Music, Meditation and Yoga: Complementary Therapies in Breast Cancer Should Be Supported

To alleviate difficulties experienced by people with breast cancer, such as anxiety, depression or mood swings , oncologists recommend that patients learn meditation and yoga techniques or listen to music for therapeutic purposes.

The American Society of Clinical Oncology (ASCO) recently announced that it endorsed the Society for Integrative Oncology (SIO) complementary therapy guidelines.

These Society for Integrative Oncology guidelines were reviewed by an ASCO expert panel co-led by Dr. Gary H. Lyman of Fred Hutchinson Cancer Research Center and Dr. Lorenzo Cohen of the University of Texas MD Anderson Cancer Center.

The full complementary therapy guidelines were published in Journal of Clinical Oncology .

Some Important Recommendations Are:

• Anxiety and stress reduction are addressed with music therapy, meditation, stress management and yoga , which are recommended.
• For depression and mood disorders, meditation, relaxation, yoga, massage and music therapy are recommended.
• Quality of life can be improved with recommended meditation and yoga.
• For chemotherapy-related nausea and vomiting, in addition to anti-nausea drugs, acupuncture is recommended.
• Glutamine for improving nausea and vomiting during chemotherapy is notrecommended.
• Carnitine is not recommended for preventing chemotherapy-induced peripheral neuropathy because of its risk of harm .
• Use of dietary supplements to manage side effects of breast cancer treatment is supported by no strong evidence.

To Explain What the Levels of Evidence Mean;

• Evidence level A: a high level of certainty that the treatment provides substantial benefit
• Evidence level B: a high level of certainty that the treatment provides moderate to substantial benefit
• Evidence level C: a moderate level of certainty that the treatment provides a small benefit
• Evidence level D: the treatment’s effect has not been demonstrated
• Evidence level H: the treatment causes harm
• Evidence Level I: current evidence for the treatment is inconclusive

When evidence is level A or B, meaning high-level evidence, treatment is recommended. At level C, its benefit is debatable. At levels D, H or I, treatment is not recommended.

People receiving breast cancer treatment and those afterward (cancer survivors) want to try every way to improve treatment effectiveness and quality of life. Experts aim to help patients make appropriate individualized treatment decisions. All existing medical literature on complementary therapies should be evaluated to determine what works and what does not.

The most important point when reviewing guidelines is: every patient is unique and independent, and the most important decisionis one made jointly by a care professional and the patient. There is also a significant lack of knowledge about the benefits and harms of many complementary therapies in oncology, and these methods require more rigorous research.

The ASCO expert panel notes that recommendations may change as additional scientific evidence is compiled. Although ASCO generally accepts the Society for Integrative Oncology recommendations, it highlighted several areas of debate concerning improvement of quality of life. Complementary treatments should therefore be approached carefully, and alternative approaches should not be considered without consulting an oncologist and reliable sources.

• What is the difference between complementary and alternative treatments?