Breast Cancer and Integrative Therapies

West Meets East, at Last

Integrative therapies means the same thing as complementary and alternative medicine (CAM) or complementary therapies. This includes things like massage, acupuncture, music therapy and support groups, as well as the diets and vitamins and supplements that many people consider.

If you have been reading this blog in the past, you are aware that I consistently take the same position: Tell your doctors what you are doing or taking or thinking about, and expect that they probably will ask you to refrain from ingesting anything during active treatment. The reason for this prohibition is that there are very few studies that have looked at the possible interaction between high doses of vitamins and radiation or chemotherapy. We do know that it may be unwise to take so-called free radicals or antioxidants: vitamin E, beta-carotene, and vitamin C during treatment. Common sense would suggest that it isn't wise to agree to chemo and/or radiation and simultaneously take something that might limit their efficacy. Once treatment is over, that worry is gone.

The American Society of Clinical Oncology (ASCO) recently issued a statement on integrative therapies that has been a long time coming. Over the years, over the decades, I have talked with many women who felt very frustrated by the seeming lack of knowledge that their doctors had about CAM treatments. As more and more people have opted to use one or another — acupuncture and meditation being the most common in my practice — there has been growing acceptance.

ASCO has carefully reviewed the recommendations from the Society for Integrative Oncology (SIO) guidelines and decided to endorse them. This may not seem like a big deal, as nothing stated in the guidelines seems very radical. But it surely indicates the long way that Western medicine has come to be able to thoughtfully support tenets long dismissed or ignored.

This likely does not change anything for most of us. If we have been going to yoga or acupuncture and enjoying how we feel, we probably would continue whatever ASCO said. It may, however, motivate some of us to consider adding one or another integrative therapy to whatever else we are doing to try to stay well.

Here is a quote from the ASCO statement:

"The key recommendations include the following: Music therapy, meditation, stress management and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment – related adverse effects."

For more information:

• Read ASCO's guidelines, Supportive Care and Treatment Related Issues.
• Read SIO's guidelines, Clinical Practice Guidelines on the Evidence-Based Use of Integrative Therapies During and After Breast Cancer Treatment.
• Read the Journal of Clinical Oncology article, Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline.