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

Greenlee, H.; DuPont-Reyes, M.J.; Balneaves, L.G.; Carlson,L.E.;Cohen, M.R.; Deng, G.; Johnson, J.A.; Mumber, M.; Seely, D.; Zick, S.M.; Boyce, L.M.; Tripathy, D.
Vol. 67 Nr. 3 Página: 194 - 232 Fecha de publicación: 06/05/2017

Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary
and integrative therapies as supportive care during cancer treatment and to manage treatmentrelated
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, chemotherapyinduced
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. CA Cancer J Clin 2017;67:194-232. © 2017 American
Cancer Society.