Integrative Medicine for Pain in Patients With Advanced Cancer Trial (IMPACT)

Inclusion criteria

• Age ≥ 18 years or older
• Having a diagnosis of the following: stage III or IV lung cancer; any stage pancreatic cancer; unresectable cholangiocarcinoma; unresectable liver cancer; unresectable ampullary or peri-ampullary cancer or other stage IV gastrointestinal cancer; stage III or IV ovarian or fallopian tube cancers or other stage IV gynecologic cancer; stage IV breast cancer; stage III testicular cancer; stage IV genitourinary cancer; stage III or IV sarcoma; stage IV melanoma; stage III or IV head/neck cancer; stage IV endocrine cancer; or hematological malignancies (lymphoma, myeloma, and leukemia)
• Be ambulatory (Karnofsky functional score of ≥ 60)
• Having musculoskeletal pain, defined as regional (joints, extremities, back, neck) or more generalized (fibromyalgia or chronic widespread pain); Patients with a neuropathic component to their pain that involves the extremities or back will be eligible.
• Having musculoskeletal pain for at least 1 month
• Having had pain for at least 15 days in the preceding 30 days
• Having a pain rating of 4 or greater in worst pain on a 0-10 numerical rating scale in the preceding week
• Having an expected prognosis of greater than six months as judged by the treating oncologist or study physician

Exclusion criteria

• Having a platelet count <15,000
• Cognitive impairment precluding response to study assessments
• Unwilling to accept random assignment
• Unwilling to commit to the 26-week study time period
• Have non-musculoskeletal pain syndromes (headache, facial pain, chest pain, visceral abdominal pain) if these are the sole source of pain but can be present as co-morbid conditions as long as a patient has a primary musculoskeletal pain condition defined as above.