Meditation and yoga get highest grades for improving quality of life. Dietary supplements get low marks for symptoms and side effects.
In newly updated clinical guidelines from the Society for Integrative Oncology (SIO), researchers at Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with an interdisciplinary team of colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering Cancer Center, and other institutions in the U.S. and Canada, analyzed which integrative treatments are most effective and safe for patients with breast cancer.

This systematic review adds to the growing literature on integrative therapies for patients with breast cancer and other cancer populations.

The latest results were published online and in print in CA: A Cancer Journal for Clinicians.

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
• A lack of strong evidence supporting the use of ingested dietary supplements or botanical natural products as part of supportive care and/or to manage breast cancer treatment–related side effects

“Studies show that up to 80 percent 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,” Greenlee continues.

In their systematic evaluation of peer–reviewed randomized 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.

Acupressure and acupuncture received a B grade as an addition to drugs used for reducing chemotherapy–induced nausea and vomiting. In general, 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.