What approaches can help you manage pain?

We present many approaches to reducing pain and summarize the evidence regarding their effectiveness.

Top practices and therapies for managing pain

Many good conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are drugs and physical therapy medicine options are available for managing cancer-related pain. Self-carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices and complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies can also support pain relief, often with fewer risks and side effects. Often, both conventional and complementary options can be used together.

Therapies and practices we have reviewed

Further therapies

Therapies recommended in clinical practice guidelines; see guidelines ›

Aquatic therapy 

Cold, heat

Electromagnetics

Hypnotherapy (hypnosis)

Massage therapy

Music therapy

Reflexology

Traditional Chinese herbal medicines

Transcutaneous electrical nerve stimulation (TENS)

Ultrasonic stimulation

Psychosocial therapies:

  • Behavioral treatment
  • Cognitive-behavioral stress management (CBSM)
  • Cognitive-behavioral therapy (CBT)
  • Support groups
  • Supportive/expressive therapy

Pain’s connections to other symptoms

Pain may be a symptom of stress or emotional states such as anxiety. If stress, fatigue, anxiety, and/or depression is contributing to your pain, managing these other symptoms will be important in reducing your pain. 

Targeting fatigue, anxiety, and depression may have a meaningful effect on pain as a related symptom and potentially have a positive impact on health-related quality of life of people with cancer.1Charalambous A, Giannakopoulou M, Bozas E, Paikousis L. Parallel and serial mediation analysis between pain, anxiety, depression, fatigue and nausea, vomiting and retching within a randomised controlled trial in patients with breast and prostate cancer. BMJ Open. 2019 Jan 24;9(1):e026809. 

Pain has a bidirectional link to anxiety, depression, fatigue, sleep disruption, stress, and muscle tension.

Professionals who provide a comprehensive approach to managing pain have found the most success by integrating approaches that target physical, emotional, mental, and spiritual aspects of pain and suffering. Start by addressing the physical pain directly, then assess and treat other dimensions of pain.2Thielking PD. Cancer pain and anxiety. Current Pain and Headache Reports. 2003 Aug;7(4):249-61. Cleeland CS. The impact of pain on the patient with cancer. Cancer. 1984 Dec 1;54(11 Suppl):2635-41. 

Thomas Smith, MD, Professor of Oncology, Johns Hopkins University School of Medicine and Director of Palliative Medicine, Johns Hopkins Medicine, discusses the importance of screening for anxiety and depression in people experiencing cancer pain and how to help them manage these conditions.

Play video

Learn about managing other symptoms and side effects common with cancer.

Conventional care

Your oncology team can recommend conventional therapies including over-the-counter and prescription medications to manage pain. Anti-inflammatory drugs—such as steroids or nonsteroidal anti-inflammatory drugs—and other therapies such as cold and heat therapies—can reduce pain from inflammation. Many other types of drugs can address pain, such as acetaminophen, muscle relaxers, antiseizure medications, and opioids. Surgery and radiation therapy are also used to manage cancer-related pain, often by removing or reducing the size of the tumor and relieving the pressure on nerves. 

Radiotherapy can be highly effective in managing cancer-related bone pain. A meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 27 studies found that almost a third of people treated with radiotherapy experienced total resolution of pain at four weeks.3Chow R, Hoskin P, Hollenberg D, et al. Efficacy of single fraction conventional radiation therapy for painful uncomplicated bone metastases: a systematic review and meta-analysis. Annals of Palliative Medicine. 2017;6:125–142. Physical therapy is also widely used to manage persistent pain.

If you do not find relief from your pain from your primary treating physician’s treatment, consider asking for a referral to a professional trained in managing cancer-related pain. 

  • Medical oncologists are usually very knowledgeable about managing cancer pain. 
  • Doctors and nurses trained in palliative care are experts in helping people manage symptoms related to chronic illnesses such as cancer. People with cancer receiving palliative care combining symptom control and psychosocial support report less pain in studies (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently)).

Some medications and treatments can cause pain as a side effect. Check with your doctor or pharmacist to see if any of your prescription medications may contribute to pain and whether adjustments can be made.

Thomas Smith, MD, Professor of Oncology, Johns Hopkins University School of Medicine and Director of Palliative Medicine, Johns Hopkins Medicine, discusses how he evaluates cancer pain and treats it with pharmaceuticals.

