Version May 2024
| Guideline Questions |
|
| Target Population |
| Patients of any age diagnosed with any cancer who are experiencing pain during any stage of their cancer care trajectory. |
| Target Audience |
| Clinicians who provide care to patients with cancer, cancer survivors, and family caregivers. |
| Methods |
| An expert panel was convened to develop clinical practice guideline recommendations on the basis of a systematic review of the health literature. |
| Recommendations |
| The following recommendations are evidence based, informed by randomized trials and systematic reviews, and guided by clinical experience. The recommendations were developed by a multidisciplinary group of experts. NOTE: The following set of recommendations are for adults with cancer. Although many of the recommendations are weak and based on low-quality evidence, the interventions do have clinical relevance, with a favorable benefit-to-harm ratio, and this is the basis for making the recommendations. There is insufficient or inconclusive evidence to make recommendations for pediatric patients with cancer. |
| Aromatase inhibitor-related joint pain |
| Recommendation 1.1. Acupuncture should be offered to patients experiencing AI-related joint pain in breast cancer (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate; Strength of recommendation: Moderate). |
| Recommendation 1.2. Yoga may be offered to patients experiencing AI-related joint pain in breast cancer (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| General cancer pain or musculoskeletal pain |
| Recommendation 1.3. Acupuncture may be offered to patients experiencing general pain or musculoskeletal pain from cancer (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate; Strength of recommendations: Moderate). |
| Recommendation 1.4. Reflexology or acupressure may be offered to patients experiencing pain during systemic therapy for cancer treatment (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate; Strength of recommendation: Moderate). |
| Recommendation 1.5. Massage may be offered to patients experiencing chronic pain following breast cancer treatment (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Moderate). |
| Recommendation 1.6. Hatha yoga may be offered to patients experiencing pain after treatment for breast or head and neck cancers (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| Recommendation 1.7. Guided imagery with progressive muscle relaxation may be offered to patients experiencing general pain from cancer treatment (Type: Evidence based, benefits and harms not assessable; Evidence quality: Low; Strength of recommendation: Weak). |
| Chemotherapy-induced peripheral neuropathy |
| Recommendation 1.8. Acupuncture may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment (Type: Evidence based/informal consensus, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| Recommendation 1.9. Reflexology or acupressure may be offered to patients experiencing chemotherapy-induced peripheral neuropathy from cancer treatment (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| Procedural or surgical pain |
| Recommendation 1.10. Hypnosis may be offered to patients experiencing procedural pain in cancer treatment or diagnostic workups (Type: Evidence based, benefits outweigh harms; Evidence quality: Intermediate; Strength of recommendation: Moderate). |
| Recommendation 1.11. Acupuncture or acupressure may be offered to patients undergoing cancer surgery or other cancer-related procedures such as bone marrow biopsy (Type: Evidence based/informal consensus, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| Recommendation 1.12. Music therapy may be offered to patients experiencing surgical pain from cancer surgery (Type: Evidence based, benefits outweigh harms; Evidence quality: Low; Strength of recommendation: Weak). |
| Pain during palliative care |
| Recommendation 1.13. Massage may be offered to patients experiencing pain during palliative and hospice care (Type: Evidence based; benefits outweigh harms; Evidence quality: Intermediate; Strength of recommendation: Moderate). |
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