Breast cancer and its treatment can be hard on the body and the mind. For many years, patients have sought complementary therapy -- everything from acupuncture to yoga -- to help them deal with the discomforts.
These types of therapies and many others have become increasingly more mainstream. Oncologists often recommend these types of therapies as a complement to conventional treatments, and many hospitals and treatment centers now even provide the facilities to host these services.
What is Complementary Therapy?
Complementary therapy, although not currently considered a part of conventional health care in the United States, includes a variety of practices that may provide some benefit to patients as a part of their overall treatment plan. For breast cancer patients, conventional treatment usually includes surgery (either lumpectomy or mastectomy), followed by radiation, chemotherapy or both. All these lifesaving measures can cause varying degrees of pain, exhaustion and nausea in the short-term, in addition to the anxiety caused by the diagnosis itself. However, many patients have found that complementary therapy, such as yoga, meditation and other practices can ease the side effects from conventional therapies and boost their sense of well-being.
You may have heard some of these complementary therapies also referred to as alternative therapies. Although both terms are correct, "alternative therapy" is meant to describe the use of these practices in lieu of conventional medicine, whereas "complementary therapy" refers to the same practices used in addition to conventional medicine. Whatever decision you make is ultimately your own, but the American Cancer Society warns that patients who altogether refuse conventional cancer treatments may be taking a serious risk.
The National Center for Complementary and Alternative Medicine is a division of the federal government's National Institutes of Health. They have defined the following five main categories of complementary medicine, with several areas of overlap among them:
Whole Medical Systems
These are as complex as conventional medicine itself and have evolved in many parts of the world. Examples include:
- Naturopathy, a system in which the body is encouraged to heal itself through changes in nutrition and lifestyle
- Ayurveda, a system in which the body, mind and spirit are integrated to prevent or treat health problems
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This includes practices that encourage the mind to positively affect the body. There are many examples of this, including:
- Meditation, a practice that encourages clearing of the mind and inward focus
- Creative therapy, such as art or music, in which patients express their feelings and hopes through drawing, painting, singing or playing a favorite instrument
- Yoga, which uses controlled breathing and postures
Biologically Based Practices
These use natural substances, such as herbs and fruits, to help the body fight illness. Some of the methods include:
- Use of purported "anti-toxin" herbs to ease the effects of chemotherapy
- Investigation of shark cartilage as a tumor-fighting agent
- Promotion of noni (a tropical fruit) juice as a means of preventing recurrence
Be careful with herbs and other supplements; they can interact with the prescribed medications and do more harm than good. For example, St. John's Wort, an herb commonly used to treat depression, can reduce the effectiveness of chemotherapy drugs. Be sure to check with your doctor first.
Manipulative and Body-Based Practices
These involve physical manipulation of the body to relax the patient, ease stress and relieve symptoms. Among the familiar examples are:
- Massage, in which the muscles of the body are rubbed and compressed into a more relaxed state, which is not advisable for patients with inflammation from radiation treatment or certain types of tumors
- Reflexology, in which pressure points on the feet are stimulated according to their correspondence with other areas of the body
- Acupuncture, in which thin needles are placed into points on the body to promote health by allowing the proper flow of the body's "Qi," or vital energy.
Energy Medicine
This involves the detection and manipulation of energy fields around the human body. It is used in a number of therapies, including:
- Reiki, in which a practitioner is said to transmit energy to the patient through hands placed on or near the body
- Qi Gong, which uses a series of breathing and movement exercises to heal and strengthen the chi, a Chinese interpretation of the body's energy or life force
Do These Actually Work?
While some of the techniques are questionable, such as the ingestion of potentially dangerous herbs, many of them are quite acceptable among practitioners of conventional medicine. Some see complementary medicine as a genuine health benefit to their patients, whereas others may simply recognize that they relax and strengthen patients when they need it most.
Clinical research has brought some clarity to the issue with promising results as mentioned in the following studies:
In 2000, researchers looked at the effect of acupuncture on nausea in breast cancer patients who were receiving chemotherapy. The 104 women (who also received drugs to suppress nausea and vomiting) were split into three groups: 1) one group received treatment confined to specific pressure points that were augmented with electric stimulation, 2) the second group received nontargeted treatment with no electric stimulation, and 3) the third group received no acupuncture at all. The group receiving targeted acupuncture with electric stimulation reported half as many episodes of nausea as the untargeted group, and a third as many episodes as the nonacupuncture group.
A 2006 University of Texas study, presented at the annual meeting of the American Society of Clinical Oncology, divided 61 women into two groups. All of these women were undergoing radiation treatment for breast cancer. One group took twice-weekly yoga classes, and the other group did not do any yoga. After 6 weeks, the yoga group reported better physical function (including, for example, the ability to lift groceries with ease and enjoy walking a mile). They also reported fewer sleep problems and feeling less depressed or withdrawn.
Also in the same year of 2006, a Swedish study placed 41 breast cancer patients into two categories: one group had weekly art therapy sessions and the other group did not. The art therapy group reported feeling significantly more able to cope with their health problems than those in the control group.
How Can I Get Started with Complementary Therapy?
First, think about the kind of results you'd like to see. Are you interested in reducing stress? Are there side effects from your treatment that you want to reduce? Are you concerned that your current treatment plan isn't enough?
Once you know what you're hoping to achieve, talk it over with your doctor, who may know of programs near you with those who are experienced in helping breast cancer patients. You may also try contacting other nearby hospitals or treatment centers to see what they recommend.
Contact professional organizations that have the kind of therapy you're interested in. Most states have boards that govern such practices as massage, acupuncture and reflexology. They can provide referrals to practitioners in your area.
You may also consider participating in a clinical trial that studies complementary therapies; see the National Institutes of Health's website to find out if there's a trial study being organized in your area.
Not too many insurance plans will cover the cost of complementary therapy, and many practitioners aren't set up to accept insurance payments. Call your insurance company to find out whether any up-front coverage is offered or if you can be reimbursed after paying out-of-pocket expenses.
Don't forget to tell your doctor about any complementary therapy that you may be considering or that you have added to your routine. Knowing about all aspects of your self-care helps your providers to serve you better.
Sources:American Cancer Society staff. "Guidelines For Using Complementary and Alternative Methods." Cancer.org. 18 Dec 2007. American Cancer Society. 6 May 2008.
American Cancer Society staff. "St. John's Wort Interferes With Chemo Treatment." Cancer.org. 21 Aug. 2002. American Cancer Society. 6 May 2008.
Cohen, L. "Randomized Trial of Yoga in Women with Breast Cancer Undergoing Radiation Treatment.." American Society of Clinical Oncology. 2006 ASCO Annual Meeting, Atlanta, Ga.. 5 June 2006.
NCCAM staff. "What is CAM?." National Center for Complementary and Alternative Medicine. Feb 2007. National Institutes of Health. 4 May 2008.
NCCAM staff. "Herbs at a Glance: Noni." National Center for Complementary and Alternative Medicine. Oct 2007. National Institutes of Health. 6 May 2008.
Shen J, et al. "Electroacupuncture for Control of Myeloablative Chemotherapy-Induced Emesis. A Randomized Controlled Trial." JAMA 2000;284(21):2755-2761.
