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Routine Use of Acetaminophen

The routine addition of acetaminophen/paracetemol to a pain regimen of opioid analgesics in patients with chronic pain has commonly been used in practice, in order to improve overall pain control. The effects of this approach in pain management are beginning to be examined through research for effectiveness in managing chronic pain in patients with cancer.


Rikkunshito is a traditional Japanese medicine that has been used to treat a variety of gastrointestinal (GI) disorders. Animal studies suggest it has an impact in the GI tract as a 5-HT4 receptor antagonist and appears to have some effect in increasing ghrelin concentrations. Rikkunshito has been studied for its effect on anorexia in patients with cancer.

Rhodiola Algida

Rhodiola algida is a Tibetan plant used in traditional Chinese medicine. It is thought to strengthen the human immune system by nourishing and invigorating Qi and activating blood circulation against stasis. It has been tested as an intervention for mucositis in patients with cancer.

Restriction of Fresh Fruits and Vegetables

The low microbial diet involves proper food and drink preparation and avoiding specific foods that may contain infection-causing organisms, such as bacteria and fungi.  Low microbial diets generally eliminate raw, unprocessed, and fresh fruits and vegetables and drinking tap water and emphasize well-cooked foods and appropriate food handling to reduce cross-contamination.  Use of a low microbial diet has been recommended for the prevention of infection in patients with cancer but has not been extensively studied.


Repifermin is a keratinocyte growth factor that stimulates the production and differentiation of keratinocytes. Keratinocytes are primarily found in the skin and are involved in epithelialization of wounds. Repifermin was evaluated in patients with cancer in the treatment of mucositis.

Remifentanil PCA

Remifentanil is an opioid that is a fentanyl derivative. Researchers have examined the effectiveness of remifentanil administered by patient controlled analgesia (PCA) in managing acute pain.

Relaxation Therapy

Relaxation therapies differ in philosophy and method. In any case, the goal is to use the power of the mind and body to achieve a sense of relaxation and lowered metabolism. Relaxation therapy interventions may incorporate breathing exercises and involve relaxing the body. These interventions may involve techniques such as diversion or visualization. Relaxation therapy differs from progressive muscle relaxation in that the specific technique of sequential muscle relaxation is not necessarily used.

Relaxation and Visual Imagery

Visual imagery involves the mental visualization and imagination to enhance relaxation and alter specific experiences and may or may not include direct suggestion. It may differ from guided imagery in that the process may not be highly specific and aimed at imagining a relaxed setting or memory. Relaxation may involve breathing exercises but not the specific process of progressive muscle relaxation.


Reiki (pronounced "RAY-kee") is a form of "energy healing" that uses vibration drawn through the practitioner into the recipient, in accordance with the recipient’s need. Proponents hypothesize that Reike re-establishes the energy balance in areas of the body associated with discomfort, thus promoting healing and increasing quality of life. Researchers have evaluated Reike in patients with cancer for its impact on anxiety, depression, pain, and fatigue.

Regional Cooling

Regional cooling involves the application of ice packs to the wrists and ankles during chemotherapy infusion. As with cryotherapy, cooling is theorized to cause vasoconstriction and decreased circulation of the chemotherapeutic drug in the regional area, less extravasation into surrounding tissue, and a resulting reduction in cutaneous toxicity.

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