Integrative Management of Cancer Pain: A Scoping Review of the Literature.

BACKGROUND

Cancer-related pain is common and debilitating. Patients frequently use integrative medicine therapies to manage this, though safety and efficacy evidence is incomplete. This scoping review aims to characterize the state of integrative cancer pain therapy (ICPT) and identify priorities for future research.

METHODS

Following PRISMA guidelines, we searched PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Cochrane for ICPT studies published between January 1, 1975 and May 26, 2022. Study findings were extracted and analyzed using descriptive statistics and thematic analysis. Interventions were categorized as follows: Whole Systems of Medicine (WSM); Mind-body Medicine (MBM); Botanicals and Supplements (BAS); and Manual Therapies (MT). Quality appraisal was performed using the Downs and Black checklist. Efficacy was "positive" if there were statistically significant differences between study arms (p < 0.05) favoring ICPT.

RESULTS

Among 1246 studies reviewed, 151 met inclusion criteria; 63.5% were excellent or good quality, and 68.9% were RCTs; 122 studies (80.7%) were published since 2010. Studies occurred in 24 countries, in variable settings, among participants with a wide range of cancers, disease status, and age ranges. Studies investigating WSM and MBM interventions were most frequent (35.7% for each), MT (20.59%), and BAS (7.9%). Overall, of the included studies, 127 (84.1%) found that the ICPT intervention reduced pain.

CONCLUSIONS

Studies on ICPT are increasingly common, and the majority of ICPT interventions demonstrated a positive impact on cancer pain. Future rigorous research should compare efficacy across integrative and biomedical interventions and explore how to incorporate evidence-based ICPT into standard cancer treatment.