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Evidence-Based Nonpharmacological Symptom Management of Palliative Care in Advanced and Metastatic Cancer Patients: A Systematic Review

Authors: Alikan Berkay, Can GülbeyazJournal: Florence Nightingale journal of nursingPublished: February 28, 2024DOI: 10.5152/FNJN.2023.23043
Strong EvidenceSystematic Reviewn=1975 participants

In Plain Language: cancer pain, explained

The aim of this systematic review is to provide reliable, high-quality data with an evidence-based, up-to-date overview of the use of nonpharmacologic interventions in the management of symptoms in advanced cancer patients with metastatic disease. A comprehensive literature search was performed by searching PubMed, EBSCO, Cochrane, and Google Scholar databases. "Nonpharmacologic," "palliative care," and "cancer" were the three main terms combined with the main symptoms of cancer palliative care such as "pain," "fatigue," "nausea and vomiting," "psychosocial distress," "loss of appetite," "dyspnea," "constipation," and "drowsiness," and each symptom was searched separately. Thirteen studies were included in this systematic review with a total of 1975 participants. Three of the studies examined "fatigue," three examined "quality of life," one examined "sleep," three examined "dyspnea," two examined "depression," and one examined "pain." To manage these symptoms, three of the studies included in the systematic review used "patient education," three of the studies used "exercise," three of the studies used "fan therapy," and the remaining studies used "reflexology," "cognitive behavioral therapy," and "occupational therapy." Number of studies done regarding the advanced and metastatic cancer patients and their symptom management through nonpharmacological methods are low, which makes it difficult to draw decisive conclusions.

Key Findings: what this systematic review found about cancer pain

  • ✓This systematic review identified 13 studies with 1,975 participants examining nonpharmacologic interventions for managing symptoms in advanced cancer patients with metastatic disease.
  • ✓The reviewed studies focused on multiple palliative care symptoms including fatigue (3 studies), quality of life (3 studies), dyspnea (3 studies), depression (2 studies), sleep (1 study), and pain (1 study).
  • ✓Nonpharmacologic interventions were examined as evidence-based alternatives to pharmacological treatments for managing common symptoms in advanced cancer palliative care.

What This Means for You

While reflexology is among the nonpharmacological options explored for cancer symptom management, the evidence base remains limited, so it's best used alongside conventional care under medical supervision.

What This Means for Practitioners

Reflexology can be positioned as part of a multimodal symptom management approach for palliative cancer care, but practitioners should emphasize the need for more rigorous research to establish its specific efficacy.

Study Design: how this systematic review was run

Sample Size
1975 participants
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Cancer pain: common questions

What does this study say about cancer pain?

While reflexology is among the nonpharmacological options explored for cancer symptom management, the evidence base remains limited, so it's best used alongside conventional care under medical supervision.

What did this study find?

This systematic review identified 13 studies with 1,975 participants examining nonpharmacologic interventions for managing symptoms in advanced cancer patients with metastatic disease. The reviewed studies focused on multiple palliative care symptoms including fatigue (3 studies), quality of life (3 studies), dyspnea (3 studies), depression (2 studies), sleep (1 study), and pain (1 study). Nonpharmacologic interventions were examined as evidence-based alternatives to pharmacological treatments for managing common symptoms in advanced cancer palliative care.

How strong is this evidence?

This is a systematic review and we rate its evidence strong. It covers 1,975 participants. It was published in Florence Nightingale journal of nursing. This study is indexed here for context; it did not test reflexology itself.

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