Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis

Alejandra Ruano; Francisco García-Torres; Mario Gálvez-Lara; Juan A Moriana

doi:10.1016/j.jpainsymman.2021.12.021

Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis

J Pain Symptom Manage. 2022 May;63(5):e505-e520. doi: 10.1016/j.jpainsymman.2021.12.021. Epub 2021 Dec 22.

Authors

Alejandra Ruano¹, Francisco García-Torres², Mario Gálvez-Lara³, Juan A Moriana³

Affiliations

¹ Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain.
² Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain. Electronic address: z12gatof@uco.es.
³ Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain.

PMID: 34952171
DOI: 10.1016/j.jpainsymman.2021.12.021

Abstract

Context: Pain is the most fearful symptom in cancer. Although there is a relationship between psychosocial variables and oncologic pain, psychological and non-pharmacological treatments for pain management in cancer patients are not very widespread.

Objectives: To analyze the efficacy of psychological and non-pharmacological treatments for reducing pain in cancer patients.

Methods: We performed a systematic review following the PRISMA protocol. In January 2021, data were extracted from PubMed, Web of Science and Scopus, including randomised controlled trials (RCT) published in the last five years (from 28 January, 2015 to December 15, 2020), in the English language and whose sample was patients with cancer pain. The database search used the following keywords: cancer, cancer-related pain, psychological intervention, non-pharmacologic intervention. The Cochrane risk of bias assess ment for randomised trials (RoB 2) was used for quality appraisal.

Results: After the inclusion and exclusion criteria were applied, ten papers were fully screened. The evidence suggested that the most effective interventions to reduce cancer pain were mindfulness-based cognitive therapy, guided imagery and progressive muscle relaxation and emotional and symptom focused engagement (EASE). Music therapy and brief cognitive behavioral strategies (CBS) require more research, while coping skills training and yoga did not show positive effects. Overall, we obtained a moderate size effect (d = 0.642, 95% CI: 0.125-1.158) favourable to psychological and non-pharmacologic treatments at post-treatment, which increased at follow-up (k = 5, d = 0.826, 95% CI: 0.141-1.511).

Conclusion: This study provides insight into psychological interventions which might be applied and contribute to cancer-related pain reduction in adults. Although the results are not completely consistent, they may shed light on psychology applications in the oncology environment.

Keywords: Cancer; meta-analysis; pain; psychological treatment; systematic review.

Publication types

Meta-Analysis
Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cancer Pain* / therapy
Cognitive Behavioral Therapy* / methods
Humans
Music Therapy*
Neoplasms* / complications
Neoplasms* / psychology
Neoplasms* / therapy
Pain Management / methods