Integrative medicine and complementary therapies for young adults

Integrative medicine is a form of medical therapy that combines practices and treatments from complementary medicine (yoga, acupuncture, and massage) with conventional medicine (surgery, chemotherapy, radiation treatment, and immunotherapy).  

Many cancer patients are using integrative medicine to help ease their cancer symptoms and reduce the side effects of cancer treatment. By integrating complementary therapies into conventional treatment plans, healthcare providers are better able to address the physical, emotional, and spiritual needs of their patients. Complementary medicine is not a replacement for cancer treatment. No complementary health treatment has been proven to cure cancer. 

Researchers are currently exploring the potential benefits of integrative medicine. The National Center for Complementary and Integrative Health (NCCIH) and the National Cancer Institute Office of Cancer Complementary and Alternative Medicine (OCCAM) support research that holds complementary therapies to the same rigorous scientific standards used to evaluate medical treatments. Researchers work to determine which treatments are effective and safe.  

Never begin a complementary treatment without speaking with your oncologist first and getting their approval. Some unproven therapies might not be safe or effective and may put your health and recovery at risk. 

Benefits of complementary therapies 

A growing number of people are turning to complementary therapies  to help manage symptoms, reduce side effects, and restore and promote a sense of control and vitality. Roughly two out of three cancer patients have tried at least one complementary therapy as part of their cancer care.  

Existing scientific evidence has found that certain complementary therapies may alleviate cancer-related symptoms and treatment side effects, such as nausea and fatigue. For example, acupuncture has been evaluated in numerous studies and is now recognized as a safe method for managing chemotherapy-associated nausea and vomiting.  

Many complementary therapies are gentle, relaxing, and minimally invasive, providing ways for patients to develop an appreciation of themselves and an awareness of their own inner strength. Some techniques are passive, requiring limited participation, such as massage and aromatherapy, while others are active, such as yoga and tai chi. 

Risks of complementary therapies  

Still, there are comparatively few studies about the safety and effectiveness of many complementary therapies. To date, there is no definitive clinical evidence that any complementary therapies can slow cancer progression.  

Unproven products or practices should not be used to replace or postpone standard medical treatment. Delaying conventional cancer treatment can be dangerous and decrease the likelihood of a remission or a cure. Any treatments  presented as alternatives to standard cancer therapies should be considered only within the context of clinical trials. 

Despite some patients’ views that complementary therapies are natural and safe, medical research indicates that not all of these therapies are harmless. Cancer patients should consult with their healthcare providers before trying any complementary therapy , whether it is cancer-related or not. 

