First clear guidelines issued on use of complementary therapies for breast cancer

More than eighty percent of breast cancer patients in the U. S. use complementary therapies following a breast cancer diagnosis, but there has been little science-based guidance to inform clinicians and patients about their safety and effectiveness. In newly published guidelines from the Society for Integrative Oncology, researchers at Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering, and other institutions in the U.S. and Canada analyzed which integrative treatments appear to be most effective and safe for patients. They evaluated more than 80 different therapies.

“Most breast cancer patients have experimented with integrative therapies to manage symptoms and improve quality of life. But of the dozens of products and practices marketed to patients, we found evidence that only a handful currently have a strong evidence base,” said Heather Greenlee, ND, PhD, assistant professor of Epidemiology at Columbia’s Mailman School of Public Health and president of the Society for Integrative Oncology.

Meditation, yoga, and relaxation with imagery were found to have the strongest evidence supporting their use. They received an “A” grade and are recommended for routine use for anxiety and other mood disorders common to breast cancer patients.  The same practices received a “B” grade for reducing stress, depression, and fatigue, but are also endorsed for most breast cancer patients.

Acupuncture received a “B” grade for controlling chemotherapy induced nausea and vomiting and can be recommended to most patients.  More than 30 interventions, including some natural products and acupuncture for other conditions, had weaker evidence of benefit due to either small study sizes or conflicting study results, and received a “C” grade. Seven other therapies were deemed unlikely to provide any benefit and are not recommended. One therapy was found to be harmful: acetyl-l-carnitine, which is marketed to prevent chemotherapy-related neuropathy, and actually increased risk for the condition.

Results and more information about the evaluations can be found in the Journal of the National Cancer Institute Monograph.