The Who, What, Where, When and Sometimes, Why.

Complementary and Integrative Therapies

Many people use complementary therapies (such as acupuncture and prayer) during or after their breast cancer care. You may also hear the terms integrative therapies or complementary health approaches.

Complementary therapies are used to relieve side effects and improve quality of life. They should not be used to treat breast cancer itself.

Below, you’ll find detailed information on some popular therapies as well as an overview of issues related to complementary therapies.

Before you begin a complementary therapy, talk with your health care provider to help avoid problems with your breast cancer treatment.

Complementary therapies are natural products, mind and body practices and other health approaches that may be used to:

  • Reduce side effects of treatment or the cancer itself (such as pain, nausea and fatigue)
  • Reduce stress
  • Improve quality of life

They should not be used to treat breast cancer itself. They are not considered standard medical treatments (such as surgery, radiation therapy and chemotherapy).

How common is the use of complementary therapies?

In 2012 (most recent data available), a National Institutes of Health and National Center for Health Statistics report estimated about 30 percent of U.S. adults had used a complementary therapy in the past year [1].

Among breast cancer survivors in the U.S., estimates range from about 15 percent to more than 80 percent [2-6].

Complementary therapies versus alternative therapies

Complementary therapies are different from alternative therapies.

Complementary and integrative therapies are used in addition to standard medical treatments.

Alternative therapies are used instead of standard medical treatments. Standard medical treatments have been proven to reduce the chances of dying from breast cancer. Alternative therapies are not proven treatments and are not recommended.

No complementary or alternative therapy can prevent or cure cancer. If you feel a product or therapy is making a false claim, check the Federal Trade Commission (FTC)’s Cancer Treatment Scams website for any consumer warnings. Your health care provider is also a good source for this information.

Categories of complementary therapies

Complementary therapies can be grouped into categories that may helpful when you talk with your health care provider.

Categories include [7]:

  • Natural products are herbs, vitamins, minerals or probiotics (such as the bacteria found in yogurt). Examples include supplements such as black cohosh and soy.
  • Mind and body practices are techniques given or taught by a trained practitioner or teacher. Examples include acupuncture and yoga.
  • Other complementary health approaches don’t fit into the above groups and may combine many types of therapies. Examples include traditional Chinese medicineAyurveda and homeopathic medicine.

Safety is a concern with complementary therapies. Understanding safety issues helps you be an informed consumer.

Unlike standard medical treatments, many complementary therapies are not regulated by the federal government and may not have quality controls.

Limited data on safety

All decisions about complementary therapies should be made jointly with your health care provider.

Few complementary therapies have been studied with the same scientific rigor as standard medicine. While some are safe, others should be avoided.

For example, some therapies can [8-13]:

  • Increase surgery risks
  • Interfere with the effectiveness of chemotherapy and radiation therapy
  • Worsen treatment side effects

Some therapies are safe at lower doses, but harmful in higher amounts.

Talking with your provider before using any complementary therapy helps avoid problems. Your provider can help you understand the risks and benefits of the therapy and whether it might be right for you.

Choosing dietary supplements

With dietary supplements, there’s no guarantee what’s on the label is what’s inside.

Choosing supplements from known, reputable manufacturers may increase the likelihood:

  • The ingredient list is accurate and complete
  • The dose and strength are listed correctly
  • The supplement doesn’t contain harmful levels of pesticides, heavy metals (such as lead, arsenic or mercury) or other contaminants
  • The supplement was made under sanitary, well-controlled conditions

One way to check that a manufacturer follows good practices in preparing supplements is the “USP verified” stamp on the label. For more on this, or to see if a supplement has been USP verified, visit the USP website.

Choosing a complementary therapy practitioner

A license to practice a complementary therapy (such as acupuncture) shows a practitioner has passed the licensing requirements in his or her field.

However, seeing a licensed practitioner isn’t a guarantee you’ll get good, safe care.

Learn more about finding a complementary therapy provider.

“Natural” vs. “safe”

Although “natural” products can be appealing, “natural” does not mean “safe” (for example, think about poison ivy and poisonous mushrooms).

The Food and Drug Administration (FDA) has limited oversight on dietary supplements and does not regulate them as strictly as medications.

If the FDA has evidence a “natural” product is harmful, it can pull the food or supplement from the market or issue a warning.

To see if any safety alerts have been issued on a product, visit the FDA website.

