An integrative healthcare team evaluates the physical, emotional and spiritual needs of each patient and then recommends specific therapies and lifestyle changes as part of a comprehensive treatment plan. Team members consider the scientific evidence, identify risks and benefits, and take into account individual preferences when they advise patients about complementary therapies.
Complementary therapies do not work for everyone. While some patients find relief from complementary therapies, some have found them to be ineffective. Benefits may vary from individual to individual. Some complementary therapies, especially natural health products such as herbs and supplements, have their own side effects and can interfere with standard cancer treatments. It is important to discuss complementary therapies with your healthcare providers.
Complementary Therapies for Side Effects
- Acupuncture has been used in China for thousands of years as part of traditional Chinese medicine. Acupuncturists insert very thin needles through the skin at strategic places known as acupuncture points. Sometimes external heat and/or pressure is used, along with the needles. Acupuncture may help with nausea and vomiting. It may also help with other side effects such as pain, hot flashes, anxiety, sleep problems, dry mouth and nerve pain. It is important for acupuncturists to follow strict clean needle procedures by using a new set of disposable needles for each patient. Ask your healthcare provider for a referral to an acupuncturist who has experience working with cancer patients.
- Aromatherapy is the use of essential oils from plants. Essential oils may be diluted and then massaged into the body. Some evidence suggests that aromatherapy massage can help reduce stress, anxiety and fatigue in cancer patients. Essential oils may also be mixed with water into a diffuser and inhaled. Aromatherapy may work by sending chemical messages to the area of the brain that affects mood and emotions. Aromatherapy may reduce stress, anxiety and fatigue. Keep in mind that aromatherapy could also trigger nausea if you are sensitive to strong smells. Essential oils could also irritate sensitive skin.
- Art therapy involves creating art to help improve health and well-being. It may include drawing, painting, working with clay, or engaging in other art forms. The participant does not have to be a skilled artist to benefit from art therapy. The process of creating and exploring feelings and emotions, not the finished product, is the key to art therapy. Art therapy may help reduce anxiety.
- Exercise, such as walking, swimming, strength training, may improve sleep and mood. Before starting an exercise program, patients should consult with their healthcare team. An exercise plan should be individualized based on the patient’s age, type of cancer, mobility and physical fitness level.
- Hypnosis is a trance like state (like daydreaming) in which the body is relaxed but the mind active. A specially trained therapist can direct the patient’s attention to specific thoughts, feelings, images, sensation or behaviors. Hypnosis may help reduce pain, anxiety, nausea and vomiting.
- Massage therapy involves a professional practitioner applying pressure to muscle and connective tissue. Massage may help relieve pain and anxiety. In most states, massage therapists must have a license to practice. Deep or intense pressure should not be used near enlarged lymph nodes or on skin that is sensitive from radiation therapy.
- Meditation is a mind-body self-practice that offers training in awareness and focused attention to get a better sense of perspective. Meditation may help relieve anxiety, stress, fatigue and sleep disturbances.
- Music therapy uses music to help improve health and well-being. It may include listening to relaxing music, singing, playing or learning a musical instrument, composing music and/or moving to music. Music therapy may reduce stress, pain, anxiety and nausea.
- Relaxation techniques, such as guided imagery and deep breathing exercises, promote health by relaxing the body and quieting the mind. These therapies are used to relieve stress and muscle tension, lower blood pressure and reduce pain.
- Tai chi is a system of sequences of very slow controlled movements that originated in China. It combines physical movement, breathing exercises and meditation to improve health and quality of life. Tai chi may help with pain, fatigue, and stress. The practice may also help increase aerobic capacity, muscular strength, balance and flexibility in patients.
- Yoga is an ancient practice that originated in India, which uses both the mind and the body. The various types of yoga usually combine physical postures, breath control and meditation or relaxation. Yoga may help improve anxiety, depression and stress. in cancer patients. Since yoga involves physical activity, it is important for patients to discuss yoga with their healthcare providers to find out whether yoga may be safe for them.
| If you are suffering from | Consider trying |
|---|---|
| Anxiety, depression, stress | Acupuncture, aromatherapy, exercise, hypnosis, massage therapy, meditation, music therapy, yoga |
| Chemotherapy-induced nausea/vomiting | Acupuncture, aromatherapy, hypnosis |
| Fatigue | Acupuncture, aromatherapy, exercise, meditation, tai chi, yoga |
| Pain | Acupuncture, hypnosis, massage therapy, music therapy, relaxation techniques |
| Sleep problems | Acupuncture, meditation, relaxation techniques, yoga |
Medical Marijuana
Marijuana has biologically active components called “cannabinoids.” The two most-studied components are the chemicals delta-9- tetrahydrocannabinol (THC) and cannabidiol (CBD). Under federal law, marijuana cannot legally be prescribed, possessed or sold. However, under most state laws, the use of marijuana to treat some medical conditions is legal. To get medical marijuana, you will need a recommendation or certification from a licensed provider, verifying that you have a qualifying condition. Each state has its own list of qualifying conditions. You may then need to enroll in your state’s medical marijuana program, which may include obtaining a medical marijuana ID card. Once enrolled, you will be able to buy medical marijuana at an approved dispensary. (Some state laws also allow the legal use of recreational marijuana by adults ages 21 and older; no states allow it for children and teens.)
In cancer care, medical marijuana is sometimes used to manage side effects, such as nausea, appetite loss, pain or anxiety, if other medications or treatments are unsuccessful. More research is needed to better understand the benefits and risks of marijuana and its cannabinoids. Do not use marijuana or products made with cannabinoids without first talking to your healthcare team. Marijuana or related products (for example, CBD oils) could interfere with other medications.
Do not obtain any kind of marijuana anywhere that is not a licensed dispensary. Marijuana products that are not obtained from licensed dispensaries carry additional risks as they may contain unknown ingredients, including infectious agents or more potent (sometimes illegal) drugs. Talk honestly with members of the healthcare team about your use of marijuana or related products.
Dietary Supplements, Vitamins, Herbs and Natural Products
While approval is required by the U.S. Food and Drug Administration (FDA) for drugs to be prescribed for a particular condition or illness, therapies such as vitamins or herbal supplements are not considered drugs, but “foods.” Unlike drugs, they do not have to be tested by the FDA before they are available to consumers, so their effectiveness and safety is often unknown.
Patients undergoing cancer treatment should not take any dietary supplements, vitamins, or herbs unless a doctor approves them. Many oncologists advise their patients to avoid these products during chemotherapy and radiation therapy.
The following are examples of how vitamins and herbal supplements can adversely affect patients:
- Few herbal products have been tested for quality and side effects. Some herbal supplements may be contaminated with microorganisms, pesticides or heavy metals that can harm patients.
- Some herbal supplements can increase or lessen the effects of other medications.
- St. John’s Wort, which is sometimes used to treat depression, can make some cancer treatments such as imatinib mesylate (Gleevec®) less effective.
- Some herbs can affect blood thinners such as warfarin and make the blood too thin or too thick, increasing a patient’s risk of bleeding or blood clots.
- Vitamins in high doses can cause side effects and/or interact with other drugs and dietary supplements.
- Some studies have shown that high doses of vitamin C may reduce the effectiveness of chemotherapy drugs.
The FDA and the Federal Trade Commission (FTC) have warned the public to be aware of fraudulent cancer treatments. The internet is full of “miracle cures,” “scientific breakthroughs” and “secret ingredients” to treat or prevent cancer. Some of these fraudulent treatments may be dangerous and cause physical harm or interfere with proven effective treatments. Any patient considering using an anticancer product seen in an advertisement or online should talk with a healthcare provider first.