Types of complementary therapies

• Acupuncture has been used in China for thousands of years as part of traditional Chinese medicine. Acupuncturists insert very thin needles through the skin at strategic places known as acupuncture points. Sometimes external heat and/or pressure is used along with the needles. Acupuncture may help with nausea and vomiting. It may also help with other side effects such as pain, hot flashes, anxiety, sleep problems, dry mouth, and nerve pain. It is important for acupuncturists to follow strict clean needle procedures by using a new set of disposable needles for each patient. Ask your healthcare provider for a referral to an acupuncturist who has experience working with cancer patients.
• Aromatherapy is the use of essential oils from plants. Essential oils may be diluted and then massaged into the body. Some evidence suggests that aromatherapy massage can help reduce stress, anxiety, and fatigue in cancer patients. Essential oils may also be mixed with water into a diffuser and inhaled. Aromatherapy may work by sending chemical messages to the area of the brain that affects mood and emotions. Aromatherapy may reduce stress, anxiety, and fatigue. Keep in mind that aromatherapy could also trigger nausea if you are sensitive to strong smells. Essential oils could also irritate sensitive skin.
• Art therapy involves creating art to help improve health and well-being. It may include drawing, painting, working with clay, or engaging in other art forms. The participant does not have to be a skilled artist to benefit from art therapy. The process of creating and exploring feelings and emotions is the key to art therapy—not the finished product. Art therapy may help reduce anxiety.
• Exercise, such as walking, swimming, and strength training, may improve sleep and mood. Before starting an exercise program, patients should consult with their healthcare team. An exercise plan should be individualized based on the patient’s age, type of cancer, mobility, and physical fitness level.
• Hypnosis is a trance-like state (like daydreaming) in which the body is relaxed but the mind is active. A specially trained therapist can direct the patient’s attention to specific thoughts, feelings, images, sensations, or behaviors. Hypnosis may help reduce pain, anxiety, nausea, and vomiting.
• Massage therapy involves a professional practitioner applying pressure to muscle and connective tissue. Massage may help relieve pain and anxiety. In most states, massage therapists must have a license to practice. Deep or intense pressure should not be used near enlarged lymph nodes or on skin that is sensitive from radiation therapy.
• Meditation is a mind-body self-practice that offers training in awareness and focused attention to get a better sense of perspective. Meditation may help relieve anxiety, stress, fatigue, and sleep disturbances.
• Music therapy uses music to help improve health and well-being. It may include listening to relaxing music, singing, playing or learning a musical instrument, composing music, and/or moving to music. Music therapy may reduce stress, pain, anxiety, and nausea.
• Relaxation techniques, such as guided imagery and deep breathing exercises, promote health by relaxing the body and quieting the mind. These therapies are used to relieve stress and muscle tension, lower blood pressure, and reduce pain.
• Tai chi is a system of sequences of very slow, controlled movements that originated in China. It combines physical movement, breathing exercises, and meditation to improve health and quality of life. Tai chi may help with pain, fatigue, and stress. The practice may also help increase aerobic capacity, muscular strength, balance, and flexibility in patients.
• Yoga is an ancient practice that originated in India, which uses both the mind and the body. The various types of yoga usually combine physical postures, breath control, and meditation or relaxation. Yoga may help improve anxiety, depression, and stress in cancer patients. Since yoga involves physical activity, it is important for patients to discuss yoga with their healthcare providers to find out whether yoga is safe for them.

Medical marijuana 

Marijuana has biologically active components called “cannabinoids.” The two most-studied components are the chemicals delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Under federal law, marijuana cannot legally be prescribed, possessed, or sold. However, under most state laws, the use of marijuana to treat some medical conditions is legal. To get medical marijuana, you will need a recommendation or certification from a licensed healthcare provider, verifying that you have a qualifying condition. Each state has its own list of qualifying conditions. You may then need to enroll in your state’s medical marijuana program, which may include obtaining a medical marijuana ID card. Once enrolled, you will be able to buy medical marijuana at an approved dispensary. (Some state laws also allow the legal use of recreational marijuana by adults ages 21 and older; no states allow it for children and teens.) 

In cancer care, medical marijuana is sometimes used to manage side effects, such as nausea, appetite loss, pain, or anxiety if other medications or treatments are unsuccessful. More research is needed to better understand the benefits and risks of marijuana and its cannabinoids. Do not use marijuana or products made with cannabinoids without first talking to your healthcare team. Marijuana or related products (for example, CBD oils) could interfere with other medications. 

Do not obtain any kind of marijuana anywhere that is not a licensed dispensary. Marijuana products that are not obtained from licensed dispensaries carry additional risks as they may contain unknown ingredients, including infectious agents or more potent—and sometimes illegal—drugs. Talk honestly with members of your healthcare team about your use of marijuana or related products.     

Dietary supplements, vitamins, herbs, and natural products  

While approval is required by the U.S. Food and Drug Administration (FDA) for drugs to be prescribed for a particular condition or illness, therapies such as vitamins or herbal supplements are not considered drugs, but foods. Unlike drugs, they do not have to be tested by the FDA before they are available to consumers, so their effectiveness and safety is often unknown. 

