IntroductionSound is a physical pervasive phenomenon inducing resonance influencing cell metabolism with bodily water mediating the effects of vibration. Tibetan Singing Bowls may induce state of wellbeing in patients with cancer which can be measured. MethodsThis pilot study included 12 metastatic cancer patients undergoing 6 sessions using Tibetan Bowls. Objective (electrocardiography, skin conductance and electroencephalography) and subjective measurements (QoL, Anxiety/Depression, Distress, Fatigue) were performed. End points were feasibility (recruitment, attendance, compliance to treatment) and benefits (amelioration in QoL, anxiety, distress, arousal and mental exhaustion). ResultsAll 12 patients were recruited over a two-week period; 83% attended all sessions. 83% of the patients completed questionnaires to assess subjective efficacy. 59 instrumental tests were performed out of 60 sessions completed. For subjective parameters, a statistically significant difference emerged only for the Distress Thermometer (2.4 vs 5.3 p=0.0005). Objective parameters: 1) tonic skin conductance level (SCL) decreased significantly (p=0.0091) and phasic SCL (p=0.0064); 2) heart rate variability (HRV) significantly increased (p=0.0041); 3) EEG registration in anterior-frontal areas revealed changes in beta, alpha and inter-hemispheric coherence, (beta: p=0.09; alpha p=0.046; coherence p=0.084). ConclusionThe feasibility endpoints (acceptance, attendance and compliance) were achieved; personalized programs should be offered to patients at risk of rapid worsening conditions and to subjects affected by bone metastases. A visual tool for subjective distress appears more appropriate than validated questionnaires. Useful tools for collection of objective data are SCL, HRV, and anterio-frontal EEG. Tibetan Bowls decrease anxiety, arousal, involuntary mental activity and stress. Larger trials should confirm these results.