Best Drug-Free Cancer Pain Relief: Acupuncture and Massage, Finds MSK Study

Jun Mao, Chief of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, performs acupuncture

"Acupuncture can have an enduring benefit," says Dr. Mao (above). "For people who do not want to take a lot of pain medication, acupuncture could even be considered as a first-line treatment for pain management."

Acupuncture and massage are the two most effective integrative therapies for cancer pain relief, according to a new study co-led by Jun Mao, Chief of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK).

The two-year study, a collaboration between the Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO), is a first-of-its-kind meta-analysis of ways to treat cancer pain without drugs. Dr. Mao says the guidelines underscore the role integrative therapies can play in cancer care.

“Pain is one of the most common and feared symptoms for cancer patients and survivors,” Dr. Mao says. “There was a critical need to study the evidence so we can make informed recommendations for clinicians and patients.”

Drug-Free Pain Relief for People With Cancer

MSK’s Integrative Medicine Service bridges traditional cancer treatments like chemotherapy, radiation, and surgery with approaches such as acupuncture, massage, reflexology, music therapy, and yoga to care for the whole patient. The new guidelines are especially timely.

“With the opioid epidemic in the United States, many doctors and patients are hesitant to start on strong medications for chronic pain,” Dr. Mao says. “Non-pharmacological treatments like acupuncture and massage can help people find relief.”

Dr. Mao details the new guidelines, which were published in September in the Journal of Clinical Oncology, below.

Can acupuncture help people with their pain from cancer?

Yes. For this study, we recommended acupuncture for breast cancer patients experiencing joint pain from hormonal medications called aromatase inhibitors. Joint pain is one of the most common side effects of these medications. Sometimes, the pain is so bad that patients stop taking them. So the symptoms not only impact quality of life but also survival rates. This is where acupuncture can be really helpful. It’s another tool people can choose as part of their pain management plan. It can give them a better quality of life, so they stay on their lifesaving medications.

We have also seen acupuncture work for people with general cancer-related pain. In 2021, we led a study of 360 patients that found that acupuncture not only reduced pain and mobility difficulties, but it also reduced the use of pain medication. Even better, the effects lasted for four months after 10 treatments. Unlike a lot of drug therapies, acupuncture can have an enduring benefit. For people who do not want to take a lot of pain medication, acupuncture could even be considered as a first-line treatment for pain management.

However, I want to make it very clear that people with severe pain should work with doctors to be on appropriate pain medications. We’re bringing integrative medicine together with those conventional approaches.

What did you learn about massage for cancer pain relief?

We found that massage can be very beneficial for people with advanced cancer. It can reduce their pain and improve their quality of life. We provide treatment in both inpatient and outpatient settings. Oncology massage therapists tailor specific techniques and level of pressure according to patients’ underlying pain conditions and cancer treatment and status.

Why is it important for someone with cancer to receive integrative treatments at MSK, rather than at a gym or spa?

If you’re going through cancer treatment, your white blood cells may be low, your immune system may be weak, and you may also have had procedures that make your skin sensitive, like a port placement or radiation. Our providers know how to treat the particular pain and symptoms that people with cancer can experience. All our therapists work closely with patients’ oncology teams and can review labs and imaging results at any time. This ensures the safety of treatment and that we are all on the same team for our patients. And just recently, we moved to a beautiful new space that has a very calming and soothing environment.

In addition, our therapists not only deliver care, but they also are actively involved in clinical research. They’re the ones actually coming up with specific research protocols and treating patients who are on clinical trials.

What research about integrative medicine for cancer pain still needs to be done?

There are certainly still gaps in our knowledge on how integrative medicine can treat the painful side effects of cancer treatment, and that drives our research. For example, we want to see if there are biological factors that influence how someone responds to treatment. Would certain treatments work better in certain populations?

Also, we still don’t have enough data for therapies like meditation, music therapy, or herbal medicine for cancer pain relief. These treatments are often used by patients to improve coping related to pain, but we need more research to build evidence-based guidelines. Some of our questions don’t have answers yet, but we are actively studying them.