***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Abstract Purpose Women with breast cancer may experience symptoms of depression , anxiety , pain , fatigue and sleep disturbances during chemotherapy .  However , there are few modalities that address multiple , commonly occurring symptoms that may occur in individuals receiving cancer treatment .  Cranial electrical stimulation ( CES ) is a treatment that is FDA cleared for depression , anxiety and insomnia . CES is applied via electrodes placed on the ear that deliver pulsed , low amplitude electrical current to the head . Methods This phase III r and omized , sham-controlled study aim ed to examine the effects of cranial microcurrent stimulation on symptoms of depression , anxiety , pain , fatigue , and sleep disturbances in women receiving chemotherapy for early-stage breast cancer . Patients were r and omly assigned to either an actual or sham device and used the device daily for 1 h. The study was registered at clinical trials.gov , NCT00902330 . Results The sample included N = 167 women with early-stage breast cancer .  Symptom severity of depression , anxiety , and fatigue and sleep disturbances were generally mild to moderate . Levels of pain were low . Anxiety was highest prior to the initial chemotherapy and decreased over time . The primary outcome assessment ( symptoms of depression , anxiety , fatigue , pain , sleep disturbances ) revealed no statistically significant differences between the two groups , actual CES vs. sham . Conclusion In this study , women receiving chemotherapy for breast cancer experienced multiple symptoms in the mild to moderate range . Although there is no evidence for the routine use of CES during the chemotherapy period for symptom management in women with breast cancer , further symptom management modalities should be evaluated to mitigate symptoms of depression , anxiety , fatigue , pain and sleep disturbances over the course of chemotherapy BACKGROUND Various interventions , including the superior hypogastric plexus block and ganglion impar block , are commonly used for the treatment of pelvic or perineal pain caused by cancer . The inferior hypogastric plexus block ( performed using a trans-sacral approach under fluoroscopy and using a local anesthetics⁄steroid combination ) for the diagnosis and treatment of chronic pain conditions involving the lower pelvic viscera was first described in 2007 . Neurolysis of the inferior hypogastric plexus may be useful for the treatment of pelvic and perineal pain caused by cancer . OBJECTIVES To assess the feasibility , safety and efficacy of the newly introduced inferior hypogastric plexus block , performed using a trans-sacral approach , for the relief of cancer-related pelvic and perineal pain . METHODS A total of 20 patients with cancer pain in the pelvis and ⁄or perineum were injected with 6 mL to 8 mL of 10 % phenol bilaterally by passing a spinal needle through the sacral foramen to perform the inferior hypogastric block . Pain intensity ( measured using a visual analogue scale ) , sleep score , activity score , psychological score and oral morphine consumption pre- and postprocedure were measured . RESULTS Two of the 20 patients  died during the follow-up period and were , therefore , excluded from the study . All patients presented with  cancer-related pelvic , perineal or pelviperineal pain . Pain scores were reduced from a mean ( ± SD ) of 7.22±1.31 preprocedurally to 4.06±1.73 one week postprocedurally ( P<0.05 ) . In addition , the mean consumption of morphine ( delivered via 30 mg sustained-release morphine tablets ) was reduced from 106.67±32.90 mg to 61.67±40.48 mg after one week ( P<0.05 ) . No complications or serious side effects were encountered during or after the block . DISCUSSION AND CONCLUSION The approach provides a good alternative technique for the treatment of low pelvic and perineal cancer-related pain . Additional studies are required for evaluation and refinement of the technique using other radiological techniques Background : Pain is 1 of the most common symptoms that a cancer patient would experience . A significant barrier to positive pain management is patients ’ misconceptions regarding analgesics and inadequate use of nonpharmacological strategies as pain relief . Objective : The purpose of this study was to investigate the effectiveness of a pain management program ( PMP ) on pain intensity , use of PRN drugs  and  nonpharmacological strategies  as pain relief , and barriers to managing pain in cancer patients . Methods : The study was conducted in the palliative care and hospice ward of a public hospital in Hong Kong . Patients were r and omized to either