Efficacy of psychological interventions versus standard care for cancer pain: a systematic review and meta-analysis.

BACKGROUND

Cancer-related pain is frequently accompanied by psychological distress, which may worsen symptom burden and impair quality of life. This systematic review and meta-analysis aimed to evaluate the efficacy of psychological interventions versus standard care for pain intensity, depressive symptoms, and anxiety in adults with cancer-related pain.

METHODS

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. PubMed, Embase, Web of Science, and the Cochrane Library were searched from inception to January 5, 2026. Randomized controlled trials comparing structured psychological interventions with routine or standard care were included. The primary outcome was pain intensity measured by the Visual Analog Scale (VAS). Secondary outcomes were depressive symptoms measured by the Beck Depression Inventory (BDI) and anxiety measured by the State-Trait Anxiety Inventory (STAI). Mean differences (MDs) with 95% confidence intervals (CIs) were pooled.

RESULTS

Fourteen randomized controlled trials involving 2, 070 participants were included. Psychological interventions significantly reduced VAS scores compared with standard care (MD = -0.91, 95% CI -1.38 to -0.44; P = 0.0001; I²=97%). Significant improvements were also observed in BDI scores across 10 trials (MD = -4.22, 95% CI -5.50 to -2.93; P<0.00001; I²=78%) and STAI scores across 5 trials (MD = -1.74, 95% CI -2.96 to -0.52; P = 0.005; I²=0%). Subgroup analyses by cancer type and mean age partly explained heterogeneity in VAS outcomes. Egger's tests showed no significant funnel plot asymmetry for VAS (P = 0.857) or BDI (P = 0.452). Adverse events and follow-up durations were inconsistently reported and could not be quantitatively synthesized. The certainty of evidence was moderate for all outcomes.

CONCLUSION

Psychological interventions may reduce pain intensity, depressive symptoms, and anxiety in adults with cancer-related pain. However, substantial heterogeneity, inconsistent follow-up reporting, and limited safety data warrant cautious interpretation and further standardized randomized trials.