Play video

Pain medications and cancer survival

The type of pain medication you use may influence cancer survival. Some evidence links opioids to poorer survival. One analysis concluded that the majority of strong opioid analgesics produce immunosuppressionpartial or complete suppression of the immune response that can lead to reduced tolerance to cancer and increased metastatic spread.4Budd K. Pain, the immune system, and opioimmunotoxicity. Reviews in Analgesia. 2004;8(1): 1-10.

More recent research adds evidence.

However, separating out the effects of opioid use from more advanced cancer and tumor-related inflammation is very difficult. “Opioid-use is likely to reflect more aggressive painful disease and is thus a ‘biomarker’ of a poor outcome.”8Boland JW, Allgar V et al. The relationship between pain, analgesics and survival in patients with advanced cancer; a secondary data analysis of the international European palliative care cancer symptom study. European Journal of Clinical Pharmacology. 2020 Mar;76(3):393-402. For example, a mid-sized observational study found lower cancer-specific survival among people with cancer with either higher cancer-related pain or opioid use compared to others.9Zheng J, He J et al. The impact of pain and opioids use on survival in cancer patients: results from a population-based cohort study and a meta-analysis. Medicine (Baltimore). 2020 Feb;99(9):e19306. The disease process driving the pain and use of opioids may have been the driver of poorer survival, and the pain and use of opioids an indicator of advancing cancer instead of the cause.

More research is needed to determine whether use of opioids among people at various stages of cancer contributes to worse survival. The pain level and its impact on quality of life, the cancer stage and progression, and the effectiveness of various pain-relief options all need to be considered when choosing therapies to manage pain. In some cases living in severe pain is not tolerable, so prioritizing quality of life is not only acceptable but also necessary.

Pain medication and body terrain

See Optimizing Your Body Terrain ›

Opioids and immune response

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of disruption of the immune system from use or sudden withdrawal from opioids; we advise against withdrawing abruptly from opioids and urge you to seek medical supervision for weaning off any opioids.

Opioids and hormone imbalance

Opioids may disturb pituitary hormone pathways and may also affect other hormones.

For information about connections between body terrain factors and pain control during surgery, see Surgery: An Integrative Approach ›

Pain medications and side effects

Various types of pain medications can not only improve comfort but also relieve side effects and symptoms. However, all medications come with side effects of their own, such as constipation with opioids. We present evidence regarding effects of different types of analgesics on pain but also several other symptoms and side effects. Choosing the right analgesic and delivery method for the type of pain being managed—and discontinuing use as soon as possible—are important. 

Depression

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher rates and severity of depression among people with chronic cancer pain using opioids

Gastrointestinal symptoms

Constipation is common among people using opioids.

Preliminary evidence of lower incidence of nausea and vomiting after open thoracotomy among people with esophageal cancer treated with patient-controlled intravenous analgesia

Pain

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of less persistent cancer pain among people treated with diclofenac

Preliminary evidence of less pain among people with cancer-related malnutrition treated with indomethacin

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on intensity of persistent cancer pain among people treated with ibuprofen, ketorolac tromethamine, naproxen, or sulindac in a large combined review of studies

Preliminary evidence of lower pain scores at rest and during coughing after open thoracotomy among people with esophageal cancer treated with patient-controlled epidural analgesia

Sleep disturbance

Preliminary evidence of a link between sleep disturbance in the first year after mastectomy and opioid use among people with breast cancer

Stress

Preliminary evidence of lower markers of stress after total abdominal hysterectomy among people treated with local wound infiltration

Other symptoms and side effects

Preliminary evidence of quicker recovery (time to first flatus and shorter hospital stay) after open thoracotomy among people with esophageal cancer treated with patient-controlled epidural analgesia

Preliminary evidence of lower incidence of itching after open thoracotomy among people with esophageal cancer treated with patient-controlled intravenous analgesia

What about addiction (substance use disorder)?

Addiction, also known as substance use disordera mental disorder affecting a person’s brain and behavior that leads to an inability to control the use of substances such as legal or illegal drugs, alcohol, or medications, is a concern among both patients and healthcare professionals. We offer some facts to address the many myths often repeated about using chemicals that interact with opioid receptors on nerve cells in the body and brain to reduce the intensity of pain signals and feelings of pain. This class of drugs includes natural, synthetic, or semi-synthetic drugs such as oxycodone, hydrocodone, codeine, morphine, heroin, fentanyl, and many others. for managing pain:

  1. Opioid use disorder or drug misuse is not common if you are taking your pain medication as your doctor prescribes and you don’t have a substance use disorder or high risk for substance use disorder. Be open with your doctor if you have or have ever had a substance use disorder so that you can get the right help in managing your pain and reduce the chances of triggering or worsening your substance abuse disorder. Although using opioids on its own doesn’t result in opioid use disorder, some people with cancer may develop this problem. One analysis of five studies found an average of 18% of people with cancer have opioid use problems, with a range of 2% to 35% across studies.30Yusufov M, Braun IM, Pirl WF. A systematic review of substance use and substance use disorders in patients with cancer. General Hospital Psychiatry. 2019 Sep-Oct;60:128-136. 
  2. Opioid use disorder and physical dependence are not the same thing. “Physical dependence occurs when the body adjusts its normal functioning around regular opioid use.”31Overdose Prevention: Commonly Used Terms. Centers for Disease Control and Prevention. Viewed May 17, 2024. Dependence is a natural phenomenon that occurs with many different substances, including caffeine, alcohol, corticosteroids, opioids, and other medications. A person can become physically dependent on opioids within a few days, such as when taking them for several days after surgery. If the substance is stopped suddenly, uncomfortable and sometimes dangerous withdrawal symptoms can result. 
  3. The risk of opioid-related death is very low in people with cancer taking opioids as prescribed under medical supervision. Most opioid side effects can be prevented or controlled.
  4. Raising the dose of an opioid as needed or even switching to another opioid can achieve good pain management with minimal side effects.
  5. Pain dampens your thinking abilities. When opioids—often combined with other pain relieving drugs and treatments—effectively control pain, cognitive function usually improves over time. 
  6. Unreported, uncontrolled pain can make you weak and lower your quality of life.

Even though substance use disorder is not common overall, some people with cancer misuse opioids by using them without a prescription or for a reason other than as directed by a physician, such as to create euphoria. Misuse also includes using opioids in greater amounts, more often, or longer than prescribed,32Overdose Prevention: Commonly Used Terms. Centers for Disease Control and Prevention. Viewed May 17, 2024. often because of insufficient pain control.

A study of women undergoing mastectomy with reconstructive surgery as part of cancer treatment studied use of opioids and sedative-hypnotic drugs. These women are at particularly high risk of becoming dependent on opioids following surgery, with about 13% of women who had not used an opioid for the year before surgery becoming a chronic user in the year following surgery. More than 6% of women became chronic users of sedative-hypnotic drugs. The researchers recommend women work closely with the prescribing professional to attempt to minimize risk of dependence.33The ASCO Post Staff. SABCS 2020: Opioid and sedative-hypnotic use after mastectomy with reconstructive surgery. December 23, 2020. Viewed February 5, 2021; Cogan JC, Raghunathan RR et al. Persistent controlled substance use following mastectomy with reconstruction surgery. Publication Number: GS3-0. 2020 San Antonio Breast Cancer Symposium®. Viewed February 5, 2021.

In response to such reports and perhaps a lack of experience or knowledge, some people—including physicians—have begun avoiding using or prescribing opioid drugs even when indicated. This can lead to unnecessary pain and suffering, as shown in a very large observational study finding a lower proportion of filled prescriptions for opioid drugs and a dramatic rise in the number of emergency department visits for pain among people with poor prognosis cancer in the last month of life in the USA in 2017 compared to 2007.34Enzinger AC, Ghosh K et al. US trends in opioid access among patients with poor prognosis cancer near the end-of-life. Journal of Clinical Oncology. 2021 Sep 10;39(26):2948-2958.

If you are not getting good pain management from prescription medications, report this to your physician as soon as possible rather than adjusting the dose or frequency on your own. Misusing opioids, even for what you consider a good reason, may possibly lead to mistrust between you and your doctor and less effective care.

Finally, bear in mind that complete obliteration of physical pain is not usually a realistic objective. A realistic goal is to manage the pain so that it is tolerable and frees you up to achieve your own goals of living well.

