Integrative Therapies in Cancer Care: An Update on the Guidelines

Author: Krisstina Gowin1, Meri Muminovic2, Suzanna M Zick3, Richard T Lee4, Christina Lacchetti5, Ashwin Mehta6
1 Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ.
2 Department of Hematology-Oncology, Memorial Cancer Institute, Memorial Healthcare System, Miami, FL.
3 Family Medicine and Nutritional Sciences, University of Michigan, Ann Arbor, MI.
4 Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Irvine, CA.
5 Senior Clinical Practice Guidelines Methodologist, American Society of Clinical Oncology, Alexandria, VA.
6 Memorial Division of Integrative Medicine, Memorial Healthcare System, Hollywood, FL.
Conference/Journal: Am Soc Clin Oncol Educ Book
Date published: 2024 Jun 1
Other: Volume ID: 44 , Issue ID: 3 , Pages: e431554 , Special Notes: doi: 10.1200/EDBK_431554. , Word Count: 246

ASCO and the Society for Integrative Oncology have collaborated to develop guidelines for the application of integrative approaches in the management of anxiety, depression, fatigue and use of cannabinoids and cannabis in patients with cancer. These guidelines provide evidence-based recommendations to improve outcomes and quality of life by enhancing conventional cancer treatment with integrative modalities.

All studies that informed the guideline recommendations were reviewed by an Expert Panel which was made up of a patient advocate, an ASCO methodologist, oncology providers, and integrative medicine experts. Panel members reviewed each trial for quality of evidence, determined a grade quality assessment label, and concluded strength of recommendations.

Strong recommendations for management of cancer fatigue during treatment were given to both in-person or web-based mindfulness-based stress reduction, mindfulness-based cognitive therapy, and tai chi or qigong. Strong recommendations for management of cancer fatigue after cancer treatment were given to mindfulness-based programs. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. The recommended modalities for managing anxiety included Mindfulness-Based Interventions (MBIs), yoga, hypnosis, relaxation therapies, music therapy, reflexology, acupuncture, tai chi, and lavender essential oils. The strongest recommendation in the guideline is that MBIs should be offered to people with cancer, both during active treatment and post-treatment, to address depression.

The evidence for integrative interventions in cancer care is growing, with research now supporting benefits of integrative interventions across the cancer care continuum.

PMID: 38820485 DOI: 10.1200/EDBK_431554