Integrative therapies may improve quality of life for patients undergoing gynecologic cancer surgery, according to research published in Cancer.1 

Preoperative touch and relaxation techniques were associated with decreased anxiety and depression in these patients. 

When acupuncture was added to preoperative touch and relaxation techniques, patients reported improvements in severe pain.

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This trial ( Identifier: NCT03560388) included 102 patients undergoing gynecologic cancer surgery. The patients were randomly assigned to 1 of 3 treatment arms: 

  • Preoperative touch/relaxation techniques plus intraoperative acupuncture and standard care (n=45)
  • Preoperative touch/relaxation and standard care (n=25) 
  • Standard care alone (n=32, 3 of whom were lost to follow-up).

Researchers assessed pain and anxiety before and after surgery using the Measure Yourself Concerns and Wellbeing and Quality of Recovery (QOR-15) questionnaires. 

Postoperative QOR scores assessing quality-of-life parameters were significantly higher among patients who received either intervention, compared with the standard care arm (P =.005). 

When grouped together, the interventions were associated with a significant improvement in severe pain, compared with standard care alone (P =.011). However, when the groups were analyzed separately, only patients in the acupuncture/touch/relaxation arm had a significant improvement in severe pain (P =.011).

When grouped together, the interventions were associated with a significant improvement in anxiety, compared with standard care alone (P =.007). The improvement in anxiety scores was significant for the acupuncture/touch/relaxation arm (P =.01) and the touch/relaxation arm (P =.032).

Depression scores were also improved with acupuncture/touch/relaxation (P =.002) and touch/relaxation (P =.006), compared with standard care alone.

“The findings suggest that preoperative touch and relaxation modalities can reduce perioperative anxiety, whereas the addition of intraoperative acupuncture may also reduce pain, at least among patients reporting severe pain,” the researchers wrote. 

The researchers also mentioned several limitations to this study, including the use of self-assessment for pain and anxiety rather than objective parameters, and variances in surgical procedure and site of cancer. 

“Ultimately, these data add to the body of integrative medicine and integrative oncology literature that are now included in National Comprehensive Cancer Network and American Society of Clinical Oncology guidelines and that support reimbursement for integrative oncology interventions such as acupuncture,” Ana Maria Lopez, MD, of Sidney Kimmel Cancer Center in Sewell, New Jersey, wrote a related editorial.2


1. Ben-Arye E, Segev Y, Galil G, et al. Acupuncture during gynecological oncology surgery: A randomized controlled trial assessing the impact of integrative therapies on perioperative pain and anxiety. Cancer. Published online January 17, 2023. doi:10.1002/cncr.34542

2. Lopez AM. Integrative oncology in cancer care: Reaching a tipping point. Cancer. Published online January 17, 2023. doi:10.1002/cncr.34539