Introduction. Chemotherapy remains a cornerstone of cancer treatment, yet its physical side effects represent a significant challenge, often compromising treatment adherence and patient QoL. Although pharmacological interventions are widely used to manage these effects, they are not always effective and may introduce additional burdens. Consequently, there is growing interest in nonpharmacological interventions that provide supportive care without introducing additional side effects.
Methods. This systematic review evaluated the effectiveness of nonpharmacological strategies in reducing common physical side effects of chemotherapy (fatigue, nausea, vomiting, pain, diarrhea, and constipation). A comprehensive search was conducted in PubMed, PsycINFO, and Web of Science for studies published between 2002 and September 2024, using the terms: “psycho*” AND “chemotherapy OR chemo” AND “side effects OR adverse effects”. Only English-language studies involving adult patients undergoing chemotherapy were included.
Results. 46 studies met the inclusion criteria. Fatigue, nausea, vomiting, and pain are the symptoms with the strongest evidence supporting the use of nonpharmacological interventions. Guided imagery showed consistent benefits across these outcomes, especially when combined with relaxation or music. Qigong appeared effective across several symptoms, including gastrointestinal ones. Physical activity showed positive effects on fatigue and some benefits for pain and nausea. Yoga showed benefits mainly for nausea and vomiting. Educational and psychological interventions yielded mixed but generally encouraging results, particularly for nausea, vomiting, and pain. Evidence for diarrhea and constipation remains limited and inconclusive.
Conclusions. Some nonpharmacological interventions may help manage certain chemotherapy-related symptoms. The mechanisms underlying their potential effectiveness appear to involve stress reduction and autonomic modulation. However, the overall quality, heterogeneity, and scope of existing studies limit the generalizability of the results. Further high-quality research is warranted to understand better which interventions are most effective, under what conditions, and for which patient populations.