The aim of this systematic review is to provide reliable, high-quality data with an evidence-based, up-to-date overview of the use of nonpharmacologic interventions in the management of symptoms in advanced cancer patients with metastatic disease. A comprehensive literature search was performed by searching PubMed, EBSCO, Cochrane, and Google Scholar databases. Nonpharmacologic, palliative care, and cancer were the three main terms combined with the main symptoms of cancer palliative care such as pain, fatigue, nausea and vomiting, psychosocial distress, loss of appetite, dyspnea, constipation, and drowsiness, and each symptom was searched separately. Thirteen studies were included in this systematic review with a total of 1975 participants. Three of the studies examined fatigue, three examined quality of life, one examined sleep, three examined dyspnea, two examined depression, and one examined pain. To manage these symptoms, three of the studies included in the systematic review used patient education, three of the studies used exercise, three of the studies used fan therapy, and the remaining studies used reflexology, cognitive behavioral therapy, and occupational therapy. Number of studies done regarding the advanced and metastatic cancer patients and their symptom management through nonpharmacological methods are low, which makes it difficult to draw decisive conclusions.

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