Multimodal Rehabilitation for Advanced Cancer Pain: a Narrative Review of Emerging Nonpharmacological Strategies

While the WHO analgesic regimen holds a central position, long-term medication use may lead to drug resistance and side effects. Nonpharmacological interventions have shown potential as effective adjuncts to pharmacological treatments, particularly in reducing medication side effects and enhancing patients' quality of life. Disparities in access, cultural acceptability, and cost-effectiveness-especially in low- and middle-income countries(LMICs)-along with publication bias and study heterogeneity remain significant challenges. Emerging technologies such as virtual reality and artificial-intelligence-driven applications show promise in addressing coverage gaps. Based on the comprehensive review of current evidence, multimodal rehabilitation incorporating nonpharmacological strategies-such as physical therapy, exercise training, psychological interventions, and complementary therapies-effectively complements pharmacologic management in alleviating advanced cancer pain and enhancing quality of life. Future efforts should focus on standardizing interventions, expanding access, and integrating these approaches within multidisciplinary frameworks to optimize pain control and functional outcomes.