New Complementary Therapy Guidelines for Cancer Pain From ASCO, SIO
Doctors should recommend acupuncture to ease joint pain in people taking an aromatase inhibitor to treat breast cancer, according to new guidelines from the American Society of Clinical Oncology (ASCO) and the Society for Integrative Oncology (SIO).
The guidelines were published online on Sept. 19, 2022, by the Journal of Clinical Oncology. Read the abstract of “Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline.”
Complementary therapies are used as a complement or addition to conventional breast cancer treatments such as surgery, chemotherapy, radiation therapy, hormonal therapy, and immunotherapy. Because complementary medicine techniques are combined with conventional treatments, they’re also called integrative medicine.
ASCO is a national organization of oncologists and other cancer care providers. ASCO develops guidelines for doctors to follow that are supported by highly credible research and experience.
SIO is an international organization of professionals from many different areas of medicine who are dedicated to studying and aiding the cancer treatment and recovery process with integrative medicine.
Pain is one of the most common symptoms reported by people diagnosed with cancer. Pain is the result of inflammation or damage to nerves, tissues, or other parts of the body.
People who’ve been diagnosed with advanced-stage breast cancer can feel pain when cancer spreads to the bones, spine, or other areas of the body away from the breast.
Many breast cancer treatments also can cause pain, including surgery, radiation therapy, chemotherapy, immunotherapy, and hormonal therapy. In particular, hormonal therapy medicines called aromatase inhibitors, which are used to treat hormone receptor-positive breast cancer, are known to cause bone and joint pain. Studies suggest that up to half the women prescribed an aromatase inhibitor stop taking the medicine early, in many cases because of bone and joint pain.
“Pain is a clinical challenge for many oncology patients and clinicians, and there’s a growing body of evidence showing that integrative therapies can be useful in pain management,” Heather Greenlee, ND, PhD, co-chair of the SIO Clinical Practice Guideline Committee, said in a statement. “But to date there has not been clear clinical guidance about when and when not to use these approaches.”
ASCO and SIO developed the new guidelines to help doctors safely and effectively use complementary therapies to treat cancer pain.
The guidelines say:
Doctors should recommend acupuncture to people diagnosed with breast cancer who have joint pain because they’re taking an aromatase inhibitor.
Doctors may recommend yoga to people diagnosed with breast cancer who have joint pain because they’re taking an aromatase inhibitor.
Doctors may recommend acupuncture to people with general pain or muscle or bone and joint pain from cancer.
Doctors may recommend reflexology or acupressure to people who have pain while receiving systemic therapy for cancer. Chemotherapy, hormonal therapy, targeted therapy, and immunotherapy are considered systemic therapy because they affect the whole body by going through the bloodstream. Reflexology is a special type of foot massage based on the idea that stimulating specific points on the feet can improve the function of corresponding organs, glands, and other body parts. In acupressure, pressure is put on specific points of the body using the fingers, thumbs, or a device.
Doctors may recommend massage to people with chronic pain after they complete breast cancer treatment.
Doctors may recommend Hatha yoga to people with pain after breast or head and neck cancer treatment is completed. Hatha yoga is the most common branch of yoga taught in North America. You move your body slowly into poses that aim to increase your strength and flexibility while focusing on your breath.
Doctors may recommend acupuncture, reflexology, or acupressure to people experiencing peripheral neuropathy related to cancer treatment.
Doctors may recommend hypnosis to people having pain during cancer treatment or during diagnostic procedures, such as a biopsy.
Doctors may recommend acupuncture or acupressure to people having surgery for cancer or other related procedures, such as a bone marrow biopsy.
Doctors may recommend music therapy to people with pain after cancer surgery.
Doctors may recommend massage to people in palliative or hospice care who are in pain.
What this means for you
If you’re in pain because of breast cancer or breast cancer treatment, you may want to show your doctor these guidelines and talk about complementary techniques that may be right for you. This is especially true for people with bone and joint pain related to taking an aromatase inhibitor.
Learn more about Complementary Therapy.
Written by: Jamie DePolo, senior editor
— Last updated on September 23, 2022, 6:30 PM