Standard medicine is practiced by holders of M.D. and D.O. degrees and allied health professionals. It is distinguished from complementary and alternative medicine (CAM), which is not integrated into the United States primary health care system. Complementary medicine is used along with standard medicine, whereas alternative medicine is used independently of standard medicine.[1] Some commonly used CAMs include alternative medical systems such as acupuncture, energy therapies, exercise therapy, mind-body interventions, nutritional therapies, and pharmacologic or biologic treatments.[2]

Acupuncture is an alternative medical system commonly used by cancer patients involving the insertion of thin needles into the skin. By placing these needles at strategic points, different areas of the body can be stimulated to relieve pain. This is believed to be achieved either by stimulating nerves, muscles, and connective tissues in the area causing more of the body’s natural painkillers to be produced or by balancing the flow of energy in the body. Because the needles are very thin, there is minimal discomfit with insertion, with many people not able to feel the needle being inserted at all. Between 5-20 needles are typically used at different depths. Once the needles are inserted, they can be manipulated by twirling or applying heat or mild electrical pulses. The needles are typically removed after about 10-20 minutes.[3]

Cancer patients have found acupuncture effective at reducing anxiety and alleviating symptoms of illness and side effects of medications. One patient said a medication she was on was causing brain fog and neuropathy (nerve pain); acupuncture helped her manage those symptoms. She said her neuropathy eased for at least a week after acupuncture treatment, and she noticed the difference if she did not go in for regular appointments. She described receiving acupuncture for the first time as being an “out-of-body experience,” where all of her anxiety and pain was lifted.[2]

Two common energy therapies are Reiki and qi gong.[2] It is theorized that energy can stagnate in the body as a result of physical or emotional pain, and energy therapies can remove the blocks and allow energy to flow freely throughout the body. Reiki involves a practitioner placing their hands lightly on or over specific areas of the body for around 2-5 minutes. There are 20 different areas of the body that may be used, and sessions may last anywhere from 15-90 minutes.[4] Qi gong incorporates meditation, breathing exercises, and gentle movements to move energy throughout the body.[5] A specific movement can be repeated to achieve a purpose. For example, the movement of pulling a bow to shoot an arrow can open the lungs, while pushing your hands to the sky can lower heart rate and blood pressure.[6] Many cancer patients have used Reiki as part of their spiritual work. One patient used Reiki to help work on his self-love, which he said was an important step for him to take in order to heal fully.[2] Cancer patients have said practicing qi gong has led to decreases in pain, fatigue, and stress as well as improving emotional well-being overall.[7]

Cancer patients are encouraged to exercise as much as possible because of its many health benefits. Fighting cancer can lead to a sedentary lifestyle that can accelerate aging by weakening bones, muscles, and the heart.[8] Many cancer patients practice exercise therapies such as yoga because it combines benefits of both exercise and meditation.[2] Yoga typically involves a series of postures done in succession and breathing exercises.9 One patient described how his idea of what being active means changed after being diagnosed with lung cancer; he said that yoga got blood flowing to areas of his body that did not get exercised while running or lifting weights. He came to recognize that he did not need to vigorously exercise to get the benefits of moving his body. Patients also said yoga helped to calm them and manage their anxiety.[2]

Meditation incorporates mindfulness and deep breathing.[10] Mindfulness is a non-judgmental awareness of the present moment including one’s thoughts, feelings, surroundings, and body.[11] There are many different types of mediation, but the common principles include: a quiet surrounding, a specific posture or movement, and a focus on a word, phrase, object, or breathing.[12] Meditation and mindfulness fall under the category of mind-body interventions.[2] Meditation can be practiced individually or with the help of a guide; options for guided meditation include in-person or virtual classes and apps for your phone or tablet.[12]

Many cancer patients have practiced meditation with an understanding that the mind and body are connected, and they should take care of themselves in all aspects: physically, mentally, and spiritually. One patient described the way he practiced meditation by focusing on his body and senses: what he saw, heard, felt, smelt, and tasted. Another meditation technique he utilized was passively observing his thoughts without reacting to them. The ‘How to Meditate’ article provides more tips on how to meditate. Cancer patients have described meditation as making them feel grounded, peaceful, calm, less anxious, and more accepting of their diagnosis. One patient described his anxiety when going in for a cancer scan to see if his cancer had come back; he said meditation greatly helped him ease this fear. He said meditation gave him the strength to deal with the ups and downs of life and changed his entire outlook on life.[2]

Mindfulness helps you feel present in the current moment, rather than worrying about the past or future. For people who struggle to stay focused enough to meditate, other mindfulness practices can be used. Listing what you are grateful for is a mindfulness practice that cancer patients found helpful. Another mindfulness practice is journaling and can take many forms such as following prompts or just writing freely.[13] Mindfulness can also be incorporated into daily activities. For example, one cancer patient explained that while brushing her teeth she tried to focus only on this and not let her mind wander to her plans for the day, what she was going to wear, etc. Simple practices such as these can be valuable tools that can be incorporated by anyone to reduce stress and improve quality of life. Mindfulness often focuses on stress reduction and there are classes offered with this goal in mind. This care can be tailored to a specific patient’s needs; one patient said mindfulness-based stress reduction classes helped her manage her fatigue and frustration around being unable to do everything she wanted.[2]

