Can People with Breast Cancer Benefit from Complementary Medicine?

Medical oncologist Ting Bao offers acupuncture to her patients to help alleviate the side effects of cancer treatment.

Medical oncologist Ting Bao offers acupuncture to her patients to help alleviate the side effects of cancer treatment.

For many people undergoing treatment for breast cancer, troubling or painful side effects can feel like a fact of life. Some of these problems are temporary, but others may linger long after treatment is completed.

But complementary — also called integrative — medicine could offer some hope. The field has increasingly identified therapies that may alleviate some of these side effects. We spoke with Ting Bao, a physician on the Integrative Medicine and Breast Oncology Services at Memorial Sloan Kettering who is also a board-certified acupuncturist — about how people with breast cancer may benefit from some of these approaches.

Complementary Versus Alternative Medicine

“It’s important to distinguish between alternative and complementary medicine, two terms that are sometimes mixed up but actually mean different things,” notes Dr. Bao. “Alternative medicine purports to replace traditional Western medicine, but there is no evidence that any of these methods are effective against cancer.”

“Complementary or integrative medicine, as these terms imply, is used together with conventional therapy. The modalities practiced are frequently studied under rigorous, randomized controlled trials,” she continues. “And some of these therapies have been found to be more effective at relieving cancer side effects than placebos or standard care.”

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Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy drugs used to treat breast cancer can cause nerve damage. Some patients may experience tingling and numbness in their fingers and toes after only a few cycles. Eventually, the neuropathy may progress to the point where daily tasks such as fastening buttons and tying shoes become difficult. These problems may linger for months or years after chemotherapy is completed.

“For these patients, we are able to offer acupuncture treatments to potentially reduce these side effects,” Dr. Bao says. “We recently completed a single-arm pilot study that suggested acupuncture may reduce neuropathic pain by as much as 50 percent, while improving nerve function in some patients.” Her team is currently applying for funding to conduct a larger clinical trial in this area.

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Nausea and Fatigue

Other common side effects patients undergoing chemotherapy may experience are nausea and fatigue. Several studies demonstrate that acupuncture is effective in treating nausea and vomiting after chemotherapy, but for patients who have concerns about needles, there are other options.

“I show all my patients who are interested how to do acupressure by applying finger pressure to corresponding acupoints on the forearm to reduce chemo-induced nausea,” Dr. Bao explains. “Many patients also get relief from wristbands that focus on these acupoints, such as Sea-Bands, which were originally developed to treat seasickness. Ginger can also help.”

“For fatigue, I always tell patients about the benefits of exercise,” she adds. “Some studies have shown it can be very helpful. It also improves a number of symptoms that can coexist, such as depression, anxiety, and loss of muscle tone.”

“There are also herbs such as American ginseng that may help with cancer-related fatigue,” she notes, “but it’s important for patients to speak with an integrative medicine physician before taking supplements, to make sure they’re doing it safely.”

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Side Effects of Aromatase Inhibitors

Almost half of patients who take a class of drugs called aromatase inhibitors (AIs) as part of their treatment may develop mild to severe musculoskeletal symptoms. These may include pain and stiffness in the joints and muscles of the hands, wrists, feet, ankles, knees, and hips. For some, the discomfort is so severe that treatment must be discontinued.

Although early studies have been inconclusive about whether acupuncture provides relief in such cases, Dr. Bao says many of her patients have benefited. Based on these clinical experiences, she routinely recommends acupuncture for patients who are being treated with AIs and who suffer from joint or muscle discomfort. In addition, a recent study has shown that exercise can help this condition.

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Hot Flashes

Hot flashes are common in people undergoing treatment for breast cancer. Younger women may go into early menopause, triggering symptoms, and drugs such as tamoxifen are directly linked to hot flashes.

“A number of trials have shown that acupuncture can decrease the number and severity of hot flashes,” says Dr. Bao. “The potential of using integrative medicine for hot flashes is appealing, because there are few side effects and many potential benefits.”

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Lymphedema refers to swelling in the arms and hands that sometimes occurs in breast cancer patients who have had lymph nodes in their armpits surgically removed. The condition causes discomfort and restricts mobility, and also can lead to infections requiring hospitalization.

A 2013 MSK study found that among 33 patients who received acupuncture twice a week for four weeks, 11 had significant reductions in swelling and another 18 had at least small reductions. There is now a larger randomized, controlled trial under way that compares patients receiving acupuncture with those undergoing only conventional treatments.

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Focus on Quality of Life

Particularly for patients receiving any kind of cancer treatment, Dr. Bao stresses the importance of discussing complementary therapies with their doctors first. “We tell patients undergoing chemotherapy not to take any herbal supplements, because there are too many unknowns about how they might interact with their cancer treatment regimens.”

“I also make an effort to discuss lifestyle changes such as diet, exercise, and stress management with my patients. I routinely recommend massage therapy for breast cancer patients who have mild lymphedema, pain, and other problems. And I recommend mind-body approaches such as meditation, yoga, and hypnosis to help patients with a range of stressors that may result from both the disease and necessary treatments,” she adds. “All of these modalities may give patients a better quality of life as well as improve their outcomes.”

