60% of high-priority research goes unfunded.
Also called mind-body therapies
Most complementary and alternative therapies have not been scientifically proven to be safe or effective in the treatment of cancer. Before making a decision about using a therapy, patients should find out all they can about the treatment and its possible effects and should discuss its use with a doctor or healthcare professional.
Mind-body medicine practices are based on the belief that the mind is able to affect the body. The connection between the mind and the body and how the health of one affects the health of the other are well known. Mind-body medicine uses a variety of techniques to enhance the mind's ability to affect body function, symptoms and health.
Many ancient Eastern healing approaches, such as traditional Chinese medicine and Ayurvedic medicine, emphasized the important link between the mind and the body. Many mind-body medicine approaches are based on Eastern religious or spiritual practices and have been used for centuries by different cultures.
Use and claims
Mind-body techniques are mainly used together with conventional treatments (as a complementary therapy) to help people cope with cancer, its treatment or side effects rather than to treat cancer itself. These techniques can help induce relaxation, reduce stress and anxiety and relieve pain or other symptoms caused by cancer or cancer treatment.
How it is given
Mind-body medicine uses a variety of techniques. Many approaches of mind-body medicine emphasize the power individuals have to heal themselves. This can be very empowering for many people. Examples of mind-body approaches include:
- creative therapies such as art or music
- imagery (visualization)
Biofeedback uses monitoring devices to help people learn how to consciously control certain body functions such as heart rate, blood pressure, temperature, sweating or muscle tension. These body functions are ones we are normally not aware of. Biofeedback is often used with relaxation.
Hypnosis is a state of relaxed and focused attention in which the person concentrates on a certain feeling, idea or suggestion. There are different types of hypnosis techniques. During hypnosis, a therapist (hypnotherapist) leads the person into a deeply relaxed state, but the person is still conscious of their surroundings. The therapist then uses suggestion to benefit the person in different ways, such as to gain control over certain symptoms or change certain behaviours.
Some people are able to learn and use self-hypnosis before having procedures or surgery done. Children can be easier to hypnotize than adults.
Imagery (guided imagery) or visualization involves mental exercises such as imagining scenes, sounds, smells or other sensations to help the body relax or to influence health and well-being. There are many different types of imagery techniques. One example of guided imagery used for people with cancer is to imagine their bodies fighting the cancer.
Meditation is a mind-body process to relax the body and calm the mind that involves focusing attention and letting go of thoughts that normally occupy the mind. It involves focused breathing and may involve focusing on the repetition of certain words or phrases (a mantra) or on an object.
There are many different types and styles of meditation. Meditation may be done while sitting or lying down, but there are also moving forms of meditation such as tai chi, qigong, walking meditation and aikido (a Japanese martial art). Mindfulness meditation and transcendental meditation are two common types of meditation. Meditation can be self-directed or guided by trained professionals such as psychologists, psychiatrists or other health professionals.
Music therapy is an example of a creative outlet that uses music to promote healing and enhance quality of life. Music therapy may be used to encourage emotional expression, promote social interaction and relieve symptoms. People with cancer either listen to music or use musical instruments under the guidance of a music therapist.
Simple breathing and relaxation techniques are useful in reducing anxiety, muscle tension and stress. These techniques can also affect the part of the nervous system that controls blood pressure and the digestive system. Relaxation techniques can help many people with cancer relax and experience a sense of calmness. Relaxation is sometimes used with meditation and visualization.
Yoga is a form of exercise that involves a program of stretches and poses, breathing exercises and meditation. There are several different types of yoga. Iyengar and Hatha are two popular types.
Summary of the evidence
Mind-body medicine is being researched extensively. Scientific evidence does not show that any of the mind-body medicine techniques are effective in treating cancer. However, studies have shown that many of the techniques are useful in relieving some of the symptoms of cancer or side effects of treatment.
