Efficacy and safety of moxibustion for relieving pain in patients with metastatic cancer: A pilot, randomized, single-blind, sham-controlled trial

Background. Moxibustion has been traditionally used to manage pain related to chronic diseases, including cancer. This study aims to investigate the efficacy and safety of moxibustion for relieving cancer pain in patients with metastatic cancer. Methods. A total of 16 patients were randomly divided into a true moxibustion (TM) group or a sham moxibustion (SM) group. In both groups, moxibustion was applied for 10 minutes, once daily for 7 consecutive days. In the SM group, the moxa cone was removed earlier than in the TM group, so as not to deliver heat stimulation completely into the skin. The changes of pain severity using the Brief Pain Inventory (BPI) and quality of life measured by the Functional Assessment of Cancer Therapy-General (FACT-G) were observed. A blinding credibility test was done to validate the sham moxibustion procedure. Results. The total BPI score significantly decreased in the TM group compared with the SM group (TM vs SM: -0.97 ± 1.05 vs 0.35 ± 0.60, P =.025). The 2 subsets of BPI, pain intensity score and pain interference score, also significantly decreased in the TM group (TM vs SM: intensity, -0.82 ± 0.93 vs 0.46 ± 0.87, P =.020; interference, -1.12 ± 1.31 vs 0.24 ± 0.61, P =.047). Even after adjusting for the values of opioid consumption, these results remained significant. FACT-G did not significantly improve in the TM group. The blinding to sham moxibustion was credible and no serious adverse events occurred. Conclusion. We suggest that moxibustion could be a safe and potential modality for cancer-related pain in patients with metastatic cancer. With the limitation of small sample size, a larger and long-term follow-up study is necessary to determine more definitely the efficacy of moxibustion.