ASCO/SIO recommendations for integrative therapy for pain in patients with cancer, sorted by type of pain, quality of the evidence, and strength of the recommendation

Integrative intervention	Type of recommendation	Quality of evidence	Level of obligation	Benefit/Harm	Strength of recommendation
AI-related joint muscle pain
Acupuncture/acutherapy	Evidence based	Intermediate	Should	Benefit outweighs harm	Moderate
Breathing exercises	Evidence based	Low	May	Benefit outweighs harm	Weak
Hatha and restorative yoga postures
Meditation
General cancer pain/musculoskeletal pain
Acupuncture/acutherapy	Evidence based	Intermediate	May	Benefit outweighs harm	Moderate
Reflexology	Evidence based	Intermediate	May	Benefit outweighs harm	Moderate
Massage	Evidence based	Low	May	Benefit outweighs harm	Moderate
Yoga	Evidence based	Low	May	Benefit outweighs harm	Weak
Guided imagery + PMR	Evidence based	Low	May	Not assessable	Weak
CIPN
Acupuncture/acutherapy	Evidence based/informal consensus	Low	May	Not assessable	Weak
Reflexology	Evidence based	Low	May	Benefit outweighs harm	Weak
Procedural pain
Hypnosis	Evidence based	Intermediate	May	Benefit outweighs harm	Moderate
Surgical pain
Acupuncture/acutherapy	Evidence based/informal consensus	Low	May	Benefit outweighs harm	Weak
Music therapy	Evidenced based	Low	May	Benefit outweighs harm	Weak
Pain during palliative care
Massage	Evidence based	Intermediate	May	Benefit outweighs harm	Moderate

ASCO: American Society of Clinical Oncology; SIO: Society of Interventional Oncology; AI: aromatase inhibitor; PMR: progressive muscle relaxation; CIPN: chemotherapy-induced peripheral neuropathy.

Reproduced with permission from: Mao JJ, Ismaila N, Bao T, et al. Integrative medicine for pain management in oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol 2022; 40(34):3998-4024. Copyright © 2022 American Society of Clinical Oncology. www.ascopubs.org/journal/jco/.

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ASCO/SIO recommendations for integrative therapy for pain in patients with cancer, sorted by type of pain, quality of the evidence, and strength of the recommendation