Which Complementary Therapy Relieves Cancer Pain – Acupuncture or Massage?

Most often arising from cancer itself, or less commonly from cancer treatments, pain is a common problem among patients with cancer. Cancer pain is often inadequately assessed and, unfortunately, its treatment receives insufficient attention, negatively affecting quality of life . Because conventional pain management uses opioids (narcotic painkillers / medications subject to red or green prescriptions in Turkey), whose side effects and potential for misuse are concerns, non-drug approaches are preferred for pain relief. Methods such as acupuncture and massage therapy have attracted attention as alternative treatment options in this area.

Definitions of Acupuncture and Massage

Acupuncture is an integral part of traditional Chinese medicine and involves inserting fine needles at specific points on the body. Electrical stimulation may sometimes be applied to these needles to enhance treatment effectiveness. Massage manipulates the muscles and soft tissues of the body to improve circulation and promote relaxation.

Long-term studies in patients who have completed cancer treatment have shown that acupuncture can contribute to pain management. Massage therapy was also studied in patients receiving palliative care or end-of-life supportive care. Massage was found to provide pain relief in patients with cancer, including these groups, but the benefit was short-lived.

In 2022, the American Society of Clinical Oncology (ASCO) and the Society for Integrative Oncology published a joint guideline on acupuncture and massage for managing cancer pain. However, the long-term effects of these methods and their comparative effectiveness in patients with advanced cancer remain unknown.

The IMPACT Study

The IMPACT study, conducted at Memorial Sloan Kettering Cancer Center, evaluated the comparative effectiveness of acupuncture and massage for pain in patients with advanced cancer.

The 298 participants had experienced pain for at least 1 month and on at least 15 days of the previous month, and a doctor had determined that they were likely to live for at least 6 months.

Patients received 10 sessions of acupuncture or massage therapy each week for up to 26 weeks.

Findings

Measurements at the end of week 26 showed the following:

• The mean change was -2.53 in the acupuncture group and -3.01 in the massage group.
• Both groups reported improvements in pain-related functional interference, fatigue, insomnia, and physical quality of life.
• At week 26, the proportion of patients using pain medication had fallen to 27.5% in the acupuncture group and 35.6% in the massage group.

Side Effects

Side effects were generally mild: bruising, localized pain, and bleeding in the acupuncture group, and temporary pain and headache in patients receiving massage.

Conclusion

There is a substantial need for safe and effective options, given innovative treatments that extend the lives of patients with advanced cancer and the many challenges associated with using opioids for pain relief.

The IMPACT study was the first to demonstrate the long-term effectiveness of acupuncture and massage for relieving pain in patients with advanced cancer. These therapies, which were safely delivered even during the COVID-19 pandemic, should be offered more widely in cancer centers. When using these treatments, it is important to choose accredited practitioners with experience working with patients with cancer.

This study supports considering acupuncture and massage as effective and safe treatments for pain management. Oncology providers are encouraged to incorporate these methods into treatment plans, as they may play an important role in improving quality of life for patients with advanced cancer.