low). (EB, B, , W)
1534123

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)
1534123

Recommendation 1.4

Reflexology or acupressure may be offered to patients experiencing pain during systemic therapy for cancer treatment. (EB, B, I, M)
1534123

Recommendation 1.5

Massage may be offered to patients experiencing chronic pain following breast cancer treatment. (Quality - Low) (EB, B, , M)
1534123

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)
1534123

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)
1534123

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)
1534123

Recommendation 1.9

Reflexology or acupressure may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment. (Quality - Low) (EB, B, , W)
1534123

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)
1534123

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)
1534123

Recommendation 1.12

Music therapy may be offered to patients experiencing surgical pain from cancer surgery. (Quality - Low) (EB, B, , W)
1534123

Pain During Palliative Care

Recommendation 1.13

Massage may be offered to patients experiencing pain during palliative and hospice care. (EB, B, I, M)
1534123

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

American Society of Clinical Oncology

Society for Integrative Oncology

Publication Month/Year

September 18, 2022

Last Updated Month/Year

October 1, 2024

Supplemental Implementation Tools

Document Type

Guideline

Country of Publication

US

Document Objectives

The purpose of this guideline is to provide guidance to clinicians on the effectiveness of integrative medicine treatment options for pain in adults and children with a cancer diagnosis.

Target Patient Population

Patients of any age diagnosed with any cancer who are experiencing pain during any stage of their cancer care trajectory.

Target Provider Population

Clinicians who provide care to patients with cancer, cancer survivors, and family caregivers.

PICO Questions

  1. What mind-body therapies are recommended for managing pain experienced by adult and pediatric patients diagnosed with cancer?

  2. What natural products are recommended for managing pain experienced by adult and pediatric patients diagnosed 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.

Supplemental Methodology Resources

Data Supplement, Evidence Tables