Jan Gura, shown here with her mother, Gloria Gura, credits fitness and integrative medicine with allowing her to feel good during her treatment for ovarian cancer.
As Jan Gura prepared to face the onslaught of standard treatments for stage 2 ovarian cancer, she knew she also wanted integrative therapies that would help her feel better.
“I didn’t know how my body would respond to chemotherapy, but I’ve always been an active person. Being able to maintain that was important to me,” she says. “So when I learned I could enroll in a clinical trial using exercise and mind-body therapies to reduce the side effects of cancer treatment, I was all in.”
Jan participated in research that’s just one example of how Memorial Sloan Kettering Cancer Center (MSK) prioritizes the quality of life for patients.
The Integrative Medicine Service, established in 1999, was the first research program in the country to focus on complementary medicine for cancer patients. This approach weaves natural treatments such as acupuncture, massage, and music therapy into patients’ overall care. At MSK, these therapies are based on evidence from rigorous studies.
Dr. Jun Mao leads MSK’s Integrative Medicine Service.
This most recent clinical trial examined whether participating in virtually delivered, live classes including yoga, tai chi, meditation, fitness, and other integrative therapies could benefit patients while they’re in active treatment. The results were clear and encouraging: These therapies not only reduced fatigue, anxiety, and depression, they also reduced the rate of hospitalizations and shortened stays for those who were hospitalized.
“MSK has more than 20 years of research showing that integrative therapies can improve a patient’s quality of life,” says integrative medicine specialist Jun Mao, MD, MSCE, who led the study, published in npg Digital Medicine. “This trial focused on making them more convenient and accessible for patients by offering them virtually.”
Results From Integrative Medicine Clinical Trial
Jan enrolled in a randomized, controlled trial with 200 patients: Half were assigned to do live, online integrative medicine classes for 12 weeks. The other half didn’t participate in live sessions and instead were given links to audio or video recordings for meditation, guided imagery, and relaxation.
The patients were being treated for a variety of solid tumors, the majority of which were breast cancers — 90% of the trial participants were female.
All were in active treatment for cancer, receiving chemotherapy, radiation therapy, targeted therapy, or immunotherapy. Jan received six rounds of chemotherapy at MSK under the care of gynecologic medical oncologist Carol Aghajanian, MD.
Relieving Cancer Patients’ Fatigue and Emotional Stress
The primary focus of the study was to assess whether the classes helped patients feel less tired and more energetic.
“Up to 80% of cancer patients feel exhausted, and previous research has shown that high levels of fatigue can predict poorer survival rates,” says Dr. Mao, who is Chief of the Integrative Medicine Service and holds the Laurance S. Rockefeller Chair in Integrative Medicine.
Compared to the control group, the patients who took the live online classes led by an instructor reported fewer side effects, including:
- Fatigue
- Anxiety
- Depression
- Insomnia
They were also less likely to require hospital stays during the trial.
- Only four patients in the experimental group were admitted to the hospital, compared with 13 in the control group.
- Of those who were hospitalized, the average stay was four days in the experimental group versus 10 days in the control group.
“This intuitively makes sense,” Dr. Mao says. “The patients regularly taking these classes were in better physical shape and therefore were better able to manage the side effects of their treatment. Those who were not were more likely to be frail and to need more care.”
The MSK Integrative Medicine at Home Program Is Widely Available
The researchers used a program called Integrative Medicine at Home (IM@Home). It’s available to MSK patients and also to those receiving treatment at other hospitals. Caregivers and other friends and family of patients often sign up for classes as well.
The program costs $25 a month and offers three types of instruction on Zoom:
- Fitness classes, including strength training, aerobics, and dance cardio
- Mind-body therapies, including yoga, qigong, and tai chi
- Mind-focused programs, including meditation and music therapy
Most patients in the study participated in several classes a week. Yoga and other fitness classes were the most popular.
“All of the classes are really fantastic,” says Jan, now 64 and cancer-free after being diagnosed in 2021. “I have told several friends who are going through cancer treatments about them — even those being treated at other hospitals in other states.”
Many patients in the study reported that they appreciated having the option to stay after class to talk with instructors and other participants. This helped to create a sense of community during cancer treatment.
“We think the social connections that patients made in these classes contributed to the decreased depression and anxiety,” Dr. Mao adds.
Other Types of Integrative Medicine for Cancer Patients
In addition to the online classes, Jan had acupuncture at MSK’s Bendheim Integrative Medicine Center the day before and again the day after each of her chemotherapy treatments. Acupuncture services are also offered at many of MSK’s regional locations. She also got advice on which supplements to take.
“I’m fully convinced of the benefits of all these integrative treatments, because I know how good they make me feel,” Jan says. “I wish that more patients would take advantage of MSK’s range of programs — both in person and online.”
Jan’s appreciation for exercise and integrative modalities was influenced by her mother Gloria’s lifelong commitment to healthy eating and exercise. Now 90, Gloria was diagnosed with ovarian cancer just days after Jan completed her treatment. She is receiving treatment from Dr. Aghajanian as well. Other than feeling tired, she has had few side effects.
“My mom and I both credit exercise and integrative medicine for allowing us to live full lives during cancer treatment,” Jan says.
Federal Funding Advances Integrative Medicine Research
Dr. Mao and his colleagues are applying for a grant from the National Institutes of Health to continue studying the benefits of these classes. One focus will be men in treatment for prostate cancer, and another will be older adults with cancer. MSK also hopes to expand these clinical trials to patients being treated at other cancer centers.
“When you help people get stronger, it can actually reduce the costs of healthcare,” says Dr. Mao. “It is not only a win for patients and their families, but for the whole healthcare system and for society at large.”
