Integrative Therapies to Reduce Toxicities Associated with Breast Cancer Radiation Therapy

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Complementary therapies are used alongside conventional therapies, whereas alternative therapies are used in place of conventional therapies. Over 50 percent of breast cancer patients undergoing definitive radiation therapy report using at least one of these therapies. However, very few discuss it with their doctor.

Integrative medicine is the coordinated use of evidence-based complementary therapies with conventional medicine. These methods may improve quality of life by reducing the common side effects of breast cancer radiation therapy, and both knowledge as well as open discussions with patients about these options are crucial.

Exercise

Physical activity is a safe, effective and low-cost measure which can improve both quality of life during and quantity of life after breast cancer treatment. Whether pre- or post-diagnosis, it is associated with a decrease in recurrence rates, breast cancer deaths and all-cause mortality. Although more investigation is needed to fine tune the intensity, type and duration of exercise for these patients, the current recommendation by the American Cancer Society is to avoid inactivity and return to normal daily activities as soon as possible following diagnosis, exercise at least 150 minutes per week, and include strength training exercises at least two days per week.

Nutrition

In addition to being associated with increased risk of diabetes, stroke and heart disease, obesity is associated with an increased risk for breast cancer, with obese postmenopausal women having a 20 to 40 percent increased risk of developing hormone receptor-positive breast cancer when compared to normal weight women.

Studies reveal that those following a plant-based diet live longer than those on the standard American diet (SAD). Data also supports this finding when you compare breast cancer survivors eating a plant-based diet to those following the SAD.

In terms of nutritional interventions limiting acute radiation toxicities during breast cancer radiation, the data is very limited. This is likely related to nutritional studies being inherently difficult to design and fund. However, in my experience as a breast cancer specialist who recommends a whole-foods, plant-based lifestyle to my patients, I frequently observe significantly less acute skin toxicity and fatigue in those patients following our nutritional recommendations.

Mindfulness-based Interventions

Stress is an often-overlooked side effect of breast cancer diagnosis and treatment. Healthcare providers versed in stress reduction techniques can play an invaluable role in restoring peace of mind and minimizing emotional distress experienced by patients. While stress can result in a decrease in patients’ health-related quality of life, it is also associated with poorer survival outcomes in breast cancer patients.

Mindfulness-based stress reduction (MBSR), is a structured program that incorporates meditation, yoga and mindful relaxation techniques. It has been shown to improve quality of life by improving both psychological status (perceived stress, anxiety, depression, fear of recurrence) as well as physical side effects such as pain, fatigue and sleep.

Cognitive-behavioral therapy (CBT) is a short-term, goal-oriented form of psychotherapy, which can be conducted on either an individual or group basis. It can be combined with hypnosis and has been shown to prevent and control fatigue as well as improve the affective experience during breast cancer radiation therapy.

Meditation can refer to a variety of techniques and procedures, all meant to reach a state of quietness and relaxation. Pranic meditation, which is relatively simple and easy to learn, can produce significant benefits for mental health and quality of life even after just a short period. After eight weeks of twice daily sessions, breast cancer survivors were shown to experience significant improvement in their quality-of-life scores as well as global health status, fatigue, sleep disturbances, body image, arm symptoms and breast symptoms. Mental health parameters, including stress, death ideation, psychosomatic disorders and severity of mental disorders, were also improved.

Yoga therapy is another technique that can yield numerous physical and psychosocial benefits for breast cancer patients. Yoga performed during a course of breast cancer radiation therapy specifically has also been shown to significantly improve quality of life, most notably sleep disturbances or depressive symptoms.

To refer a patient for breast cancer care, call Breast Care Coordinators Beth Joannou, BSN, RN, OCN, CBCN, at Call407-303-2514,Jackie Barrett, BSN, RN, CBCN, at Call407-303-1483, or Jenny Edwards, BSN, RN, OCN, at Call407-303-5412.

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