This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cassileth, B. R. Articles by Vickers, A. J. Search for Related Content PubMed PubMed Citation Articles by Cassileth, B. R. Articles by Vickers, A. J.

Complementary Therapies and Integrative Oncology in Lung Cancer^*

ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)

^* From the Memorial Sloan-Kettering Cancer Center (Drs. Cassileth, Deng, Gomez, and Vickers), New York, NY; Emory University School of Medicine (Dr. Johnstone), Atlanta, GA; and H. Lee Moffitt Cancer Center & Research Institute (Dr. Kumar), Tampa, FL.

Correspondence to: Barrie R. Cassileth, MS, PhD, Laurance S. Rockefeller Chair in Integrative Medicine, Chief, Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Ave at Seventy-Fourth St, New York, NY 10021; e-mail: Cassileth{at}mskcc.org

Background: This chapter aims to differentiate between "alternative" therapies, often promoted falsely as viable options to mainstream lung cancer treatment, and complementary therapies, adjunctive, effective techniques that treat symptoms associated with cancer and its mainstream treatment, and to describe the evidence base for use of complementary therapies.

Methods and design: A multidisciplinary panel of experts in oncology and integrative medicine evaluated the evidence for complementary (not alternative) therapies in the care of patients with lung cancer. Because few complementary modalities are geared to patients with only a single cancer diagnosis, symptom-control research conducted with other groups of patients with cancer was also included. Data on complementary therapies such as acupuncture, massage therapy, mind-body therapies, herbs and other botanicals, and exercise were evaluated. Recommendations were based on the strength of evidence and the risk-to-benefit ratio.

Results: Patients with lung and other poor-outlook cancers are particularly vulnerable to heavily promoted claims for unproved or disproved "alternatives." Inquiring about patients’ use of these therapies should be routine because these practices may be harmful and can delay or impair treatment. Mind-body modalities and massage therapy can reduce anxiety, mood disturbance, and chronic pain. Acupuncture assists the control of pain and other side effects and helps reduce levels of pain medication required. Trials of acupuncture for chemotherapy-induced neuropathy and postthoracotomy pain show promising results. Herbal products and other dietary supplements should be evaluated for side effects and potential interactions with chemotherapy and other medications.

Conclusions: Complementary therapies have an increasingly important role in the control of symptoms associated with cancer and cancer treatment.

Key Words: acupuncture • botanicals • cancer • complementary and alternative medicine • complementary therapies • fitness • herbs • integrative medicine • massage therapy • mind-body therapies • music therapy • oncology