A Leading Oncology Association Says Some Complementary Therapies Are Helpful to Women With Breast Cancer

The American Society of Clinical Oncology, the world’s leading group of cancer doctors, has released guidelines on the use of integrative health therapies to help manage the symptoms and side effects of breast cancer treatment.

The report, published June 11 in the Journal of Clinical Oncology, acknowledges the growing popularity and usefulness of yoga, meditation, acupuncture and other integrative health modalities to address aspects of healing that conventional medicine may overlook.

The ASCO guidelines are based on a report published by the Society of Integrative Oncology in 2017 that analyzed randomized, peer-reviewed clinical trials, conducted from 1990 to 2013, on various integrative therapies for breast cancer patients.

The guidelines also address therapies that may be unsafe or that have little scientific proof of efficacy, such as the use of many types of dietary supplements, says Heather Greenlee, ND, PhD, who is a co-author of the paper and an associate member of the cancer prevention program at the Fred Hutchinson Cancer Research Center in Seattle.

“Just because something is natural doesn’t mean it’s safe,” she says. “We’re hoping that this will help patients understand that not all integrative therapies are the same. There are different risk profiles and different levels of efficacy.”

The authors of the ASCO guidelines identified integrative therapies and issued letter grades to reflect the scientific evidence behind that practice, such as grade A for a practice that offers high certainty of substantial benefit and B for those with moderate benefit. Grades C, D, H, and I indicate lower levels of certainty, therapies that are discouraged, therapies that are likely harmful, and therapies with insufficient evidence for any recommendation, respectively.

The guidelines include endorsements for:

- Music therapy, meditation, stress management, and yoga for anxiety and stress reduction
- Meditation, relaxation, yoga, massage, and music therapy for depression and mood disorders
- Meditation and yoga to improve quality of life
- Acupressure and acupuncture for reducing chemotherapy-induced nausea and vomiting

Among therapies that were not recommended were acetyl-L-carnitine for prevention of chemotherapy-induced peripheral neuropathy because of a possibility of harm, and dietary supplements to manage breast-cancer-treatment-related adverse effects.

Integrative therapies — including nutrition, music therapy, acupuncture, hypnosis, and healing touch — are popular among many patients during and after breast cancer treatment. Many patients find such therapies help them cope with anxiety, stress, and fatigue. Others turn to nutrition and nutritional supplements or massage therapy to reduce some of the side effects of treatment, such as pain, nausea, and insomnia.

Between 60 and 80 percent of cancer patients use at least one integrative health therapy after being diagnosed with cancer, according to numerous surveys, Dr. Greenlee says.

“Patients are looking for ways to care for themselves and to promote overall wellness,” she says. “Often they are using these therapies to treat other conditions they have.”

The evidence-based guidelines should reassure breast cancer patients that many integrative practices are conducive to healing and that their doctors should support their wishes to engage these services, says Greenlee. “It is a big step for the field for ASCO to weigh in on this and endorse these guidelines,” Greenlee says. “ASCO is the largest oncology organization in the world, with the broadest reach.”

While a growing number of cancer centers embrace evidence-based integrative therapies and offer such services to patients, other cancer centers and individual doctors have little knowledge about integrative therapies and may not discuss the topic with their patients. Organized by side effects — such as help with pain or help with anxiety — the guidelines are meant to steer patients and oncologists to effective integrative health strategies, Greenlee says.

“Now oncologists have a readily available, clear list of integrative therapies that have been shown in randomized clinical trials to be effective in managing some of the side effects their patients face,” she says. “A lot of these side effects are things that conventional treatment doesn’t manage well.”

Organizations offering integrative services will also welcome the guidelines, says Gillian Cilibrasi, the program director of the Urban Zen Integrative Therapy Program, which offers integrative healing services to patients and caregivers as part of the nonprofit Urban Zen Foundation.

“We are thrilled that ASCO has endorsed a set of SIO guidelines to help breast cancer patients and their clinicians to use integrative therapies, like meditation and yoga, along with their conventional cancer treatment,” Cilibrasi says. “This is a positive step for integrative healthcare and for women who are battling breast cancer.”

Researchers are increasingly interested in understanding not only which integrative therapies work but how they work, Greenlee says. As additional studies are conducted and published, the guidelines will likely undergo revisions.

Moreover, ASCO hopes to publish guidelines on integrative therapies for other types of cancers or treatment-related side effects. ASCO started with breast cancer because there are a substantial number of randomized, controlled studies on the use of integrative therapies among breast cancer patients.

“This is a very important step going forward,” says Greenlee. “We hope it doesn’t stop here. We hope both SIO and ASCO will continue to develop guidelines in the future as more research comes out.”

Source: everydayhealth.com