Journal of Pain and Symptom Management
September 1, 2023
Benjamin R. Lewis, Eric L Garland, Kevin Byrne et al.
60 citations
Psilocybin-assisted group therapy appears safe and feasible for treating depression in cancer patients. In an open-label pilot trial, twelve participants with a depressive disorder received one high-dose (25 mg) psilocybin session within a three-week group program. Depression scores on the HAM-D scale decreased substantially from an average of 21.5 at baseline to 10.09 at two weeks and 14.83 at six months. Six of twelve participants met remission criteria (HAM-D below 7) at two weeks, and no serious adverse events occurred. The group format may reduce therapist time while maintaining possible efficacy, warranting further study.
Journal of Pain and Symptom Management
February 11, 2022
Lucas Oliveira Maia, Yvan Beaussant, Ana Cláudia Mesquita Garcia
59 citations
A systematic review of 20 studies found that psychedelic-assisted therapies show positive effects for symptom control in patients with serious illness, particularly for psychological and spiritual symptoms. Most studies used lysergic acid diethylamide, psilocybin, or N,N-dipropyltryptamine in cancer patients. Adverse effects were physical or psychological, mild to moderate, transient, and self-resolving. The evidence suggests considerable safety of use.
Journal of Pain and Symptom Management
March 1, 2026
William B Alexander, Eric D Hansen, Brian T Anderson et al.
1 citation
Loss of meaning is a hallmark of demoralization syndrome, a prevalent condition in palliative care linked to diminished quality of life, increased symptom burden, and higher suicide risk. Existential psychological interventions improve psychosocial outcomes, but evidence for their effect on demoralization is limited. Psychedelic therapies, which enhance meaning-making and integrate existential approaches, show promise for existential distress and demoralization in early clinical trials. Novel combined pharmacological and psychological interventions like psychedelic therapy warrant further investigation.
Journal of Pain and Symptom Management
January 3, 2026
Karolina L Bryl, Adam W. Hanley, Raymond E Baser et al.
1 citation
Chronic pain is common among cancer survivors but often goes untreated. Existing treatments carry risks or offer limited relief, and non-drug options have shown only modest benefits. Mindfulness-Oriented Recovery Enhancement (MORE), an intervention that targets the neurocognitive mechanisms of chronic pain, has helped people without cancer but had not been tested in cancer survivors. This pilot trial enrolled 60 cancer survivors with moderate-to-severe pain (average age 60; 75% female) and randomly assigned them to one of three MORE formats (16, 8, or 2 hours) or a waitlist. MORE proved feasible, with high enrollment (71%) and assessment completion (91%), and acceptable, with high adherence and satisfaction.
Journal of Pain and Symptom Management
August 1, 2026
Paul Noufi, Joshua B Borris, Danielle Chammas et al.
Ketamine and esketamine offer rapid antidepressant effects, with intravenous ketamine producing moderate-to-large improvements within 1–24 hours that last one to two weeks, and a number needed to treat of three in the first week. Esketamine nasal spray shows similar early efficacy and is FDA-approved for treatment-resistant depression and major depression with suicidal ideation. Evidence specific to people with serious illnesses is limited to perioperative cancer trials and small open-label studies, showing short-term reductions in depressive symptoms and suicidal ideation but not addressing long-term management. Safety is generally favorable, with transient dissociation, hypertension, and somnolence as common adverse effects. Rigorous psychiatric trials in serious illness are lacking.
Journal of Pain and Symptom Management
August 1, 2026
Stefan Aguiar, Mary Makarious, Orly Lipsitz et al.
In adults with advanced cancer receiving palliative care, intranasal ketamine was associated with clinically meaningful improvements in existential distress, anxiety, symptom burden, and quality of life. Fifteen participants who completed three doses of ketamine showed improvements exceeding established minimal clinically important differences on measures of anxiety, death and dying distress, overall symptoms, and quality of life. Improvements in existential well-being were larger than those in physical symptoms. Changes in depression did not significantly correlate with changes in existential distress outcomes, suggesting ketamine may have independent effects on multiple dimensions of distress in this population.
Journal of Pain and Symptom Management
March 27, 2026
Ana Cláudia Mesquita Garcia, Geovanna Maria Isidoro, Cremilson de Paula Silva
For people with serious illness, psychedelic experiences can transform how they relate to their own finitude. Before the experience, death is a dominant threat, marked by fear and an illness-centered identity. During the psychedelic state, expanded consciousness enables transcendence—symbolic encounters with death, ego expansion, spiritual unity, and emotionally challenging experiences—which allow people to reinterpret suffering as transformative and reconstruct their personal narratives. Afterward, finitude becomes integrated into life with greater acceptance of mortality, reduced death anxiety, and a revaluation of life priorities. The process does not eliminate suffering but involves its traversal and integration, supporting existential adaptation at the end of life.
Journal of Pain and Symptom Management
September 1, 2019
Buddy Marterre
A composer and cognitive musicologist named Bruno, who integrated Taoism, Tibetan Buddhism, Zen, Christian mysticism, mathematics, and music into his life, experienced an exceptionally graceful dying process and death. His spirituality interconnected diverse faith traditions and philosophies, and his art forms of light and music moved and challenged many people. The author presents his story to encourage other healers in hospice and palliative care, noting that while some aspects of Bruno's transformation from being to nonbeing were obvious, others were inscrutable.
Journal of Pain and Symptom Management
February 24, 2020
Sunre Park, Yasuko Sato, Yuka Takita et al.
An eight-week mindfulness-based cognitive therapy (MBCT) program, compared with a wait-list control, improved psychological distress, fear of cancer recurrence, fatigue, spiritual wellbeing, and quality of life in Japanese patients with stage I to III breast cancer. Benefits were maintained four weeks after the intervention ended.
Journal of Pain and Symptom Management
February 13, 2020
K. Milbury, S. Weathers, Sania Durrani et al.
A couple-based meditation program delivered via FaceTime to brain tumor patients and their partners is feasible and acceptable. Patients who completed the program reported fewer cognitive and general disease symptoms, better relationship well-being, and greater compassion compared with those receiving usual care, with medium to large effects. No significant benefits were observed for partners. The findings suggest that remote dyadic interventions may help patients manage symptom burden, though further research is needed.
Journal of Pain and Symptom Management
January 1, 2015
Carolyn Jacobs
Social workers are increasingly recognizing the importance of contemplative practices and spirituality in patient care. The profession's historical focus on the whole person and the roles of both social worker and patient in healing and coping with loss makes it essential for social workers to understand the place of contemplative practice in their own lives. This article establishes the context for this work and describes a program designed to enhance social workers' awareness and practice skills for engaging spirituality in the clinical relationship.