The efficacy of behavioral interventions for cancer treatment-related side effects.

The use of increasingly aggressive methods of cancer treatment (e.g., cytotoxic doses of chemotherapy and total body irradiation) has resulted in the need for more effective management of pain, nausea, and other aversive side effects. One of the most promising approaches is nonpharmacologic intervention based on behavioral research and theory. The purpose of this article is to review the efficacy of behavioral intervention methods in controlling aversive side effects of cancer treatments. Sixty-seven published studies were identified for review. Results indicated that: (1) behavioral intervention can effectively control anticipatory nausea and vomiting in adult and pediatric patients undergoing cancer chemotherapy. However, evidence for the efficacy of behavioral intervention to control post-chemotherapy nausea and vomiting is mixed; (2) behavioral intervention integrating several behavioral techniques can decrease levels of anxiety and distress associated with invasive treatments and cancer diagnosis; and (3) although a variety of behavioral methods have been shown to reduce acute treatment-related pain, not all behavioral techniques are equally effective. Hypnotic-like methods involving relaxation, suggestion, and imagery appear to have the greatest impact on cancer-related pain management. The use of behavioral theory and techniques has an important place in the care of patients undergoing invasive cancer treatments.