False claims

No complementary or alternative therapy can prevent or cure cancer. If a complementary or alternative therapy makes this claim, it’s a scam. Beware of words like “miracle cure,” “ancient remedy” or “secret ingredient” [14].

If you feel a product or therapy is making a false claim, check the Federal Trade Commission (FTC)’s Cancer Treatment Scams website for any consumer warnings. Your health care provider is also a good source for this information. 

The quality of the scientific evidence behind different complementary therapies varies. Few have been studied with the same scientific rigor as standard medicine.

For some therapies, there’s good evidence on safety and effectiveness. For many others, data are limited, making it hard to draw conclusions.

Weighing the scientific evidence

There are many ways to assess the quality of scientific evidence. Most look at:

  • The types of studies done
  • The number of studies done
  • The consistency of findings across studies

Together, these basic factors form the weight of evidence behind a therapy and help answer important questions about its safety and effectiveness.

Types of studies

Some types of research studies hold more weight than others when it comes to the strength of their results.

In general, randomized controlled trials are considered the best type of study for learning whether a complementary therapy is safe and effective. Prospective cohort studies and case-control studies also can be used to assess complementary therapies.

Study quality and study size (the number of people taking part in a study) are also important factors in assessing results.

The results of a small, poorly-designed randomized controlled trial may be weaker than those of a large, well-designed cohort or case-control study.

Learn more about different types of research studies.

Learn more about study size.

Number of studies

The more studies on a complementary therapy, the more evidence there is to draw conclusions about its risks and benefits.

The type, quality and size of the studies are also important. One large, well-designed randomized controlled trial can be more compelling than 20 small studies.

In general, though, the more studies there are on a therapy, the better health care providers and researchers are able to draw conclusions about its safety and effectiveness.

Consistency of findings

Whether or not studies tend to show the same results is important in weighing the evidence on a complementary therapy. Evidence is more compelling when most studies have similar results.

When some studies show a therapy is effective and other studies show it’s not effective, it’s hard to draw conclusions.

It’s similar to asking 3 friends what they thought of a movie. If all 3 liked it, you have evidence the movie was good. If one friend liked it, one didn’t and one thought it was OK, it’s hard to know what to think.

Limited data on safety

While some complementary therapies are safe, others should be avoided.

Learn more about safety and complementary therapies

Any decisions about complementary therapy use should be made jointly with your health care provider. Some complementary therapies can [8-12]:

  • Interfere with the effectiveness of chemotherapy and radiation therapy
  • Increase surgery risks
  • Worsen treatment side effects

Some therapies are safe at lower doses, but harmful in higher amounts.

Talking with your provider before using any complementary therapy helps avoid problems and ensure all the risks and benefits to your health are carefully considered.

Learn more about safety and complementary therapies.

Tips for talking with your provider

  • Don’t be shy. Be open with your provider. Share your thoughts, interests and concerns about complementary therapies.
  • Make a list. Before your office visit, write down the things you want to discuss. (This is useful for any office visit with your provider.)
  • Be specific about each therapy. For supplements, make a note of the name, the ingredients, the manufacturer and how much of the supplement you’re thinking about or are already taking. It’s helpful to bring the supplement bottle with you.

    For other types of therapies, make a note of the exact therapy, how often you’d like to use it and who (if anyone) will be providing it.

  • Keep a symptom diary. When you start a complementary therapy, keep a daily diary of any side effects or relief from symptoms.
  • One therapy at a time. Don’t try more than one new complementary therapy at a time. That way, if a side effect occurs, you’ll know which therapy is likely causing the problem. And, if you get relief from symptoms, you’ll know which therapy is likely helping.

Discuss your complementary therapy use at each office visit. Use your symptom diary to talk about how you’ve been feeling while using the therapy.

Questions for your provider

The following questions may help you talk with your provider about complementary therapies:

  • How do you feel about complementary therapies?
  • Have you ever referred a patient to a complementary therapy practitioner?
  • What’s the best way to find a licensed complementary therapy practitioner?
  • I’m using these complementary therapies (name therapies). Should I stop them during or after my breast cancer treatment?
  • Should I let you know before I start a complementary therapy? Which therapies should I be sure to avoid?
  • Is this complementary therapy (name therapy) safe? Is there research showing it’s safe? Will it interfere with my breast cancer treatment?
  • Are there side effects with this complementary therapy (name therapy)?
  • Is there a clinical trial studying this complementary therapy (name therapy)?

