Clinical practice guidelines on the evidence‐based use of integrative therapies during and after breast cancer treatment

Abstract

Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. 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 are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided.

Psychosocial, Cognitive, and Physical Impact of Elaborate Consultations and Life Review in Female Patients with Non-Metastasized Breast Cancer

“…This is in accordance with previous meta-analyses in this field [29,30,31]. Because of this ‘strong evidence base' of psychotherapy and psychoeducation [33], the recently published clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment excluded these interventions from analyses as both interventions are ‘often considered to be mainstream rather than integrative or complementary'. ECLR, in form and content often viewed as part of psychoeducation, has, however, not been evaluated in meta-analyses or randomized controlled studies yet [11,12,13].…”

Nanomedicine applications in the treatment of breast cancer: current state of the art

“…13,14 The first two modalities are used mainly for eradicating the primary breast tumor and locoregional cancerous tissues. 13 Their value tends to decline as the cancer progresses and metastasizes. Our focus is on the last modality, drug therapy, which serves to reduce the tumor burden and prevent, control or treat cancer metastasis.…”

“…Our focus is on the last modality, drug therapy, which serves to reduce the tumor burden and prevent, control or treat cancer metastasis. 13 Breast cancer drug therapy often consists of hormonal therapy, which uses hormones or hormone-like drugs to suppress cancer cell proliferation, and chemotherapy, which mainly relies on killing cancer cells with cytotoxic compounds. 13 In recent years, with the latest breakthroughs in molecular biology and immunotherapy, targeted therapies tailored to the specific pathophysiology of different breast cancer subtypes are increasingly included.…”

“…13 Breast cancer drug therapy often consists of hormonal therapy, which uses hormones or hormone-like drugs to suppress cancer cell proliferation, and chemotherapy, which mainly relies on killing cancer cells with cytotoxic compounds. 13 In recent years, with the latest breakthroughs in molecular biology and immunotherapy, targeted therapies tailored to the specific pathophysiology of different breast cancer subtypes are increasingly included. This approach generally involves a small molecule drug or monoclonal antibody targeting a specific molecular pathway; therefore, cancer proliferation, progression, spreading and/or drug resistance can be prevented or controlled.…”

Das Potential von Mind Body Medicine in der Onkologie

“…Insbesondere für diese Symptomatiken haben sich Verfahren der MBM wirksam gezeigt. Die American Society for Clinical Oncology hat die Empfehlungen der Society for Integrative Oncology (SIO) [18,19] befürwortet. Demnach sollte allen Brustkrebspatientinnen folgendes empfohlen werden (Empfehlungsgrad A) :…”