What are Society for Integrative Oncology guidelines for use of integrative therapy in breast cancer?

Updated: Feb 04, 2021
  • Author: Pavani Chalasani, MD, MPH; Chief Editor: John V Kiluk, MD, FACS  more...
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The Society for Integrative Oncology has released clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. Recommendations include the following [168] :

  • Meditation, yoga, and relaxation with imagery may be useful for alleviating anxiety and mood disorders (grade A evidence)

  • Stress management, yoga, massage, music therapy, energy conservation, and meditation may reduce stress, improve mood, decrease fatigue, and improve quality of life (grade B evidence)

  • Acetyl-L-carnitine for the prevention of taxane-induced neuropathy may increase neuropathy and should not be used (grade H [likely harmful])

  • Evidence of benefit is weak or lacking for many interventions


A systematic review of 37 systematic reviews of rehabilitation interventions for women after breast cancer treatment found the strongest evidence in support of exercise/physical activity and yoga. Overall, the review identified five rehabilitation areas and reached the following conclusions [169] :

  • Exercise and physical activity improved outcomes such as shoulder mobility, lymphedema, pain, fatigue, and quality of life (QoL).
  • Yoga significantly improved QoL and reduced anxiety, depression, sleep disturbance, fatigue, and gastrointestinal symptoms.
  • Complementary and alternative medicine (CAM; tai chi, acupoint stimulation, massage) had positive effects on nausea, pain, fatigue, anger, and anxiety; however, those results need to be interpreted with caution because of low methodological quality in the studies reviewed.
  • Lymphedema treatment: Resistance training had positive effects on volume reduction and muscle strength.
  • Psychosocial interventions (eg, cognitive-behavioral therapy) had positive effects on QoL, anxiety, depression, and mood disturbance.

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