Many individuals turn to complementary or alternative medicine (CAM) following a breast (or other) cancer diagnosis. Is this something you should explore?
CAM and Breast Cancer
CAM describes health practices outside of normal standard of care treatments, which for cancer patients includes surgery, chemotherapy, radiation therapy, and biological therapies.
Generally complementary practices work with traditional medical treatments, while alternative therapies replace them. CAM therapies include mind-body medicine (for example, yoga or meditation), biologically-based therapies (vitamins, herbs), manipulative and body-based practices (massage), energy medicine (tai chi), and whole systems (such as traditional Chinese medicine).
Patients most commonly turn to CAM to help them cope with side effects from cancer and treatment and to manage cancer related stress, depression, and anxiety. CAM also helps patients regain a lost sense of control following their cancer diagnosis. Some patients turn to alternative therapies to try to treat or cure their cancer, skipping traditional treatments entirely.
CAM has become such an important component of total cancer care that the National Cancer Institute (NCI) has even created an Office of Cancer Complementary and Alternative Medicine (OCCAM).
What Works
The Society for Integrative Oncology (SIO), a non-profit made of up physicians, nurses, integrative medicine practitioners, patient advocates, and patients from a broad cross- section of cancer centers and other health-related institutions, is creating scientifically-based guidelines to help healthcare practitioners and patients incorporate safe CAM practices into a holistic approach to cancer care. Based on the available data, the Society has rated a number of therapies on the strength of evidence that they either provide benefits or cause harm.
Scientists have good evidence suggesting some forms of CAM do help patients manage symptoms and side effects. For instance, in patients receiving treatment for breast cancer, researchers found strong evidence that meditation, yoga, and relaxation techniques (such as visualizing being in a favorite place or imagining stress physically flowing out of your body) help patients manage anxiety and treatment-related mood disorders and generally improves quality of life. Other stress management techniques, such as massage, music therapy, and meditation also help with mood, anxiety, and treatment-related fatigue.
On the other hand, scientists have found taking acetyl-carnitine, a dietary supplement used to prevent chemotherapy-induced nerve damage, is actually harmful and patients should avoid it.
For other types of CAM treatments, there currently isn’t enough evidence to recommend (or caution against) the therapy.
To date, there is no scientific evidence that any CAM practice effectively cures or prevents cancer.
Bottom Line
Patients and healthcare professionals should evaluate and decide together whether the risks and benefits of any CAM practice make sense for individual patients. Many types of CAM pose little risk and may also ease pain, anxiety, or treatment-related fatigue. However, some may interfere in the effectiveness of cancer treatment. Be sure to discuss all treatments with your cancer care team.
"I encourage mediation, yoga, and relaxation techniques," says Rajiv V. Datta, MD, FACS, FRCS, Medical Director of the South Nassau Communities Hospital Cancer Center in Oceanside, NY. "I tell patients not to interrupt standard of care treatment as they continue complimentary therapy and if they start taking oral medications or supplements, such as herbs which are not well known, I strongly recommend they check with their medical oncologist."
The NCI provides a helpful downloadable resource, Talking About Complementary and Alternative Medicine with Healthcare Providers: A Workbook and Tips.
Rajiv V. Datta, MD, FACS, FRCS, reviewed this article.
Sources
Rajiv V. Datta, MD, FACS, FRCS, Medical Director, Cancer Center, South Nassau Hospital. Email message to author, November 26, 2014.
Greenlee, Heather, Lynda G. Balneaves, Linda E. Carlson, Misha Cohen, Gary Deng, Dawn Hershman, Matthew Mumber, Jane Perlmutter, Dugald Seely, Ananda Sen, Suzanna M. Zick, Debu Tripathy. "Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer." Journal of the National Cancer Institute Monographs 2014 50. DOI:10.1093/jncimonographs/lgu041.
"Cancer and Complementary Health Approaches." National Center for Complementary and Alternative Medicine. Last updated May 2013, accessed November 13, 2014.
"Treating Cancer: Integrative Medicine." DrWeil.com. Accessed November 13, 2014.
"Iyengar Yoga May Improve Fatigue in Breast Cancer Survivors." National Center for Complementary and Alternative Medicine. December 16, 2011. Accessed November 13, 2014.
"Talking about Complementary and Alternative Medicine with Health Care Providers: A Workbook and Tips." National Cancer Institute. Accessed November 13, 2014.