Opioids: bottom line

In light of both benefits and risks of opioid use, we recommend they be used when necessary but in the smallest effective amount and, in the case of acute pain, for the shortest period possible. We encourage you to consider non-opioid options such as ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) when available. Unfortunately, not all cancer patients can take NSAIDs safely, and acetaminophen cannot be taken at a dose higher than 3 grams a day. Other nontraditional options for pain control are available and may help to reduce the amount of pain medication needed.

Also see Commentary in Are you a health professional? › for considerations about prescribing opioids.

Physical therapy

Non-drug conventional approaches to managing pain include physical therapy. After a prostatectomy, men frequently experience pelvic pain, and physical therapy may be beneficial.

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less pelvic pain after prostatectomy among people with stress urinary incontinence treated with an individualized program of exercise for underactive pelvic floor dysfunction

Self-care practices and complementary therapies

Practices and therapies with strong, good, or modest evidence of benefit for pain

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) indicates confidence that the practice or therapy has an effect as noted.Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.

A therapy may show a stronger effect or have more evidence in some situations than in others. The evidence supporting the effects for each therapy is listed in the full reviews available through the image links.

Eating Well: modest and preliminary evidence

Not specific to cancer:

  • Less chronic or neuropathic pain (not specific to cancer) with the recommended dietary patterns
    (modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently))
  • Better measures of physical function and less pain among overweight and obese older adults with knee pain and osteoarthritis participating in a weight-loss diet, sometimes with exercise (modest evidence)
  • Less musculoskeletal pain (not specific to cancer) among people eating blueberry, strawberry, and passion fruit peel extract (preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))
  • Less pain and joint stiffness, better measures of sleep quality and quality of life among people with fibromyalgia eating an uncooked vegan diet rich in lactobacteria (preliminary evidence)
Moving More: good and preliminary evidence

Less pain among people with many types of cancer, but not lung cancer, participating in exercise without regard to treatment phase (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently))

Less pain during cancer treatment except insufficient evidence regarding aromatase inhibitor-associated joint pain (good evidence)

Less pain among women recovering after breast cancer surgery participating in 12 months of physical activity (preliminary evidence)

Recommended in a practice guideline for treating pain; see guidelines ›

Managing Stress: modest evidence

A prolonged or exaggerated stress response may perpetuate pain (modest evidence)

A link between distress or stress and pain among people with cancer (modest evidence)

Manage your body weight: modest evidence

Not specific to cancer:

  • Less pain (not specific to cancer) among people losing excess weight (modest evidence)
Don’t smoke: modest evidence

Less pain from esophagitis from radiation therapy to the chest among people avoiding tobacco (modest evidence)

We are still researching tobacco use; these assessments are from our work so far.

Acupressure: modest and preliminary evidence

Less cancer-related pain among people treated with auricular acupressure (modest evidence)

Less severe pain among women with breast cancer treated with relaxing acupressure, but less pain interference among those treated with stimulating acupressure (preliminary evidence)

Less pain during bone marrow biopsy among people with cancer treated with acupressure (preliminary evidence)

Recommended in practice guidelines for treating pain; see guidelines ›

Acupuncture: mixed evidence

Less cancer-related pain without regard to treatment phase among people treated with acupuncture, whether alone or in addition to conventional pain treatments (good evidence)

Less pain related to surgery among people with cancer treated with acupuncture (good evidence)

Less pain related to aromatase inhibitors among people treated with acupuncture (modest evidence)

Fewer headaches during or after chemotherapy among people with breast cancer treated with acupuncture (preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on pain during chemotherapy, radiotherapy, or hormone therapy among people treated with acupuncture in combined analyses of studies

Recommended in practice guidelines for treating pain; see guidelines ›

Cannabis: mixed evidence

Less cancer-related pain among people treated with either cannabis or some cannabinoids (modest evidence)

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on pain among people treated with opioids when adding cannabinoids in combined analyses of studies

Not specific to cancer:

  • Lower pain scores among people with pain treated with cannabis or cannabinoids (good evidence)
  • Less opioid use among people receiving opioid treatment for chronic pain also treated with medical cannabis for at least 30 days (modest evidence)
Guided imagery: modest and preliminary evidence

Less pain during chemotherapy among people treated with guided imagery (preliminary evidence)

No evidence of an effect on pain from surgery among people with cancer treated with guided imagery in several trials

Less pain and related distress, and more perceived control over pain during hospitalization among people with cancer treated with analgesic imagery (preliminary evidence)

