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Efficacy of Complementary and Alternative Medicine Therapies in Relieving Cancer Pain: A Systematic Review

Aditya Bardia, Debra L. Barton, Larry J. Prokop, Brent A. Bauer, Timothy J. Moynihan

From the Departments of Internal Medicine, Medical Oncology, and Medical Library, Mayo Clinic College of Medicine, Rochester, MN

Address reprint requests to Timothy J. Moynihan, MD, Department of Medical Oncology, 200 First St SW, Rochester, MN 55905; e-mail: moynihan.timothy{at}mayo.edu

PURPOSE: Despite widespread popular use of complementary and alternative medicine (CAM) therapies, a rigorous evidence base about their efficacy for cancer-related pain is lacking. This is a systematic review of randomized controlled trials (RCTs) evaluating CAM therapies for cancer-related pain.

METHODS: RCTs using CAM interventions for cancer-related pain were abstracted using Medline, EMBASE, CINAHL, AMED, and Cochrane database.

RESULTS: Eighteen trials were identified (eight poor, three intermediate, and seven high quality based on Jadad score), with a total of 1,499 patients. Median sample size was 53 patients, and median intervention duration was 45 days. All studies were from single institutions, four had sample size justification, and none reported any adverse effects. Seven trials reported significant benefit for the following CAM therapies: acupuncture (n = 1), support groups (n = 2), hypnosis (n = 1), relaxation/imagery (n = 2), and herbal supplement/HESA-A (n = 1, but study was of low quality without control data). Seven studies reported immediate postintervention or short-term benefit of the following CAM interventions: acupuncture (n = 2), music (n = 1), herbal supplement/Ai-Tong-Ping (n = 1), massage (n = 1), and healing touch (n = 2). Four studies reported no benefit of CAM interventions (music, n = 2; massage, n = 2) in reducing cancer pain compared with a control arm.

CONCLUSION: There is paucity of multi-institutional RCTs evaluating CAM interventions for cancer pain with adequate power, duration, and sham control. Hypnosis, imagery, support groups, acupuncture, and healing touch seem promising, particularly in the short term, but none can be recommended because of a paucity of rigorous trials. Future research should focus on methodologically strong RCTs to determine potential efficacy of these CAM interventions.

Presented in part in oral format at the International Union Against Cancer (UICC) World Congress, Washington, DC, July 8-12, 2006.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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