Non-pharmacological integrative therapies for chronic cancer pain

Abstract

Objective Chronic pain is one of the most detrimental symptoms exhibited by cancer patients, being an indication for opioid therapy in up to half of the patients’ receiving chemotherapy and in 90% of advanced cases. Various successful non-pharmacological integrative therapy options have been explored and implemented to improve the quality of life in these patients. This review aims to highlight the mechanisms implicated; assessment tools used for cancer pain and summarize current evidence on non-pharmacological approaches in the treatment of chronic cancer pain. Data sources A review of the literature was conducted using a combination of MeSH keywords including “Chronic cancer pain,” “Assessment,” “Non-pharmacological management,” and “Integrative therapy.” Data summary Data on the approach and assessment of chronic cancer pain as well as non-pharmacological integrative options have been displayed with the help of figures and tables. Of note, non-pharmacological integrative management was divided into three subcategories; physical therapy (involving exercise, acupuncture, massage, and transcutaneous electric nerve stimulation), psychosocial therapy (e.g. mindful practices, supportive therapy), and herbal supplementation. Conclusions The use of non-pharmacological integrative therapy in the management of chronic cancer pain has been grossly underestimated and must be considered before or as an adjuvant of other treatment regimens to ensure appropriate care.

BUSER Transcutaneous Electric Nerve Stimulator Device Design

“…Transcutaneous electrical nerve stimulation (TENS) is a physical therapy method commonly used in the treatment of pain (Vance et al, 2012;Santuzzi et al, 2013). It is used as a technique with successful results in the reduction of fibromyalgia (Dailey et al, 2022), primary dysmenorrhea pain (Arik et al, 2022), shoulder pain (Bilek et al, 2021), back pain (Vella et al, 2022) and chronic cancer pain (Katta et al, 2022). TENS enhances local inhibitory control and is indicated in focal neuropathic pain (NP) (Guastella et al, 2008).…”

Brain stimulation for chronic pain management: a narrative review of analgesic mechanisms and clinical evidence

“…Considering the possible side effects of long-term opioid use (78% overall adverse event rate, including 7.5% serious adverse events) and the risk of addiction, the harms outweigh the benefits of opioid therapy [ 19 ]. For this reason, in treatment-resistant cases, dose reduction or discontinuation of opioid treatment may be considered towards alternative therapies [ 20 , 21 ]. Numerous therapeutic approaches were proposed as a potential treatment for chronic pain including non-opioid pharmacological agents, nerve blocks, acupuncture, cannabidiol, stem cells, exosomes, and neurostimulation techniques [ 22 – 27 ].…”

Acupuncture techniques and acupoints used in individuals under chemotherapy or radiotherapy treatment of cancer: A systematic review

“…Currently, complementary and alternative medicine (CAM), including acupuncture, meditation, massage therapy, deep breathing exercises, among others that have been increasingly adopted by cancer patients for seeking relief from cancer‐associated symptoms. Importantly, acupuncture has been implicated as an effective approach in improving cancer‐associated symptoms, as in the management of chronic cancer pain (Katta et al, 2022; Smith & Bauer‐Wu, 2012).…”