Music therapy [MB5] can also be considered a type of mind-body intervention. It can involve listening to music, playing music, dancing, singing, and writing or discussing song lyrics.[14] Music therapy has been shown to improve mood, decrease anxiety and depression, and decrease symptoms such as shortness of breath and pain in cancer patients.[15]

Nutritional therapies such as supplements or vitamins have been used by some cancer patients. While there are many recommendations out there for nutritional therapies, it is important to check with your oncologist to ensure any supplements you take do not interfere with your cancer treatment. One patient took a variety of essential oils, mineral supplements, and vitamins. Another patient on a vegan diet took B12 supplements; vitamin B12 is present only in meat and a deficiency can cause hair loss. One patient said she took multivitamins and calcium supplements before getting cancer; after getting cancer, she continued these supplements while also adding L-lysine to combat mouth sores caused by chemotherapy and biotin and silica to promote hair growth. With the help of a doctor, patients can determine which supplements may be helpful to them given their individual situation.[2]

Pharmacologic and biologic treatments such as cannabidiol (CBD), marijuana, and herbal supplements have also been used by some cancer patients.2 CBD is an active ingredient in marijuana, but it is derived from the hemp plant; therefore, CBD does not cause a high.[16] One patient said CBD oil relaxed her and helped her get to sleep. Another patient using CBD oil said it helped with her pain; her stomach was too sensitive to take Ibuprofen, so she used CBD oil instead. Others found CBD to not be effective enough at controlling their pain. One patient said when she was having pain from her cancer recurring, CBD worked for a while to ease the pain but then stopped working. Some patients preferred CBD over marijuana because they did not like the feeling of being high. Others who smoked marijuana before getting cancer continued to do so.[2]

References

1.     Complementary and Alternative Medicine https://www.cancer.gov/about-cancer/treatment/cam#:~:text=Types%20of%20Complementary%20and%20Alternative%20Medicine%201%20Mind%E2%80%93Body,Biofield%20Therapy.%20...%205%20Whole%20Medical%20Systems.%20 (accessed Jun 3, 2021).

2.     Achkar, M. A. Complementary and Alternative Medicine. In Roads to meaning and resilience with cancer: forty stories of coping, finding meaning and building resilience while living with incurable lung cancer; Morhaf Al Achkar, 2019.

3.     Acupuncture https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763 (accessed Jun 3, 2021).  

4.     Everything you need to know about reiki https://www.medicalnewstoday.com/articles/308772#where-can-I-get-reiki (accessed Jun 3, 2021).

5.     Qigong for Beginners - a Complete Guide https://mindmonia.com/qigong/ (accessed Jun 3, 2021).

6.     The Basic Movements of Qigong Exercises https://qigong.com/the-basic-movements-of-qigong-exercises/ (accessed May 21, 2021).

7.     Qigong for Cancer Survivors: Patient Experiences https://www.mskcc.org/videos/qigong-survivors-patient-experiences (accessed Jun 4, 2021).

8.     Physical Activity and the Cancer Patient https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/physical-activity-and-the-cancer-patient.html (accessed May 13, 2021).

9.     What is Yoga? https://www.yogapedia.com/definition/4/yoga (accessed Jun 3, 2021).

10.  Meditation for Cancer Patients https://www.roswellpark.org/cancertalk/201702/meditation-cancer-patients#:~:text=Meditation%20for%20Cancer%20Patients%201%20Sit%20tall.%20The,5%20Repeat%20a%20mantra.%20...%20More%20items...%20 (accessed May 19, 2021).

11.  Mindfulness Definition: What Is Mindfulness https://greatergood.berkeley.edu/topic/mindfulness/definition (accessed May 21, 2021).

12.  Simon, S. Take a Moment With Meditation https://www.cancer.org/latest-news/take-a-moment-with-meditation.html (accessed May 19, 2021).

13.  Bush, M. Three Simple Mindfulness Practices You Can Use Every Day https://www.mindful.org/three-simple-mindfulness-practices-you-can-use-every-day/ (accessed Jun 15, 2021).

14.  Music therapy https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/music (accessed May 19, 2021).

15.  Eldridge, L. The Emotional and Physical Benefits of Music on Cancer Patients https://www.verywellhealth.com/benefits-of-music-therapy-for-cancer-patients-2248912 (accessed May 19, 2021).

16.  Grinspoon, P. Cannabidiol (CBD) - what we know and what we don't https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 (accessed Jun 4, 2021).

 [MB1]Link to ‘acupuncture’ article

 [MB2]Link to ‘exercise for cancer patients’ article

 [MBA3]Link to ‘benefits of meditation’ article

 [MBA4]Link to ‘how to meditate’ article

 [MB5]Link to ‘music therapy’ article