Safety and side effects of non-pharmacological interventions as a therapy for cancer

Document Type

Book Chapter


Springer Science


Faculty of Health, Engineering and Science


School of Nursing and Midwifery / Clinical Nursing and Midwifery Research Centre




Williams, A. M., Bulsara, C. E., & Petterson, A. S. (2013). Safety and side effects of non-pharmacological Interventions as a therapy for cancer. In W. C. S. Cho (Eds.). Evidence-based non-pharmacological therapies for palliative cancer care (pp. 219-252). Dordrecht, Netherlands: Springer Science . Original book available here


Persons diagnosed with cancer are increasingly using non-pharmacological interventions as a therapy for cancer, either independently or in addition to usual medical treatment. Within mainstream medical systems, information availability and access to these therapies is generally limited and patients’ usage is commonly self-initiated. Self-initiation raises issues regarding personal safety, efficacy of the intervention, and the minimisation of potential side effects. A search was undertaken to identify relevant scientific literature related to the use of 15 non-pharmacological interventions widely used in cancer populations as therapy: acupuncture, biofeedback, exercise, meditation, music, visualization/guided imagery, yoga, kinesiology, massage, reflexology, healing touch, Qigong, Reiki, and transcutaneous electrical nerve stimulation. These interventions were classified as mind-body, touch-based or energy-based therapies. This literature search was not intended to be a systematic review, but a comprehensive assessment of current scientific publications relating to the safety and side effects of each intervention. This chapter reveals that such interventions had been used in a number of different countries worldwide, in a variety of cancer populations, to address approximately 23 different symptoms associated with the experience of cancer. For all of the interventions reviewed, the recorded occurrence of side effects was minimal. Safety issues and precautions were rarely discussed in the literature relating to these non-pharmacological therapies, apart from the literature relating to the use of exercise. For hospitals considering the use of non-pharmacological interventions, a framework to facilitate the safe administration of non-pharmacological interventions as a therapy for cancer is presented. There are six main elements of this framework: the considered selection of non-pharmacological interventions, recruitment of quality practitioners, provision of oncology education and preparation for the care of persons with cancer, the use of clinical practice guidelines for each intervention, careful monitoring of persons receiving non-pharmacological interventions, and adherence to the principles of occupational health and safety. It is important that these elements are addressed by hospitals offering non-pharmacological interventions. In addition, the provision of detailed and accurate information to enable patients to continue certain therapies independently and after hospitalisation is also essential.