Most Beneficial Integrative Therapies for Breast Cancer Patients

Recently updated clinical guidelines from the Society for Integrative Oncology (SIO) examined integrative treatments to determine which ones were safest and most effective for patients with breast cancer.

The latest findings, published in CA: A Cancer Journal for Clinicians, add to the growing body of literature on integrative therapies for patients with breast cancer and other types of cancer.

For the systematic review, investigators evaluated more than 80 different therapies and assigned them letter grades based on the strength of evidence in the peer-reviewed randomized clinical trials.

The letter grade “A” indicated that the specific therapy is recommended for a certain clinical indication, and that there is high certainty of substantial benefit for the patient.

Based on the findings, the SIO made the following recommendations: the use of music therapy, meditation, stress management, and yoga for anxiety and stress reduction; use of meditation, relaxation, yoga, massage, and music therapy for depression and mood disorders; use of meditation and yoga to improve quality of life; use of acupressure and acupuncture to reduce chemotherapy-induced nausea and vomiting; and the lack of strong evidence supporting the use of ingested dietary supplements or botanical natural products as part of supportive care and/or to manage adverse events (AEs) related to treatment.

“Studies show that up to 80% of people with a history of cancer use 1 or more complementary and integrative therapies, but until recently, evidence supporting the use of many of these therapies had been limited,” said Heather Greenlee, ND, PHD, former president of SIO. “Our goal is to provide clinicians and patients with practical information and tools to make informed decisions on whether and how to use a specific integrative therapy for a specific clinical application during and after breast cancer treatment.”

Meditation had the strongest evidence based on results from 5 trials that supported its use. It is recommended to reduce anxiety, treat symptoms of depression, and improve overall quality of life.

Music therapy, massage, and yoga all received a “B” for the same symptoms and providing benefits for patients with breast cancer. Yoga received a “B” grade for improving quality of life based on findings form 2 recent trials. Yoga and hypnosis received a “C” for fatigue.

“The routine use of yoga, meditation, relaxation techniques, and passive music therapy to address common mental health concerns among patients with breast cancer is supported by high levels of evidence,” said Debu Tripathy, MD, chair of breast oncology at the University of Texas MD Anderson Cancer Center, and past president of SIO. “Given the indication of benefit coupled with the relatively low level of risk, these therapies can be offered as a routine part of patient care, especially when symptoms are not well controlled.”

Acupressure and acupuncture received a B grade as an addition to drugs used to reduce chemotherapy-induced nausea and vomiting.

There was a lack of strong evidence supporting the use of ingested dietary supplements and botanical natural products as part of supportive cancer care and to manage treatment-related AEs.

“Clinicians and patients need to be cautious about using therapies that received a grade of C or D and fully understand the potential risks of not using a conventional therapy that may effectively treat cancer or help manage [AEs] associated with cancer treatment,” said Lynda Balneaves, RN, PhD, president-elect of SIO.

Dr Greenlee echoed Balneaves’ warnings about therapies that have little to no evidence supporting their claims.

“Patients are using many forms of integrative therapies with little or no supporting evidence and that remain understudied,” Dr Greenlee said. “This paper serves as a call for further research to support patients and health care providers in making more informed decisions that achieve meaningful clinical results and avoid harm.