Learn more about the acupuncture, massage, mind-body, and other services offered at our Bendheim Integrative Medicine Center.

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Commenting is disabled for this blog post.

I am post menopausal, age 59, had stage I estrogen/progesterone positive cancer (have had a lumpectomy and 7 weeks of radiation treatment) and had a very low score on the Oncogene test (6, I believe), showing a very low recurrence probability. I had previously had endometriosis and took pergonal for fertility treatments (3 or more treatments) over 20 years ago, so feel I was at higher risk for both breast and endometrial cancer. I was on HRT (estradiol and micronized progesterone) for over 10 years, as I went through menopause in my mid 40's.

I have now been taking supplements such as Magnolia bark extract, Indole -C-carbinol, Calcium-d-glucarate, AHCC, modified citrus pectin, and Blue scorpion venom tincture. I also continue to take many anti-oxidant supplements as I have for quite a while. I am hoping that I can manage the recurrence through these alternatives instead of the drug route for the next 10 years. Do you do this type of counseling that might preclude the use of Tamoxifen or aromatase inhibitors or do you strictly manage their side effects with your methods?

Can acupuncture relieve chemo-induced neuropathy a decade after treatment or does it need to take place during treatment? Also, can acupuncture needles be inserted in the arm on the side surgery and radiation occurred without risk of lymphedema developing? Thank you.

Rebecca, we sent your questions to Dr. Bao. To answer your question about chemotherapy-induced peripheral neuropathy, she said, “Acupuncture may be able to help as we have treated patients with chemo-induced peripheral neuropathy up to 8 years after chemotherapy and were able to help alleviate their symptoms. ”

To answer your other question, she said, “Outside a clinical trial, we usually avoid inserting needles in the arms with lymphedema to reduce risk of infection. With that being said, we currently have an ongoing clinical trial to study the effect of acupuncture in reducing the severity of lymphedema. That acupuncture protocol does involve inserting needles in the arms with lymphedema. So far, there is no increased risk of infection associated with acupuncture needle insertion.”

Thank you for your comments.

Is it necessary to remind MSKCC that offering a treatment that has no science-based evidence for benefit and safety, but merely a placebo effect, is considered unethical?

To Linda Rosa, RN: Who are you to tell doctors what they can and cannot do? Doctors are highly trained, independent professionals capable of analyzing chemical and scientific evidence to determine what to do or not to do in the treatment of their patients. As a patient, I want MORE OPTIONS, not less. I don't care what the AMA says, what pharmaceutical companies say, or any other self-interest group that does not put patient interests at the top of their priority list. The fact is, anyone with a life-threatening illness is already experimenting on themselves with a plethora of alternative treatments. You'd be stupid not to, given the statistical outcomes for mainstream treatments. And in order for there to be evidence-based research, there have to be patients willing to be experimented on. It's gotta start somewhere - you don't just get "evidence-based treatments" out of the blue. Think about it. Pharmaceutical companies experiment on patients everyday. As long as patients know what they're getting into, it's ethical. The only thing that's unethical, is lack of informed consent.

I want to make appointment with Dr. Tina Bao I have clover medicare insurance to she take that insurance. Thank U

I have had on and off edema in my left breast where I had a lumpectomy for stage 2 breast cancer 8 years ago. My surgery was followed up with chemo and radiation. Over the years I have noticed occasional swelling of the affected breast. In the last two years what my breast surgeon has called intermittent lymphodema of the breast has now become almost constant. Is acupuncture recommended and has Dr Boa had experience with this phenomenon?

I have had on and off edema in my left breast where I had a lumpectomy for stage 2 breast cancer 8 years ago. My surgery was followed up with chemo and radiation. Over the years I have noticed occasional swelling of the affected breast. In the last two years what my breast surgeon has called intermittent lymphodema of the breast has now become almost constant. Is acupuncture recommended and has Dr Boa had experience with this phenomenon?

Dear Michelle, we are sorry to hear about your experience with lymphedema. We can’t offer specific recommendations on our blog, but if you would like to discuss your acupuncture questions further with a specialist at our Integrative Medicine Center, please call 646-888-0800. Thank you for reaching out to us.

I am interested in doing the Budwig Protocol in addition to being on IBrance for breast cancer. Is there any conflict known between these two?

Dear Kristen, we recommend that you discuss this with your oncologist.

You may also be interested in reading about the Budwig Protocol on MSK’s About Herbs website, which includes purported uses, side effects, and contra-indications:…

While eating a well-balanced diet, rich in vegetables and fruit, can be beneficial for a person’s general health, a restricted diet can lead to nutritional deficiencies. It’s important to know that there is no scientific evidence that supports the Budwig Diet in disease prevention. More importantly, delaying or avoiding standard medical treatment can have serious consequences.

In addition, here is our patient education fact sheet on Palbociclib (brand name Ibrance), which also contains some useful information:

Again, it’s best to discuss all this with your doctor. Thank you for reaching out to us.