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 may relieve some side effects and improve quality of life. They do not treat breast cancer.

Below you’ll find detailed information on some popular complementary therapies and an overview of topics related to complementary therapies.

Some complementary therapies can interfere with breast cancer treatment. To avoid problems, talk with your health care provider about possible benefits and risks before you use a complementary therapy.

Complementary therapies are natural products, mind and body practices and other health approaches that may be used to [1]:

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

Complementary therapies do not treat breast cancer. They are not standard medical treatments, such as surgery, radiation therapy and chemotherapy.

How common is the use of complementary therapies?

One study found more than 40 percent of U.S. women recently diagnosed with breast cancer had used a complementary therapy in the past year [2].

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 of complementary therapies
Category	Description
Nutritional	Natural products, including special diets, dietary supplements, herbs, vitamins, minerals or probiotics (such as the bacteria found in yogurt)
Psychological	Practices that focus on the mind, including meditation, hypnosis, relaxation therapy and music therapy
Physical	Practices that focus on the body, including acupuncture and massage
Combinations	Therapies that combine psychological and physical practices (mind and body practices), including yoga and tai chi
Adapted from National Center for Complementary and Integrative Health materials [2].

Safety can be a concern with some 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.

Safety of complementary therapies during breast cancer treatment

Some therapies can interfere with breast cancer treatments. So, all decisions about complementary therapies should be made jointly with your health care provider.

Limited data on safety

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 [1,3-12]:

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

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

Talking with your health care provider before using any complementary therapy helps avoid problems. Your provider can help you understand the risks and benefits of the therapy.

The National Center for Complementary and Integrative Health (part of the National Institutes of Health) has safety information on many complementary therapies. To learn about possible side effects and cautions of therapies, visit the National Center for Complementary and Integrative Health website.

Choosing dietary supplements

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

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 their field.

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

Learn more about finding a complementary therapy provider.

“Natural” vs. “safe”

“Natural” products can be appealing, but “natural” does not mean “safe.” For example, poison ivy and poisonous mushrooms are natural, but they aren’t safe.

The Food and Drug Administration (FDA) has limited oversight on dietary supplements and doesn’t 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.

You may see false claims about alternative therapies being used to treat or cure breast cancer on the Internet and in social media. Beware of words like “miracle cure,” “ancient remedy” or “secret ingredient” [9].

The quality of the scientific evidence behind complementary therapies varies. Few therapies 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. In randomized controlled trials, researchers randomly assign (as if by coin toss) people to groups to compare different interventions.

Say, a randomized trial is studying exercise and fatigue. Half the participants might be randomly assigned to walk 10 minutes a day and the other half to walk 2 hours a day. The researchers could then see which group was more likely to reduce fatigue, those who walked 10 minutes a day or those who walked 2 hours a day.

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 when 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 scientific 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.

Learn more about study size.

Consistency of findings

Whether or not studies tend to show the same results is important in weighing the scientific 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 [1,3-12]:

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

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

Talking with your health care provider before using any complementary therapy helps avoid problems. Your provider can help you understand the risks and benefits of the therapy.

Learn more about safety and complementary therapies.

Tips for talking with your health care provider

Don’t be shy. Be open with your health care provider. Share your thoughts, interests and concerns about complementary therapies.

Make a list. Before meeting with your health care provider, write down the things you want to discuss. (This is useful for any visit with your health care 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, if you can.

Keep a symptom (or relief) 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 visit. Use your symptom diary to talk about how you’ve been feeling while using the therapy.

Questions for your health care provider

The following questions may help you talk with your health care 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 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 health care 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.

Doctors, nurses and other health care providers (such as 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 safe, high-quality 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.

Discuss the practitioner’s:

Experience treating people with cancer
Qualifications
Views on using complementary therapies with standard medical treatments
General approach to therapy

Discuss 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 Care Helpline

If you or a loved one needs information or resources about clinical trials, call the Komen Breast Care 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.

To date, Komen has provided about $1.1 billion to researchers in 47 states, the District of Columbia and 24 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 we are funding, because nothing would make us happier than ending breast cancer forever.

Updated 09/17/21

TOOLS & RESOURCES

Fact Sheet

Facts For Life: Integrative and Complementary Therapies

Research Fast Facts

Complementary and Integrative Therapies