Not specific to cancer

  • Less pain and use of pain medications after surgery or during hospitalization among people treated with guided imagery, including virtual reality (modest evidence)

Recommended in practice guidelines for treating pain; see guidelines ›

Melatonin: modest and preliminary evidence

Less pain during treatment among people with cancer treated with melatonin (preliminary evidence)

Not specific to cancer:

  • Less pain from surgery not specific to cancer among people treated with melatonin (modest evidence)
Reiki: modest and preliminary evidence 

Less pain among people with cancer treated with reiki (preliminary evidence)

Not specific to cancer:

  • Less surgical pain among people treated with reiki (modest evidence)
  • Less pain not specific to cancer among people treated with reiki (modest evidence)

Recommended in a practice guideline for treating pain; see guidelines ›

Relaxation techniques: modest and preliminary evidence

Less pain among people with breast cancer treated with relaxation-based interventions (modest evidence)

Less pain during cancer treatment as a whole among people treated with relaxation training (modest evidence)

Less aromatase inhibitor-associated joint pain among postmenopausal women with non-metastatic breast cancer treated with relaxation techniques (modest evidence)

Less pain during chemotherapy among people treated with progressive muscle relaxation (preliminary evidence)

No evidence of an effect on pain after conventional resection of colorectal carcinoma among elderly people treated with relaxation techniques in a preliminary study

Less pain among hospitalized people with cancer treated with relaxation techniques (preliminary evidence)

Recommended in a practice guideline for treating pain; see guidelines ›

Relaxation techniques combined with guided imagery: modest and preliminary evidence

Less pain during cancer treatment among people treated with relaxation techniques and imagery (modest evidence)

Less pain among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation (preliminary evidence)

Less body discomfort during brachytherapy among people with gynecologic or breast cancer treated with relaxation techniques and guided imagery (preliminary evidence)

Tai chi or qigong: modest and preliminary evidence

Less pain without regard to treatment phase among people with cancer practicing either tai chi or qigong (modest evidence)

Less pain during chemotherapy among people practicing qigong or tai chi (preliminary evidence)

Time in nature or forest bathing: modest evidence

Not specific to cancer:

  • Less pain among people listening to recordings of nature-based sounds (modest evidence)
Vitamin C: intravenous use: modest evidence

Less pain during or after cancer treatment among people with cancer treated with intravenous vitamin C (modest evidence)

Not specific to cancer:

  • Insufficient (conflicting) evidence of an effect on pain after surgery among people treated with intravenous vitamin C (not specific to cancer)
Vitamin D

Less opioid use among people with advanced cancer with 25(OH)D levels less than 50 nmol/L treated with vitamin D (preliminary evidence)

Lower pain during hormone therapy among people treated with vitamin D, and especially among people starting with lower 25(OH)D levels (modest evidence)

No evidence of an effect on pain after brain tumor surgery among people with vitamin D serum levels of 20 ng/dL or lower treated with vitamin D before surgery in a small study

Not specific to cancer:

  • Fewer requests for pain medication but no evidence of an effect on pain scores overall among people with vitamin D levels below 50 nmol/L treated with vitamin D (good evidence)
Yoga: modest evidence

Less anxiety, usually only for a short time after practice, among people with cancer practicing yoga (good evidence)

Recommended in clinical practice guidelines for treating pain; see guidelines ›

Practices and therapies with preliminary or weak evidence of benefit for pain

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) typically indicates that not much research has been published so far, although the outcomes may be meaningful. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that only very preliminary research has been published.

Combining Eating Well and Moving More Learn moreSee Less
Sleeping Well Learn moreSee Less
Sharing Love and Support Learn moreSee Less
Artemisia annua (sweet wormwood) and artemisinin Learn moreSee Less
Artesunate and other artemisinin-based drugs Learn moreSee Less
Astragalus Learn moreSee Less
Electroacupuncture Learn moreSee Less
Enhanced recovery after surgery Learn moreSee Less
Green tea or EGCG Learn moreSee Less
Guided imagery with music Learn moreSee Less
Healing touch Learn moreSee Less
Low-dose naltrexone Learn moreSee Less
Mediterranean diet Learn moreSee Less
Metformin Learn moreSee Less
Mistletoe Learn moreSee Less
Modified citrus pectin Learn moreSee Less
Moxibustion Learn moreSee Less
Polarity therapy Learn moreSee Less
Progressive muscle relaxation with breathing, meditation, guided imagery, and self-hypnosis, plus acupressure antinausea wristbands Learn moreSee Less
QR-333 Learn moreSee Less
Quercetin Learn moreSee Less
Therapeutic Touch™ Learn moreSee Less
Turkey tail mushroom Learn moreSee Less
Turmeric and curcumin Learn moreSee Less
Vitamin C supplements Learn moreSee Less
Zyflamend Learn moreSee Less

