Mind-Body Therapies Improve Quality of Life, More for Breast Cancer Patients
by Rynae Golke
A new study shows that mind-body therapies could improve quality of life for breast cancer patients.
Researchers performed a literature review to assess the effectiveness and safety of mind-body therapies when it comes to improving quality of life, alleviating stress and anxiety associated with cancer, easing chemotherapy-related nausea and vomiting, and other factors associated with cancer and its treatment. Based on these findings, the Society for Integrative Oncology (SIO) updated its resources on integrative oncology.
Researchers from Columbia University’s Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center worked with an interdisciplinary team of colleagues at University of Michigan, MD Anderson Cancer Center, and Memorial Sloan Kettering Cancer Center. A number of other institutions in the United States and Canada also participated in the literature review.
“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 past president of SIO Heather Greenlee, ND, PhD, assistant professor of Epidemiology at Columbia University’s Mailman School of Public Health.
“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.”
The researchers performed a systematic literature review from materials published from 1990 through 2015, and created new clinical guidelines based on these results.
In this systematic review, the researchers analyzed literature on the ability of integrative therapies to improve quality of life or present other benefits to patients with breast cancer and other types of cancer. The scientists analyzed the effects of a number of integrative treatments on quality of life, nausea and vomiting, anxiety and other issues facing cancer patients to determine the safest, most effective therapies for these patients.
The review evaluated more than 80 different integrative therapies, including:
- Music therapy
- Stress management
- Dietary supplements
The researchers evaluated the potential effects of these integrative therapies, including their ability to modulate:
- Symptoms of depression
- Quality of life
- Nausea and vomiting
The researchers developed grades of evidence to indicate the strength of confidence in the estimation of an effect. A letter grade of “A” indicates strong evidence-based support for the use of a specific therapy for a particular clinical indication. There is a high certainty that integrative therapies earning an “A” grade will provide substantial benefit for the patient. There is slightly less certainty that therapies earning a “B” grade will provide these benefits for cancer patients, and even less certainty about integrative therapies earning “C” grades.
The Evidence Supports Use of Mind-Body Therapies during Breast Cancer Treatment
The researchers found a growing body of evidence supporting the use of mind-body therapies during breast cancer treatment.
Among the various interventions included in the meta-analysis, meditation and yoga were best for improving quality of life. Dietary supplements fared worse, earning low marks for symptoms and side effects.
Based on results from five trials, the strongest evidence supported the use of meditation, particularly for reducing anxiety, treating depression symptoms, and improving quality of life. Yoga, music therapy, and massage received a “B” grade for addressing those same issues of anxiety, depression, and quality of life. Additionally, data from two recent trials helped yoga earn a “B” for improving quality of life. Yoga and hypnosis each received a “C” for their ability to ease fatigue.
Acupuncture and acupressure received “B” grades for reducing nausea and vomiting when used in conjunction with standard anti-emetic drugs.
The literature did not provide strong evidence supporting the use of dietary supplements and botanical natural products to support cancer care or manage treatment-related side effects.
Based on their findings, SIO makes the following recommendations regarding the use of specific integrative therapies as part of supportive care:
• Use of music therapy, yoga, meditation, and stress management for anxiety and stress reduction
• Use of music therapy, yoga, meditation, relaxation, and massage for depression and mood disorders
• Use of yoga and meditation to improve quality of life
• Use of acupuncture and acupressure for to reduce nausea and vomiting from chemotherapy
“Clinicians and patients need to be cautious about using therapies that received a grade of C or D and fully understand the potential risks of not using a conventional therapy that may effectively treat cancer or help manage side effects associated with cancer treatment,” warned Lynda Balneaves, RN, PhD, associate professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, Canada, and president-elect of SIO.
“Patients are using many forms of integrative therapies with little or no supporting evidence and that remain understudied,” remarked 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.”
The newly updated clinical guidelines from the Society for Integrative Oncology, published in April 2017, reflect these findings. Clinicians and patients use SIO guidelines as a reliable source of information to help them make evidence-based decisions on the use of integrative treatments during breast cancer therapy. The review also adds to the expanding literature on integrative therapies for patients with cancer, particularly those with breast cancer.
“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 another past president of SIO Debu Tripathy, MD, chair of Breast Oncology at The University of Texas MD Anderson Cancer Center. “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.”
The results are available online and in print in CA: A Cancer Journal for Clinicians, a publication of the American Cancer Society.