Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer
Language: 
English
Abstract: 

BACKGROUND: The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies. METHODS: Following the Institute of Medicine's guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system. RESULTS: The search (January 1, 1990-December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (n = 32) had weaker evidence of benefit (Grade C). Some interventions (n = 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (n = 138) did not have sufficient evidence to form specific recommendations (Grade I). CONCLUSIONS: Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.

Author(s): 
Greenlee, Heather
Balneaves, Lynda G.
Carlson, Linda E.
Cohen, Misha
Deng, Gary
Hershman, Dawn
Mumber, Matthew
Perlmutter, Jane
Seely, Dugald
Sen, Ananda
Zick, Suzanna M.
Tripathy, Debu
Society for Integrative Oncology
Item Type: 
Journal Article
Publication Title: 
Journal of the National Cancer Institute. Monographs
Journal Abbreviation: 
J. Natl. Cancer Inst. Monographs
Publication Date: 
2014-11
Publication Year: 
2014
Pages: 
346-358
Volume: 
2014
Issue: 
50
ISSN: 
1745-6614
DOI: 
10.1093/jncimonographs/lgu041
Library Catalog: 
PubMed
Extra: 
PMID: 25749602 PMCID: PMC4411539

Turabian/Chicago Citation

Heather Greenlee, Lynda G. Balneaves, Linda E. Carlson, Misha Cohen, Gary Deng, Dawn Hershman, Matthew Mumber, Jane Perlmutter, Dugald Seely, Ananda Sen, Suzanna M. Zick, Debu Tripathy and Society for Integrative Oncology. 2014-11. "Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer." Journal of the National Cancer Institute. Monographs 2014: 50: 346-358. 10.1093/jncimonographs/lgu041.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1093/jncimonographs/lgu041 | issn = 1745-6614 | volume = 2014 | pages = 346-358 | last = Greenlee | first = Heather | coauthors = Balneaves, Lynda G., Carlson, Linda E., Cohen, Misha, Deng, Gary, Hershman, Dawn, Mumber, Matthew, Perlmutter, Jane, Seely, Dugald, Sen, Ananda, Zick, Suzanna M., Tripathy, Debu, Society for Integrative Oncology | title = Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer | journal = Journal of the National Cancer Institute. Monographs | date = 2014-11 | pmid = | pmc = }} </ref>