an experimental group ( receiving the PMP ) or a control group ( routine care ) . There were 38 hospitalized patients , with 20 ( 13 males and 7 females ) in the experimental group and 18 ( 11 males and 7 females ) in the control group ; mean age was 61.95 years ( experimental group ) to 63.94 years ( control group ) . Results : Upon the completion of PMP , pain scores were significantly reduced in both groups , yet patients in the experimental group showed a significant increase in the use of PRN analgesics and nonpharmacological strategies to relieve pain ( P < .05 ) and significantly reduce barriers to managing their cancer pain ( P < .05 ) compared with the control group . Conclusion : Cancer patients should be empowered with pain management education to gain knowledge and correct misconceptions in managing their cancer pain . Implication s for Practice : Integration of the PMP into routine clinical work may help to improve the st and ard of care for cancer patients . It is recommended to provide pain management education to all cancer patients AIM Checklists may improve management of patients in different setting s. However , no studies have been conducted to investigate the use of this tool to improve  inpatient pain control .  This study , conducted in Italy , aims to describe the experience , in terms of pain control , of the widespread introduction of a checklist for pain control in oncological patients , according to current Italian legislation . MATERIAL S & METHODS In total , 92 Italian centers were r and omly assigned to the use of the 38Checkpain to monitor pain management or to continue their st and ard practice without the use of this tool . RESULTS The 38Checkpain improved the control of pain compared with centers who did not use this tool . CONCLUSION Overall , the findings of this study suggest that the application of the 38Checkpain may help improve control of pain of hospitalized oncological patients PURPOSE / OBJECTIVES To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management , decreasing pain intensity , and improving functional status and quality of life ( QOL ) . DESIGN R and omized clinical trial . SETTING Six outpatient oncology clinics ( three Veterans Affairs [ VA ] facilities , one county hospital , and one community-based practice in California , and one VA clinic in New Jersey ) Sample : 318 adults with various types of cancer-related pain . METHODS Patients were r and omly assigned to one of three groups : control , st and ardized education , or coaching . Patients in the education and coaching groups viewed a video and received a pamphlet on managing cancer pain . In addition , patients in the coaching group participated in four telephone sessions with an advanced practice nurse interventionist using motivational interviewing techniques to decrease attitudinal barriers to cancer pain management . Question naires were completed at baseline and six weeks after the final telephone calls . Analysis of covariance was used to evaluate for differences in study outcomes among the three groups . MAIN RESEARCH VARIABLES Pain intensity , pain relief , pain interference , attitudinal barriers , functional status , and QOL . FINDINGS Attitudinal barrier scores did not change over time among groups . Patients r and omized to the coaching group reported significant improvement in their ratings of pain-related interference with function , as well as general health , vitality , and mental health . CONCLUSIONS Although additional evaluation is needed , coaching may be a useful strategy to help patients decrease attitudinal barriers toward cancer pain management and to better manage their cancer pain . IMPLICATION S FOR NURSING By using motivational interviewing techniques , advanced practice oncology nurses can help patients develop an appropriate plan of care to decrease pain and other symptoms BACKGROUND Arthralgia is a common and debilitating side-effect experienced by breast cancer patients receiving aromatase inhibitors ( AIs ) and often results in premature drug discontinuation . METHODS We conducted a r and omised controlled trial of electro-acupuncture ( EA ) as compared to waitlist control ( WLC ) and sham acupuncture ( SA ) in postmenopausal women with breast cancer who self-reported arthralgia attributable to AIs . Acupuncturists performed 10 EA/SA treatments over 8 weeks using a manualised protocol with 2 Hz electro-stimulation delivered by a TENS unit . Acupuncturists administered SA using Streitberger ( non-penetrating ) needles at non-traditional acupuncture points without electro-stimulation . The primary end-point was pain severity by Brief Pain Inventory ( BPI ) between EA and WLC at