Learn more about talking with your healthcare provider.

Learn more about clinical trials.

Once you’ve talked with your health care provider and decided a complementary therapy may be right for you, the next step is finding a practitioner who specializes in the therapy.

Referrals from your health care provider

The best place to start is your health care provider. Your provider may be able to refer you to a complementary therapy practitioner in your area.

Physicians and other providers (such as nurses, physical therapists and psychologists) can offer many complementary therapies. For example, physical therapists may offer massage therapy and nurses may use reiki and therapeutic touch

Checking licensing status

Finding a licensed complementary therapy practitioner is a good step. While a license doesn’t guarantee good, safe care, it does mean a practitioner has passed licensing requirements in the field.

The websites below can be used to check the licensing status of many complementary therapy practitioners:

National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
http://www.nccaom.org

Federation of Chiropractic Licensing Boards
http://www.fclb.org/

American Association of Naturopathic Physicians
http://www.naturopathic.org/

National Certification Board for Therapeutic Massage and Bodywork
http://www.ncbtmb.org/

American Massage Therapy Association
http://www.amtamassage.org

Interview your potential practitioner

Before you begin a complementary therapy, have a brief meeting with the practitioner and discuss:

  • The practitioner’s:
    • Experience treating people with cancer
    • Qualifications
    • Views on using complementary therapies with standard medical treatments
    • General approach to treatment
  • Your:
    • Medical history
    • Current medicines and breast cancer treatments
    • Health care provider’s recommendations and contact information
    • Potential benefits and risks from the therapy
    • Therapy costs (only a few therapies are covered by health insurance plans)

If you aren’t comfortable with what you hear, or feel things didn’t seem quite right, go somewhere else.

Don’t settle just because you’ve taken the time and effort to find and meet with a practitioner. Keep looking until you find one that’s right for you. 

Taking part in a clinical trial gives you a chance to use a complementary therapy in a well-monitored setting.

It’s important to discuss joining a clinical trial with your health care provider. Your provider can discuss the benefits and any risks with you.

These websites can help you find clinical trials of complementary therapies:

Susan G. Komen® Breast Cancer Clinical Trial Information Helpline

If you or a loved one needs information or resources about clinical trials, call our Clinical Trial Information Helpline at 1-877 GO KOMEN (1-877- 465- 6636) or email clinicaltrialinfo@komen.org.

Learn more about clinical trials.

Our commitment to research

At Susan G. Komen®, we are committed to saving lives by meeting the most critical needs in our communities and investing in breakthrough research to prevent and cure breast cancer. Our Research Program is an essential driving force for achieving this mission.

Since our inception in 1982, Komen has provided funding to support research grants that have greatly expanded our knowledge of breast cancer and helped us understand that breast cancer is not just a single disease but many diseases, unique to each individual.

Going forward, our commitment to research will contribute significantly to our ability to achieve our Bold Goal of reducing the current number of breast cancer deaths in the U.S. by 50 percent.

To date, Komen has provided more than $1 billion to researchers in 47 states, the District of Columbia and 22 countries to support research that has resulted in a better understanding of breast cancer; earlier detection; personalized, less invasive treatments for what was once a “one-treatment-fits-all” disease; and improvements in both quality of life and survival rates.

Learn more about our continuing investment in research and the exciting research that we are funding, because nothing would make us happier than ending breast cancer forever. 

 

 Our commitment to research

At Susan G. Komen©, we are committed to saving lives by meeting the most critical needs in our communities and investing in breakthrough research to prevent and cure breast cancer. Our Research Program is an essential driving force for achieving this mission. Since our inception in 1982, Komen has provided funding to support research grants that have greatly expanded our knowledge of breast cancer and helped us understand that breast cancer is not just a single disease but many diseases, unique to each individual. Going forward, our commitment to research will contribute significantly to our ability to achieve our bold goal of reducing the current number of breast cancer deaths in the U.S. by 50 percent by 2026.

To date, Komen has provided more than $920M to researchers in 48 states and 21 countries to support research that has resulted in a better understanding of breast cancer; earlier detection; personalized, less invasive treatments for what was once a “one-treatment-fits-all” disease; and improvements in both quality of life and survival rates.

Learn more about our continuing investment in research and the exciting research that we are funding, because nothing would make us happier than ending breast cancer forever.