Is breathing exercise effective for pain relief in cancer survivors?

Introduction
Effective pain management is essential for cancer survivors to ensure their quality of life. Breathing exercise may have potential benefit for pain relief in cancer survivors. A systematic review was conducted to identify the effects and safety of using breathing exercise for pain management in cancer survivors.

Methods
Thirteen databases were searched including Medline, PubMed, CENTRAL, CINAHL, JBI, EMBase, ScienceDirect, PsycINFO, SocINDEX, Scopus,WanFang, Web of Science, and CNKI from inception to 24th May 2021. Relevant articles in reference lists were also checked for potentially eligible studies. Cochrane Risk of Bias Tools were utilized for bias assessment. Descriptive analysis was applied to report outcomes.

Results
Ten studies with 1030 participants were included. Risks of bias were unclear or high in most studies. For post-surgical pain, slow pursed lip breathing showed promising outcomes, but contradictory findings were found for ‘Enhanced Recovery After Surgery’ breathing practice. ‘Active Cycle of Breathing’ and 5-minute mindful breathing did not show statistically significant effect on pain relief in adult cancer survivors. Slow deep breathing and ‘Hey-Hu’ breathing showed promising effect for pain management in paediatric cancer survivors. One study addressed safety of breathing exercise and no adverse events occurred.

Conclusions
Breathing exercise may be beneficial for pain relief in cancer survivors. More high quality studies are required to generate more robust evidence on this topic.