Results from a randomized clinical trial approved by the institutional review board at Memorial Sloan Kettering Cancer Center show the potential for symptom management—particularly, pain—through acupuncture and massage in advanced cancer patients. The Integrative Medicine for Pain in Patients with Advanced Cancer Trial (IMPACT) compared the long-term effectiveness of acupuncture versus massage in people living with advanced cancer and how the two could reduce pain and help manage symptoms such as fatigue and insomnia to improve quality of life for advanced cancer patients.
Logistics of the IMPACT
The clinical trial was conducted at multiple US cancer centers from September 19, 2019, through February 23, 2022, offering 298 patients weekly acupuncture or massage for 10 weeks, with monthly booster sessions up to 26 weeks. The goal was to observe a change, if any, in pain intensity scores per the Brief Pain Inventory (BPI) from baseline over 26 weeks, with observations regarding secondary outcomes including fatigue, insomnia, and subsequently, quality of life. (The BPI ranges from 0 to 10, with higher numbers indicating worse pain intensity or interference.)
The mean (SD) baseline worst pain score was 6.9 (1.5), and over the course of the 26 weeks, acupuncture was shown to have reduced the worst pain score with a mean change of –2.53 (95% CI, –2.92 to –2.15) points, and massage reduced the BPI worst pain score with a mean change of –3.01 (95% CI, –3.38 to –2.63) points. The difference between the acupuncture and massage groups was not significant, and both treatments also demonstrated improvements in fatigue, insomnia, and quality of life, also without significant differences between groups.
Essentially, the results from the IMPACT study indicate that acupuncture and massage therapy could be viable solutions for advanced cancer patients to manage pain and other symptoms. Moreover, the two modalities provide about the same effectiveness, should patients prefer one over the other.
Alternative Therapies Among the Opioid Crisis
Advanced cancer patients experience pain and other adverse effects like fatigue and insomnia on a consistent basis, and one of the most common treatment methods—especially for pain management—involves using opioids. But due to the ongoing opioid crisis, more people living with advanced cancer and other conditions are seeking alternative treatments to manage pain and symptoms. If therapies like massage and acupuncture can provide significant and reliable relief (as suggested by the results of this study), advanced cancer patients will have more holistic treatment options with far less risk of effects like addiction and with much greater access and affordability.
Massage and bodywork are also whole-body modalities that can be used to target pain anywhere in the body, whether acute or widespread. Patients suffering from pain in specific areas of the body can, in theory, rely on focused massage or bodywork to relieve pain rather than relying on opioids, which affect the entire body.
More research is encouraged to further investigate the benefits of massage and acupuncture (and potentially other alternative therapies) regarding pain and symptom management in advanced cancer patients. However, the results of the IMPACT provide hope for more accessible and less risky treatment options for those living with advanced cancer.
Resources
Epstein, AS, et al. “Acupuncture vs Massage for Pain in Patients Living With Advanced Cancer: The IMPACT Randomized Clinical Trial.” JAMA Network Open 6, no. 11 (2023): e2342482. doi:10.1001/jamanetworkopen.2023.42482.
Garlapow, Megan. "Acupuncture, Massage Offer Equivalent Symptom Management in Advanced Cancer." Oncology Nurse Advisor, December 15, 2023. oncologynurseadvisor.com/home/hot-topics/side-effect-management/cancer-acupuncture-massage-equivalent-symptom-management-treatment/.
Jun J Mao. "Integrative Medicine for Pain in Patients With Advanced Cancer Trial (IMPACT)." Memorial Sloan Kettering Cancer Center. September 17, 2019–September 30, 2022. https://clinicaltrials.gov/study/NCT04095234.
