Complementary and integrative medicine for metastatic breast cancer

Complementary and integrative medicine (CIM) describes the combination of conventional cancer treatment and complementary therapies, such as acupuncture, guided imagery, and nutrition and exercise, that can help ease treatment side effects such as fatigue or pain. If you’ve been diagnosed with metastatic breast cancer, complementary and integrative medicine can be an especially helpful approach.

Many complementary therapies have been studied in clinical trials involving people with metastatic breast cancer. Research shows that adding these approaches to a conventional treatment plan can improve quality of life, and in some cases, improve survival.

You may hear people using different terms, some inaccurate, to describe CIM. Here’s a clear breakdown:

• Complementary therapies are physical, mental, and spiritual practices used in addition to conventional medical care, both during and after cancer treatment. For example, a person may decide to try Mindfulness-Based Stress Reduction to help reduce anxiety during chemotherapy sessions.
• “Integrative medicine” is the term that describes the blending of conventional medical treatments with complementary therapies to reduce diagnosis-related anxiety or treatment side effects, such as nausea. Integrative medicine can support physical, mental, and spiritual well-being at the same time.
• “Alternative medicine” is used in place of conventional medical care. This means deciding not to have conventional treatment with chemotherapy, surgery, hormonal therapy, targeted therapy, or immunotherapy. Instead, people who choose alternative medicine are choosing to rely on other methods that are not scientifically proven to help people with cancer when used without conventional treatments.

LBBC believes the most effective approach to cancer care is conventional medical treatment that includes managing side effects, either with or without complementary therapies. We do not support or recommend alternative medicine, which is used in place of conventional medical care.

The evidence behind complementary therapies

Many clinical trials have been conducted to study complementary therapies in people living with metastatic breast cancer. These therapies can range from body-based approaches, such as acupuncture and massage, to vitamins and herbal supplements. It is important to know that the strength of evidence varies greatly across therapies.

To learn more about what the research shows:

• Visit the individual complementary therapy pages listed in the “Types of complementary therapies” section below.
• Read LBBC’s Ask the Expert: Vitamins and supplements for information on benefits, precautions, potential interactions, and answers to frequently asked questions.
• Explore Memorial Sloan Kettering Cancer Center’s free About herbs database.
• Visit CancerChoices’ free Supplements and Therapies database.

Types of complementary therapies

It’s important to talk with your care team before starting any complementary therapies. They can provide guidance on any potential precautions and interactions with your conventional treatment plan.

Below, you can find some of the most popular complementary therapies.

• Acupuncture
• Art therapy
• Expressive writing
• Guided imagery
• Hypnosis
• Massage therapy
• Medical marijuana
• Mindfulness-Based Stress Reduction (MBSR)
• Qigong and tai chi
• Yoga

Nutrition and exercise are also important parts of integrative medicine. Visit the LBBC Nutrition and exercise section for more information.

In addition, the Society for Integrative Oncology offers a free, downloadable guide on types of complementary therapy.

How to find CIM programs and practitioners

Complementary therapies and integrative medicine programs are often available at cancer centers. If not, there may be licensed CIM practitioners available in your community or through online programs. If you’re interested in trying complementary therapies, here are some ways to find programs and practitioners:

• Ask your nurse navigator or hospital social worker if your cancer center offers a complementary therapy program. There may be classes or sessions led by professional, licensed practitioners who work with your care team.
• Ask your nurse navigator or hospital social worker about licensed practitioners or organizations, such as Cancer Support Community, offering complementary therapies in your area.
• If complementary therapies aren’t available where you live or if you aren’t able to travel, some therapies — such as guided imagery, art therapy, and Mindfulness-Based Stress Reduction — may be offered remotely through online video sessions or using a phone app so you can participate from home. Your cancer center’s nurse navigator or social worker may be able to direct you to remote resources.
• If you are searching for CIM practitioners on your own, look for professionals who have a certification or degree containing the words “oncology” and/or “integrative.” Ask if they have experience working with people who’ve been diagnosed with metastatic breast cancer.

Questions to ask a potential CIM practitioner

Here are some questions to ask a CIM practitioner before you begin working together:

• What training or certification do you have specifically for working with people who have been diagnosed with breast cancer?
• How much experience do you have working with people with metastatic breast cancer?
• How will your practice interact with my medicines or treatment?
• Is it safe to use your practice while I am also receiving treatment for cancer?
• Is your practice safe for people with specific areas of metastatic breast cancer, such as the bones?
• For practices such as yoga: If I can’t do a pose or position safely, do you have recommendations for modified poses?
• Are there skills you can teach me to practice on my own?

It’s important to avoid any CIM practitioners claiming that their therapy or medicine can cure cancer. If anyone makes this claim, or tells you to stop conventional treatment before working with you, look for someone else.

Always let your care team know before you start any kind of complementary therapy to make sure the practice is safe for you and that it does not interfere with any of your conventional medical treatments.

Paying for complementary therapy

Health insurance plans sometimes cover part or all of the cost of complementary therapies, so it’s worth contacting your insurance provider to ask.

You can also ask your nurse navigator or cancer center social worker if there are low-cost or free complementary therapy resources at the center or in your area.

The importance of integrative care while being treated for metastatic breast cancer

Metastatic breast cancer treatment is focused on controlling the cancer with the fewest side effects possible. Since treatment is ongoing, adding complementary therapies as part of integrative care puts the main focus on your sense of well-being and quality of life.

While complementary therapies do not treat cancer directly, they can reduce the severity of some side effects, such as nausea, fatigue, pain, anxiety, and depression.

To learn more about complementary therapies, listen to “Metastatic Breast Cancer: The Role of Integrative Care” featuring Pallav K. Mehta, MD, Director of Integrative Oncology at MD Anderson Cancer Center at Cooper.

In this presentation, Dr. Mehta addresses:

• Things to consider when researching integrative care
• Details on specific practices such as acupuncture and meditation
• Why it’s important to talk with your healthcare team about integrative care
• Ways to find qualified integrative care practitioners