Mozart, meditation and a yoga mat: Oncologists welcome integrative therapies for breast cancer

The SIO guidelines were reviewed by an ASCO expert panel co-chaired by Dr. Gary H. Lyman, an oncologist with Fred Hutchinson Cancer Research Center in Seattle, and Dr. Lorenzo Cohen of the University of Texas MD Anderson Cancer Center in Houston.

The full guidelines appear online in the Journal of Clinical Oncology. Some of the key recommendations include:

• 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 in addition to anti-nausea medications are recommended for reducing chemotherapy-induced nausea and vomiting.
• Glutamine is not recommended for improving nausea and vomiting during chemotherapy.
• 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.

"Patients undergoing and surviving breast cancer treatment naturally want to use every tool available to them to enhance the effectiveness of treatment and improve their quality of life," Lyman said. "Our goal is to help cancer care specialists and their patients make appropriate individualized treatment decisions -- evaluating the current medical literature on complementary therapies to determine what works, what doesn't work and what might actually be harmful instead of helpful. The guidelines should be seen only as that -- guidelines -- because each patient's case is unique, and there's nothing more important than the judgment of an independent, caring professional. There is a considerable lack of information on the benefits and harms of many integrative therapies in oncology and further rigorous research of such methods is greatly needed."

ASCO's expert panel said recommendations may be subject to change as additional scientific evidence is compiled, and although ASCO generally endorsed the SIO recommendations, the panel brought attention to several areas of discussion, including safety concerns about mistletoe, sometimes taken to improve quality of life, and ginseng, sometimes taken to counter fatigue. Certain forms of ginseng could have estrogenic properties, but more research is needed to evaluate risk in patients with estrogen receptor-positive breast cancer.