Mind-body therapies for breast cancer – can they help?

Their review adds to the growing literature on integrative therapies for patients with breast cancer and other cancer populations. It was published in CA: A Cancer Journal for Clinicians, a publication of the American Cancer Society.

Alternatives are popular

The researchers evaluated more than 80 different therapies and developed grades of evidence. Based on those findings, the Society for Integrative Oncology makes the following recommendations:

• 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 for reducing chemotherapy-induced nausea and vomiting

“Studies show that up to 80% of people with a history of cancer use one 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, assistant professor of Epidemiology at Columbia University’s Mailman School of Public Health, and past 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,” she adds.

Making the grade

In their systematic evaluation of high quality clinical trials, the researchers assigned letter grades to therapies based on the strength of evidence. A letter grade of “A” indicates that a specific therapy is recommended for a particular clinical indication, and there is high certainty of substantial benefit for the patient.

Meditation had the strongest evidence supporting its use, and is recommended for reducing anxiety, treating symptoms of depression, and improving quality of life, based on results from five trials. Music therapy, yoga, and massage received a B grade for the same symptoms, as well as for providing benefits to breast cancer patients. Yoga received a B grade for improving quality of life based on two 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 a 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 for reducing chemotherapy-induced nausea and vomiting.

Disappointingly, 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 side effects. This finding, however, could reflect the general paucity of studies in this area.

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