Article: Borm, K. J., Schiller, K., Asadpour, R., & Combs, S. E. (2020). Complementary and Alternative Medicine in Radiotherapy: A Comprehensive Review. Top Magn Reson Imaging, 29(3), 149-156. doi:10.1097/rmr.0000000000000244

Abstract: Complementary and alternative medicine (CAM) approaches are widely used by patients throughout a broad range of medical fields and diseases, and often self-administered by patients without the involvement of physicians or other members of the health care team. CAM use is well documented in cancer and chronic illnesses, and emerging data in radiation oncology show CAM usage of 26% to 97% in radiation therapy patients. No information is, however, available on CAM usage in radiology and in the imaging procedure fields. This article reviews the fundamental principles and the experience with the wide spectrum of CAM in radiation oncology-a field that shares many parallels with radiology, such as prevalence of imaging, procedural requirements, and cooperation demanded from patients.CAM is defined as "approaches and practices that are typically not part of conventional medical care," and includes the use of mind- and body-based practices (eg, meditation, massage, acupuncture), natural products (eg, herbs, vitamins, minerals), and other interventions. Supplements are used frequently to alleviate side effects of therapy and promote overall well-being. Specifically, the mindfulness/meditation approaches of CAM are known to reduce anxiety and enhance physical and emotional wellbeing in patients with chronic diseases, such as cancer or neurologic diseases, through physiological, psychological, and perhaps placebo mechanisms. Such patients often require repetitive and invasive imaging examinations or procedures, such as for cancer treatment, cancer surveillance/follow-up, or monitoring of chronic diseases, for example, surveillance MRI in multiple sclerosis. Such parallels suggest that the vastly understudied area of CAMs deserve further investigation in both the radiation oncology and the imaging fields. Further research on CAM is needed to develop refined recommendations and national/and international guidelines on its use.

Review: Between 26% and 97% of cancer patients who undergo radiation report using complementary and alternative medicine(CAM), yet these practices are seldom communicated to the health care team. Mind-body practices (e.g., meditation, massage, acupuncture) and natural products (e.g., herbs, vitamins, minerals) may be used to promote well-being and reduce side-effects. Empirical evidence to support these practices among radiology patients, however, is lacking and worthy of future study. Open discussion between patients and clinicians about CAM is recommended to help maximize potential benefits and reduce potential harms.

Article: Lopes-JĂșnior, L. C., Rosa, G. S., Pessanha, R. M., Schuab, S. I. P. D. C., Nunes, K. Z., & Amorim, M. H. C. (2020). Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review. Rev Lat Am Enfermagem, 28. doi:10.1590/1518-8345.4213.3377

Abstract: Objective: to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care.

Method: a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers.

Results: eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%).

Conclusion: while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.

Review: Pain is a common quality of life reducing condition among cancer patients. Complementary therapies such as massage therapy, progressive muscle relaxation, guided imagery, and acupuncture may be helpful for managing pain. This systematic review found support for pain reduction among massage, progressive muscle relaxation, and guided imagery studies, yet mixed results for acupuncture. This suggests additional scientific inquiry regarding acupuncture for pain in diverse cancer populations is warranted.