UICC World Cancer Congress 2006

Objective: Cancer pain is a major debilitating symptom of cancer and conventional therapy is not uniformly effective. Despite widespread popular use, complementary and alternative interventions (CAM) lack rigorous evidence base. The objective of this abstract is to present a systematic review of randomized controlled trials evaluating CAM therapies for cancer pain.

Methods: Randomized controlled trials (RCTS) that used CAM intervention for cancer-related pain were included. Relevant trials were abstracted using Medline, EMBASE, and CINAHL and scanning additional references of relevant articles. The trials were appraised based on their quality using Jadad score.

Results: A total of 101 references were identified, out of which 20 trials including 1621 participants met criteria. Nine trials found significant benefits of CAM interventions including acupuncture (1), support groups (2), hypnosis (1), relaxation/imagery (2), capsaicin cream (2) and Traditional Chinese Medicine/HESA-A (1); Seven found immediate/short term benefit of acupuncture (2), music (1), herbal supplement/ATP (1), massage (1) and healing touch (2); Four found no benefit of music (2), massage (2) in reducing cancer pain as compared to placebo. Most trials were from single institutions, had less than 100 subjects, had short duration (median 33 days), low Jadad quality score and only two reported adverse effects. In summary, there is a paucity of well designed, multi-institutional RCTs evaluating CAM interventions for cancer pain that have adequate power, duration and sham control. Several CAM modalities report promising-appearing data but none can be fully recommended due to the paucity of rigorous trials. Further well designed RCTs are needed to determine potential efficacy.