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

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.