Therapies with no evidence of benefit

Iodine ›

  • No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on muscle pain among women with stage 2 or 3 breast cancer treated with molecular iodine

Probiotics and prebiotics ›

Not specific to cancer:

  • No evidence of an effect on pain intensity after elective orthopedic or colorectal surgery (not specific to cancer) among elderly people treated with probiotics in a small trial

Support groups and interventions ›

  • No evidence of an effect on pain among people with cancer participating in interventions including their family caregivers in a combined analysis of studies

Vitamin C supplements ›

  • No evidence of an effect on pain among people with advanced cancer treated with 10 g oral vitamin C in a mid-sized study

Further complementary therapies used to manage pain

These therapies are used to manage pain. Those in bold are recommended in at least one clinical practice guideline; see guidelines ›

Aquatic therapy 

Avocado soybean unsaponifiables

Beta-carotene

Caffeine (for tension headaches)

Capsaicin

Contrast hydrotherapy

Curcuma (curcumin) ›

Electromagnetics

Ginger

Ginseng

Glucosamine

Grape seed extract

Green tea extract / EGCG ›

Hypnotherapy (hypnosis)

Lycopene ›

Massage therapy

Music therapy

Omega-3 fatty acids or polyunsaturated fatty acids ›

Red light therapy (infrared and cold laser)

Scrambler therapy

Soy supplements ›

Sulforaphane

Traditional Chinese herbal medicines

Transcutaneous electrical nerve stimulation (TENS)

Ultrasonic stimulation

Psychosocial therapies:

  • Behavioral treatment
  • Cognitive-behavioral stress management (CBSM)
  • Cognitive-behavioral therapy (CBT)
  • Support groups
  • Supportive/expressive therapy

Helpful links

Keep reading about pain

Authors

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
View profile

Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher
View profile

Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Reviewer

Wayne B. Jonas, MD

Integrative physician and CancerChoices advisor
View profile

Dr. Wayne B. Jonas is a practicing family physician, an expert in integrative health and healthcare delivery, and a widely published scientific investigator. Dr. Jonas is the executive director of Samueli Integrative Health Programs, an effort supported by Henry and Susan Samueli to increase awareness and access to integrative health and supporting the scientific investigation of healing processes in the areas of stress, pain, and resilience. Additionally, Dr. Jonas is a retired lieutenant colonel in the Medical Corps of the United States Army. From 2001 to 2016, he was president and chief executive officer of Samueli Institute, he was the director of the Office of Alternative Medicine at the National Institutes of Health (NIH) from 1995 to 1999, and prior to that served as the director of the Medical Research Fellowship at the Walter Reed Army Institute of Research. He is a Fellow of the American Academy of Family Physicians.

Dr. Jonas’s research has appeared in peer-reviewed journals such as the Journal of the American Medical AssociationNatural MedicineThe Journal of Family PracticeThe Annals of Internal Medicine, and The Lancet. His books include the 2018 best seller How Healing Works: Get Well and Stay Well Using Your Hidden Power to Heal.

Dr. Jonas received the 2015 Pioneer Award from the Integrative Healthcare Symposium, the 2007 America’s Top Family Doctors Award, the 2003 Pioneer Award from the American Holistic Medical Association, the 2002 Physician Recognition Award of the American Medical Association, and the 2002 Meritorious Activity Prize from the International Society of Life Information Science in Chiba, Japan.

Dr. Jonas’s view: “We know so little about the mystery of life and the body that we need to consider all systems and explanations for their wisdom.”

Wayne B. Jonas, MD Integrative physician and CancerChoices advisor

Last update: May 6, 2024

Last full literature review: August 2022

We are grateful to Dr. Giovanni Elias for his review of several sections of this handbook.

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

 

References[+]