Integrative Medicine for Pain in Patients With Advanced Cancer Trial (IMPACT)

Inclusion Criteria:

• Age ≥ 18 years or older

• Having a diagnosis of the following: stage III or IV lung cancer; any stagepancreatic cancer; unresectable cholangiocarcinoma; unresectable liver cancer;unresectable ampullary or peri-ampullary cancer or other stage IV gastrointestinalcancer; stage III or IV ovarian or fallopian tube cancers or other stage IVgynecologic cancer; stage IV breast cancer; stage III testicular cancer; stage IVgenitourinary cancer; stage III or IV sarcoma; stage IV melanoma; stage III or IVhead/neck cancer; stage IV endocrine cancer; or hematological malignancies (lymphoma, myeloma, and leukemia)

• Be ambulatory (Karnofsky functional score of ≥ 60)

• Having musculoskeletal pain, defined as regional (joints, extremities, back, neck)or more generalized (fibromyalgia or chronic widespread pain); Patients with aneuropathic component to their pain that involves the extremities or back will beeligible.

• Having musculoskeletal pain for at least 1 month

• Having had pain for at least 15 days in the preceding 30 days

• Having a pain rating of 4 or greater in worst pain on a 0-10 numerical rating scalein the preceding week

• Having an expected prognosis of greater than six months as judged by the treatingoncologist or study physician

Exclusion Criteria:

• Having a platelet count <15,000

• Cognitive impairment precluding response to study assessments

• Unwilling to accept random assignment

• Unwilling to commit to the 26-week study time period

• Have non-musculoskeletal pain syndromes (headache, facial pain, chest pain, visceralabdominal pain) if these are the sole source of pain but can be present as co-morbidconditions as long as a patient has a primary musculoskeletal pain condition definedas above.