Acupuncture

Efficacy 
The evidence for the effects of acupuncture on distress is inconclusive. Only one small pilot RCT (n=31) assessed distress and found a decrease in distress among breast cancer patients.

Safety 
Generally safe when administered by a professional qualified practitioner. Mild adverse effects, such as pain or bleeding at the site of acupuncture, can be expected in about 10% of all cases. Serious complications seem to be very rare. 
 
Read the full version of the Acupuncture for cancer pain summary.

Music interventions 

Efficacy 
The evidence is contradictory on the effect of music therapy on distress. Two SRs (n=30 RCTs, n=25 RCTs) found conflicting results; one found a small significant effect on physical symptom distress, and the second one did not find significant effects on distress; low-quality evidence. 

Safety 
Generally considered safe with no safety issues on record. Caution is advised for acutely distressed and/or emotionally fragile patients, particularly in patients with serious and life-threatening cancers. 

Read the full version of the Music interventions summary.

Mindfulness

Efficacy 
The evidence is contradictory small-, medium-, and long-term effects of mindfulness-based interventions on general distress. Two SRs (n=29 RCTs, n=4 mixed study designs) reported positive effects of mindfulness on distress. One systematic review reported positive effects in children and adolescents with mixed types of cancer; however, the results are limited by methodological flaws of the included studies. 

Safety 
Mindfulness-based interventions are generally considered to be safe in supportive cancer care. However, no rigorous assessment of the safety of mindfulness-based approaches in cancer patients is available. 

Read the full version of the Mindfulness summary.

Reiki

Efficacy 
Only few data are available which suggest reiki to not be effective for distress. One RCT (n=26), assessed the effect of Reiki on distress and no significant effect was found. 

Safety 
Generally considered safe when administered by a qualified practitioner, reiki has not been associated with any direct safety issues. 
 
Read the full version of the Reiki summary. 

Massage (Classical/Swedish) 

Efficacy 
The available evidence suggests massage therapy not to be effective on distress. A systematic review reported four RCTs (n=35 to n=380) where there was no significant effect of massage on distress and one (n=56) where massage decreased emotional distress after treatment.  
 
Safety 
Generally considered safe when administered by a qualified professional.  Contraindications include strong forceful massage in patients suffering from haemorrhagic disorders, low platelet counts, and blood thinning medication. 

Read the full version of the  Massage (Classical/ Swedish) summary. 

Qigong

Efficacy 
The evidence suggests qigong to not be effective on distress based on one SR including two RCTs reporting on distress. 

Safety 
Generally considered safe when administered by a qualified practitioner. As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis or musculoskeletal difficulties. 
  
Read the full version of the Qigong summary.