SIO guideline on the use of integrative therapies for breast cancer

The Society for Integrative Oncology (SIO) produced an evidence-based guideline on the use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. The new guidelines were published in the Journal of Clinical Oncology.

The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications.

Key recommendations include:

• 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 in addition to anti-nausea medications are recommended for reducing chemotherapy-induced nausea and vomiting.


• Glutamine is not recommended for improving nausea and vomiting during chemotherapy. Ginger and relaxation can be considered as additions to antiemetic drugs to control nausea and vomiting during chemotherapy.


• Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm.


• No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects.


• Aloe vera and hyaluronic acid cream should not be recommended for improving acute radiation skin reaction


• Hypnosis and ginseng can be considered for improving fatigue during treatment.


• Low-level laser therapy, manual lymphatic drainage, and compression bandaging can be considered for improving lymphedema.


• Soy is not recommended for hot flashes in patients with breast cancer due to lack of effect.

Upon detailed appraisal of the guideline and supporting evidence, ASCO has decided to endorse the SIO guideline on the use of integrative therapies during and after breast cancer treatment. This endorsement reinforces the recommendations provided in the SIO guideline and acknowledges the effort put forth by SIO to inform practitioners who care for patients with breast cancer.