Integrative guidelines for breast cancer

Raquel Forsgren  has summarized a recent study that provides recommendations for integrative practices for individuals with breast cancer. The recommended therapies are intended to assist with managing side effects caused by treatment and to provide supportive care. 

Click here to read the abstract of the research report.

Click here to read her summary, or read below. 

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Nov 15, 2017

Author's Comments / Take Away:

The Society for Integrative Oncology published the first evidence based guidelines recommending different types of complementary integrative therapies for patients with breast cancer in 2014. What is exciting to our yoga community, are the updated guidelines published in April, 2017 now recommend yoga and meditation as an adjunct to conventional treatment for people with breast cancer. 

The authors conducted a rigorous systematic review of published randomized controlled clinical trials between January 1, 2014 through December 31, 2015, organized by specific clinical conditions such as anxiety, stress, fatigue, to name a few. Within the guidelines, a grading system was used (A - I) based on strength of evidence, number of trials, quality of trials, magnitude of effect, statistical significance, sample size, consistency across studies, and whether the outcomes were primary or secondary.

A key point about these Guidelines is the term, recommendation. In the setting of Integrative Oncology, the term, recommendation, is not written as a suggestion that the therapy should be used as standard of care as in other Guidelines. Rather, the recommendation concludes that the therapy should be considered as a viable but not singular option for the management of a specific symptom or side effects.  In essence, adjunct.

For our practical utilization as Yoga Teachers, Yoga Therapists, and Health Care Providers, the Guidelines specifically recommend the following:

1:  Use of music therapy, meditation, stress management and yoga for anxiety and stress reduction,

2: Use of meditation, relaxation, yoga, massage and music therapy for depression and mood disorders,

3:  Use of meditation and yoga to improve quality of life,

4: Use of acupressure and acupuncture for reducing CINV, and

5:  There is lack of strong evidence supporting the use of ingested idetary supplements or botanical agents as supportive care and/or to manage breast cancer treatment-related side effects.

The authors also note that "implementing integrative therapies in a clinical setting requires a coordinated team approach with well-trained providers. Training and credentialing for many integrative providers varies by jurisdictions. Best practices suggest that providers be trained to the highest standard of their profession and educated in other relevant disciplines.

In conclusion, it will be important for the International Association of Yoga Therapists (IAYT) to continue to support yoga therapists in leading and participating in clinical studies that further increase the body of evidence in breast cancer and other cancers so that the Guidelines can be updated to include those recommendations. In addition, and even more importantly, is developing a partnership between the IAYT and the SIO to ensure that Yoga Therapists are part of the health care team that support the patient as these individuals have the highest level of credentialing and are trained in specific cancer rehabilitation programs to support the person with cancer.