Below is a summary I wrote for YogaMate. The abstract and link are at the end of the summary.
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 dietary 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.
Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Clinical practice guidelines are based on a systematic literature review from 1990 through 2015. 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 are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-L-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy due to a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related side effects. In summary, there is a growing body of evidence supporting the use of integrative therapies, especially mind-body therapies, as effective supportive care strategies during breast cancer treatment. Many integrative practices, however, remain understudied, with insufficient evidence to be definitively recommended or avoided.
April 24, 2017
CA: A Cancer Journal for Clinicians
Volume / Issue:
Volume 67, Issue 3
Heather Greenlee ND, PhD, MPH, Melissa J. Dupont-Reyes MPH, MPhil, Lynda Balneaves RN, PhD, Linda Carlson PhD, Misha Cohen OMD, LAc, Gary Deng MD, PhD, Jillian A. Johnson PhD, Matthew Mumber MD, Dugald Seeley ND, MSc, Suzanna M. Zick ND, MPH, Lindsay M. Boyce MLIS, Debu Tripathy MD