Cancer Pain & Complementary Therapies

 
Posted on Monday, November 26, 2007
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A new study examines the role of acupuncture, massage, mind-body techniques, and dietary supplements in dealing with the pain associated with cancer by Stephanie Watson

Often one of the most difficult aspects of dealing with a cancer diagnosis is living with the pain of the disease. Although a wide range of medications are available to treat cancer-related pain, they don’t always work for every patient, and they can have some pretty significant side effects.

Patients and their doctors are increasingly turning to complementary and alternative medicine (CAM) techniques, such as massage, acupuncture, and herbal supplements to relieve cancer pain in conjunction with medication. These treatments not only have fewer adverse side effects than conventional pain drugs, but they are actually very effective at relieving pain and anxiety in cancer patients, according to a review of current research in the August 2007 issue of Current Pain and Headache Reports.*

“Complementary therapies are generally safe, non-invasive, and free of toxicity,” explains one of the authors, Jyothirmai Gubili, Assistant Editor in the Integrative Medicine Service of Memorial Sloan-Kettering Cancer Center. “They can be used along with standard pain management techniques to improve outcomes and reduce the need for pain medication.”

The study reviewed several popular CAM therapies:

Acupuncture
This staple of Chinese medicine has been practiced for more than 2,000 years, and recently it has caught on in the U.S. as an effective treatment for many painful conditions. Acupuncture stimulates pressure points in certain areas of the body, triggering the release of natural opoid painkillers. A 2003 study demonstrated that acupuncture of the ear significantly reduced the intensity of pain in cancer patients. Acupuncture also has been shown to relieve cancer-related nausea and fatigue.

Massage
Although many people view massage as a way to relieve everyday stress, researchers are noting that the practice has real therapeutic benefits. A 2004 study at Sloan-Kettering indicated that massage reduced cancer symptoms, including pain, by up to 50 percent. Cancer patients who have tried massage also have reported feeling less anxiety, anger, and depression.

Mind-Body Techniques
Yoga, hypnosis, guided imagery, and deep breathing are all methods that help people take charge of their body and change their perceptions—including those of pain. In a small 2007 study, women with advanced breast cancer felt less pain and fatigue, and were more relaxed after they participated in a yoga program. In another study deep breathing, muscle relaxation, and imagery techniques all reduced the perception of pain in hospitalized cancer patients.

Dietary Supplements
Several herbs and supplements have anti-inflammatory and pain relieving properties, including capsaicin, willow bark, and glucosamine. One trial found that a topical cream made from capsaicin, a component of chili peppers, reduced nerve pain in cancer patients who had undergone surgery. Willow bark, which contains a chemical similar to aspirin, has been used since the time of Hippocrates to relieve inflammation. And studies have shown that glucosamine can relieve severe pain even better than medication.

Turning to Complementary Care
Today many large randomized and controlled trials supported by the National Institutes of Health (NIH), American Cancer Society, and other major institutions are showing a real benefit to CAM practices. “The evidence is convincing enough to recommend the use of some CAM therapies,” according to Gubili.

CAM techniques are all relatively safe when administered by trained professionals, but they aren’t necessarily for everyone. For example, acupuncture carries a greater risk of bleeding or infection in people who have a low white blood cell count (neutropenia) or low blood platelets (thrombocytopenia). Herbal supplements can interact with chemotherapy drugs, reducing their effectiveness or increasing the potential for side effects. “We recommend that patients discuss their choices with their physicians before using any CAM therapies,” Gubili says.
 
* Cassileth B, Trevisan C, Gubili J. Complementary therapies for cancer pain. Curr Pain Headache Rep, August 2007;11:265-269.


Additional Sources:

Alimi D, et al. Analgesic Effect of Auricular Acupuncture for Cancer Pain: A Randomized, Blinded, Controlled Trial. Journal of Clinical Oncology, November 2003;21:4120-4126.

Carson JW, et al. Yoga for women with metastatic breast cancer: results from a pilot study. J Pain Symptom Manage, March 2007;33:331-341.

Sloman R, et al. The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer. Contemp Nurse, March 1994;3:6-12.

Ellison N, et al. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients. J Clin Oncol, August 1997;8:2974-2980.