Effects of a patient-tailored integrative oncology intervention in the relief of pain in palliative and supportive cancer care

J Cancer Res Clin Oncol. 2021 Aug;147(8):2361-2372. doi: 10.1007/s00432-020-03506-1. Epub 2021 Jan 12.

Abstract

Context and objectives: The present study examined the impact of an integrative oncology treatment program in the relief of pain in patients undergoing chemotherapy and/or palliative care.

Methods: In this pragmatic prospective controlled study, patients undergoing chemotherapy and/or palliative care were referred by their oncology healthcare providers to an integrative physician (IP) consultation, followed by weekly integrative treatments. Patients attending ≥ 4 sessions during the first 6 weeks of the study were considered to be highly adherent to integrative care (AIC). Pain was assessed at baseline and at 6 and 12 weeks using the ESAS (Edmonton Symptom Assessment Scale) and EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) tools.

Results: Of 815 eligible patients, 484 (59.4%) were high-AIC and 331 low-AIC. Mean pain scores decreased significantly from baseline to 6 and 12 weeks in both groups. However, ESAS and EORTC pain scores improved significantly more in the high-AIC group at 6 weeks (p= 0.008), though not at 12 weeks. Between-group analysis of participants undergoing adjuvant/neo-adjuvant chemotherapy showed higher pain reduction in the high-AIC group at 6 weeks (ESAS, p = 0.006; EORTC, p = 0.046), as was the case with patients receiving palliative care (ESAS p = 0.04; EORTC p = 0.056).

Conclusions: High adherence to integrative care was found to be associated with a greater effect on pain relief at 6 weeks but not at 12 weeks in patients undergoing chemotherapy and/or palliative care.

Keywords: Integrative oncology; Pain; Palliative care; Quality of life.

Publication types

  • Controlled Clinical Trial
  • Pragmatic Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Cancer Pain / diagnosis
  • Cancer Pain / epidemiology
  • Cancer Pain / therapy*
  • Complementary Therapies
  • Female
  • Humans
  • Integrative Oncology / methods*
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Neoplasms / therapy*
  • Pain Management / methods
  • Pain Measurement
  • Palliative Care / methods*
  • Patient Compliance / statistics & numerical data
  • Precision Medicine / methods*
  • Quality of Life
  • Surveys and Questionnaires