Patients undergoing cancer treatment should not take any dietary supplements, vitamins, or herbs unless a doctor approves them. Many oncologists advise their patients to avoid these products during chemotherapy and radiation therapy. 

The following are examples of how vitamins and herbal supplements can adversely affect patients: 

• Few herbal products have been tested for quality and side effects. Some herbal supplements may be contaminated with microorganisms, pesticides, or heavy metals that can harm patients.
• Some herbal supplements can increase or lessen the effects of other medications:
• St. John’s Wort, which is sometimes used to treat depression, can make some cancer treatments such as imatinib mesylate (Gleevec®) less effective
• Some herbs can affect blood thinners such as warfarin and make the blood too thin or too thick, increasing a patient’s risk of bleeding or blood clots
• Vitamins in high doses can cause side effects and/or interact with other drugs and dietary supplements:
• Some studies have shown that high doses of vitamin C may reduce the effectiveness of chemotherapy drugs 

The FDA and the Federal Trade Commission (FTC) have warned the public to be aware of fraudulent cancer treatments. The internet is full of “miracle cures,” “scientific breakthroughs,” and “secret ingredients” to treat or prevent cancer. Some of these fraudulent treatments may be dangerous and cause physical harm or interfere with proven effective treatments. Any patient considering using an “anticancer” product seen in an advertisement or online should talk with a healthcare provider first. 

Questions to ask your healthcare team  

Use the following questions as a guide to discuss complementary therapies with your healthcare team: 

• Are there complementary therapies you would recommend?
• What research is available about this therapy’s safety and effectiveness?
• What are the benefits and risks of this therapy?
• How will I know if the therapy is working or not?
• Will this therapy interfere with standard cancer treatments?
• Are there potential side effects of this therapy? What should I look for?
• Do you offer this therapy as part of your practice? If not, can you refer me to a licensed practitioner in the area?
• Are there specific therapies that you would advise against?
• Do you know if this therapy is part of a clinical trial? How can I learn more about clinical trial eligibility and enrollment? 

Clinical trials 

Clinical trials to study various complementary therapies are underway in many locations across the country to assess their safety, benefits, dosing, and relative effectiveness. Patients enrolled in complementary studies receive the best standard cancer treatment either with or without the complementary therapies in question.  

Learn more about clinical trials.

Complementary therapies and Insurance coverage 

Some health insurance companies have started covering certain types of complementary therapies, such as acupuncture or chiropractic care. Check with your insurance provider to find out about your coverage. 

How to find an integrated medicine specialist or a complementary health practitioner 

If you are looking for a complementary health practitioner for treatment, it is important to conduct a careful and thorough search. Here are some suggestions to help in your search for a practitioner: 

• See if your oncologist or cancer center may be able to refer you to a complementary health practitioner. A local hospital or medical school, professional organizations, state regulatory agencies, licensing boards, or even your health insurance provider may also be able to give you a referral.
• Ask family and friends if they can recommend a practitioner for the type of therapy you are seeking
• Be sure to find out whether the practitioners you are considering are licensed or certified and if they have worked with cancer patients:
• Before scheduling any appointments, ask how many years they have been in practice, where they received their training, and the estimated cost of treatment. The goal is to find practitioners who will work with your oncologist and other healthcare providers so that together, they can devise a treatment plan that meets your needs. 

An integrative healthcare team evaluates the physical, emotional, and spiritual needs of each patient and then recommends specific therapies and lifestyle changes as part of a comprehensive treatment plan. Team members consider the scientific evidence, identify risks and benefits, and take into account individual preferences when they advise patients about complementary therapies. 

Complementary therapies do not work for everyone. While some patients find relief from complementary therapies, others have found them to be ineffective: benefits may vary from individual to individual. Some complementary therapies, especially natural health products such as herbs and supplements, have their own side effects and can interfere with standard cancer treatments. It is important to discuss complementary therapies with your healthcare providers.