Introduction and aims Fatigue, experienced by patients during and following cancer treatment, is a significant clinical problem. It is a prevalent and distressing symptom yet pharmacological interventions are used little1 and confer limited benefit for patients.2 However, many cancer patients use some form of Complementary and Complementary medicine (CAM) and some evidence suggests it may relieve fatigue.3 A systematic review was conducted to appraise the effectiveness of CAM interventions in ameliorating cancer-related fatigue (CRF).

Methods Systematic searches of biomedical, nursing and specialist CAM databases were conducted, including Medline, Embase and AMED (August 2010). Included papers described interventions classified as CAM by the National Centre of Complementary and Alternative Medicine, and evaluated through randomised controlled trial (RCT) or quasi experimental design.

Results 15 studies were eligible for the review, of which 12 were RCTs. Forms of CAM interventions examined included acupuncture, massage, yoga and relaxation training. Findings suggested acupuncture, medical qigong and restorative yoga are somewhat effective for reducing CRF, whereas vitamins, massage and hypnosis are not.

Conclusion Acupuncture appeared to confer most benefit to patients. However, trials incorporated within the review varied greatly in quality; most were methodologically weak and at high risk of bias. Consequently, there is currently insufficient evidence to conclude with certainty the effectiveness or otherwise of CAM in reducing CRF. The design and methods employed in future trials of CAM should be more rigorous; increasing the strength of evidence should be a priority.