Week 8 ; durability of response at Week 12 and comparison of EA to SA were secondary aims . FINDINGS Of the 67 r and omly assigned patients , mean reduction in pain severity was greater in the EA group than in the WLC group at Week 8 ( -2.2 versus -0.2 , p=0.0004 ) and at Week 12 ( -2.4 versus -0.2 , p<0.0001 ) . Pain-related interference measured by BPI also improved in the EA group compared to the WLC group at both Week 8 ( -2.0 versus 0.2 , p=0.0006 ) and Week 12 ( -2.1 versus -0.1 , p=0.0034 ) . SA produced a magnitude of change in pain severity and pain-related interference at Week 8 ( -2.3 , -1.5 respectively ) and Week 12 ( -1.7 , -1.3 respectively ) similar to that of EA . Participants in both EA and SA groups reported few minor adverse events . INTERPRETATIONS Compared to usual care , EA produced clinical ly important and durable improvement in arthralgia related to AIs in breast cancer patients , and SA had a similar effect . Both EA and SA were safe CONTEXT Integrated interventions with combined elements of body movement and psychotherapy on treatment-related symptoms in cancer patients are relatively scarce . OBJECTIVES The aim of the present study is to investigate the effectiveness of dance movement therapy ( DMT ) on improving treatment-related symptoms in a r and omized controlled trial . METHODS A total of 139 Chinese patients with breast cancer awaiting adjuvant radiotherapy were r and omized to DMT or control group .  The intervention included six 1.5-hour DMT sessions provided twice a week over the course of radiotherapy . Self-report measures on perceived stress , anxiety , depression , fatigue , pain , sleep disturbance , and quality of life were completed before and after the three-week program . RESULTS DMT showed significant effects on buffering the deterioration in perceived stress , pain severity , and pain interference ( Cohen d = 0.34 - 0.36 , P < 0.05 ) . No significant intervention effects were found on anxiety , depression , fatigue , sleep disturbance , and quality of life ( Cohen d = 0.01 - 0.20 , P > 0.05 ) . CONCLUSION The short-term DMT program can counter the anticipated worsening of stress and pain in women with breast cancer during radiotherapy The objective of this study was to assess the impact of a Swedish massage intervention on oncology patients '  perceived level of distress . Each patient 's distress level was measured using 4 distinct dimensions : pain , physical discomfort , emotional discomfort , and fatigue . A total of 251 oncology patients volunteered to participate in this nonr and omized single-group pre- and post design study for over a 3-year period at a university hospital setting in southeastern Georgia . The analysis found a statistically significant reduction in patient-reported distress for all 4 measures : pain ( F = 638.208 , P = .000 ) , physical discomfort ( F = 742.575 , P = .000 ) , emotional discomfort ( F = 512.000 , P = .000 ) , and fatigue ( F = 597.976 , P = .000 ) . This reduction in patient distress was observed regardless of gender , age , ethnicity , or cancer type . These results lend support for the inclusion of a complementary massage therapy program for hospitalized oncology patients as a means of enhancing their course of treatment BACKGROUND Pancreatic cancer is often accompanied by severe abdominal or back pain . It 's the first study to evaluate the analgesic effect of electroacupuncture on pancreatic cancer pain . A r and omized controlled trial compared electroacupuncture with control acupuncture using the placebo needle . METHODS Sixty patients with pancreatic cancer pain were r and omly assigned to the electroacupuncture group ( n = 30 ) and the placebo control group ( n = 30 ) . Patients were treated on Jiaji ( Ex-B2 ) points T8-T12 bilaterally for 30 min once a day for 3 days . Pain intensity was assessed with numerical rated scales ( NRS ) before the treatment ( Baseline ) , after 3 treatments , and 2 days follow-up . RESULTS Baseline characteristics were similar in the two groups . After 3 treatment , pain intensity on NRS decreased compared with Baseline ( -1.67 , 95 % confidence interval [ CI ] -1.46 to -1.87 ) in the electroacupuncture group ; there was little change ( -0.13 , 95 % CI 0.08 to -0.35 ) in control group ; the difference between two groups was statistically significant ( P < 0.001 ) . Follow-up also found a significant reduction in pain intensity in the electroacupuncture 
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FINDINGS : Based on evidence , recommended interventions to reduce chronic cancer pain are celiac plexus block for pain related to pancreatic and abdominal cancers and radiation therapy for bone pain .