Integrative Oncology by Abrams Donald I.; Weil Andrew;

Integrative Oncology by Abrams Donald I.; Weil Andrew;

Author:Abrams, Donald I.; Weil, Andrew;
Language: eng
Format: epub
Publisher: Oxford University Press, Incorporated
Published: 2014-08-15T00:00:00+00:00


REDUCING OR RELIEVING CANCER-RELATED PAIN

Pain is both a physical sensation and an emotional experience. It is one of the most common, burdensome, and feared symptoms experienced by patients with cancer (Sheinfeld et al., 2012), and is often underreported, underdiagnosed, and undertreated (Levy, Chwistek, & Mehta, 2008). The prevalence of pain in patients with cancer has been reported to be between 50% and 70% during cancer treatment and 65% for those with advanced disease (Pujol & Monti, 2007). The way a patient manages stress, tension, and emotions can amplify or reduce the suffering associated with their pain.

Pharmacologic treatment of pain does not always meet patients’ needs and may produce difficult side effects. Research shows that mind–body interventions can reduce or relieve pain in cancer patients, whether from the disease itself or from side effects of treatments, and allows patients to participate in their own care (Cassileth, Trevisan, & Gubili, 2007; Porter & Keefe, 2011). The World Health Organization (WHO) recommends behavioral and psychosocial interventions as a standard of care in cancer pain treatment (Jadad & Browman, 1995). The American Pain Society similarly recommends psychosocial interventions for pain management in cancer. A meta-analysis concluded that psychosocial interventions should be systematically implemented as part of a multimodal approach for cancer pain management (Sheinfeld et al., 2012).

Redd, Montgomery, and DuHamel (2001) reviewed 54 published studies of behavioral intervention methods in the control of aversive side effects of cancer treatments, and reported that hypnotic-like methods, involving relaxation, suggestion and distracting imagery, showed the greatest effects for pain management. Devine (2003) conducted a meta-analysis of the effect of psychoeducational interventions on pain in adults with cancer from 25 studies published between 1978-2001 and concluded that reasonably strong evidence exists for relaxation-based cognitive—behavioral interventions, education about analgesic usage, and supportive counseling.

A randomized clinical trial with 124 women with metastatic breast cancer concluded that hypnosis is an effective treatment for pain (Butler et al., 2009). Another randomized study with 201 cancer patients reported beneficial effects of hypnosis to reduce pain (Lang et al., 2008). Dalton, Keefe, Carlson, and Youngblood (2004) showed in a randomized study of 131 cancer patients that a cognitive behavioral therapy tailored to patient characteristics reduced pain and interference of pain with sleep, activities, walking, and relationships, and less confusion. Cutson (1998) reported that inclusion of nonpharmacologic treatments, including psychological, are important for effective management of cancer pain. Liossi, White, and Hatira (2006) and Richardson, Smith, McCall, and Pilkington (2006) both reported that hypnosis produced significant reductions in pain, anxiety, and distress in children with cancer undergoing lumbar punctures and other diagnostic and therapeutic procedures. Spiegel and Bloom (1983) showed that both group therapy and hypnosis reduced pain in a randomized study of 54 women with metastatic breast carcinoma. Both interventions reduced pain, and the combination worked better than each alone. Syrjala et al. (1995) also found that relaxation and imagery training reduced pain levels in a study with 94 cancer patients receiving bone marrow transplants.



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