Therapies such as acupuncture, massage, relaxation therapy, and hypnosis are widely used for symptom control by the general public. Acupuncture, for example, is widely used in the United States to treat conditions such as back pain, and massage therapy is sought to help treat for anxiety disorders. Similarly, complementary therapies are increasingly used to treat symptoms of cancer or its treatment. A description of the most important complementary therapies is given below, followed by a review of the evidence for their effects against cancer-related symptoms. On the basis of this evidence, the following principles apply to the use of complementary modalities for cancer symptoms:
• Hypnosis or relaxation therapy should be considered for acute or chronic cancer pain, particularly when pain is poorly controlled with medication or when medication causes unacceptable adverse effects.
• Acupuncture is indicated to help control chronic cancer pain that remains severe despite medication or when medication causes unacceptable adverse effects.
• Mild or moderate mood disorders can be alleviated with therapies such as relaxation, imagery, meditation, and massage. Music therapy is available for inpatients at some cancer centers and appears effective for mood disorder in this population.
• Hypnosis or acupuncture is often effective for poorly controlled acute or subacute nausea in cancer patients.
• Botanicals do not relieve hot flashes.
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