Evidence from several studies of people with various types of cancer suggests that mind-body practices can improve mood, quality of life and coping. These practices can also reduce some of the symptoms caused by cancer or its treatment, such as pain or chemotherapy-induced nausea and vomiting. Some studies have suggested that mind-body approaches may alter certain parts of the immune system, but it is not clear whether these alterations have an impact on cancer or a person's prognosis.
Biofeedback can improve the quality of life for some people with cancer. Biofeedback can help muscle strengthening exercises be more effective. Research has found that biofeedback can be helpful for people regaining urinary and bowel function (continence) after cancer surgery.
Biofeedback is also effective for relieving many types of chronic pain, especially tension and migraine headaches.
Several trials have shown that hypnosis can help with anxiety, depression and mood in people with cancer. Hypnosis and relaxation techniques have been shown to be effective in reducing chemotherapy-related nausea and vomiting in both children and adults.
Some mind-body techniques, such as hypnosis, have also been used to relieve pain, including procedure-related pain in children with cancer. Children having painful medical procedures such as a bone marrow aspiration or lumbar puncture had less pain and anxiety when hypnosis was used compared to non-hypnosis behaviour techniques. Some studies have also found that hypnosis can reduce anxiety and distress in children.
A randomized controlled trial in women having breast cancer surgery showed that hypnosis helped reduce pain, nausea, fatigue, discomfort and emotional upset related to surgery. Overall, the present evidence supports the use of hypnosis with surgery.
Guided imagery may help reduce some of the side effects of cancer treatment. Some studies also suggest that imagery may affect the immune system.
Guided imagery has been effective in reducing anticipatory nausea and vomiting in children and adults receiving chemotherapy and for reducing anxiety and pain during invasive medical procedures. Controlled trials have shown that guided imagery significantly reduces tension, stress and fatigue.
There is some evidence that meditation is associated with potentially beneficial health effects. It is not fully known what changes occur in the body during meditation and whether these influence health. Meditation may help reduce anxiety, stress, blood pressure, chronic pain and insomnia. It may help to improve the quality of life for people with cancer and help them feel more in control. More research is needed before firm conclusions can be made about the health effects of meditation.
There is evidence that music therapy can help reduce pain and relieve chemotherapy-induced nausea and vomiting when used with other conventional medical treatments. It may also relieve stress and provide an overall sense of well-being. Some studies have found that music therapy can lower heart rate, blood pressure and breathing rate.
Music therapy is particularly effective in palliative care. Trials show that this therapy can benefit people by reducing anxiety, mood disturbances and pain and generally increasing quality of life.
Relaxation has been effective in reducing anticipatory nausea and vomiting in both children and adults receiving chemotherapy. Controlled trials have shown that relaxation techniques significantly reduce anxiety, tension, stress, fatigue and can also be effective in relieving pain, especially while invasive medical procedures are being done.
Research has shown that yoga can be used to control physical functions such as blood pressure, heart rate, breathing, metabolism and body temperature. This can improve physical fitness, lower stress and increase the feeling of relaxation and well-being. Some studies have reported that yoga is helpful for people with cancer who have problems with sleep and may improve overall sleep quality.
Potential side effects and risks
Most mind-body medicine practices are generally considered safe when done with trained, qualified practitioners. Each mind-body technique may have its own side effects and risks associated with it. Talk to your doctor or healthcare professional if you have questions or concerns about a particular mind-body technique.
Relying on mind-body medicine approaches alone, and avoiding or delaying conventional medical care for cancer, may have serious health consequences.
Biofeedback is thought to be a safe mind-body technique. It is not invasive and requires little effort. Some people may have dizziness, anxiety, disorientation or a sensation of floating. Biofeedback requires a trained, qualified professional to manage the equipment, interpret changes and teach and monitor the person using this technique. Battery-operated devices sold for home use are generally not reliable.
Problems can occur if hypnosis is done by an untrained person. Side effects of hypnosis are mostly short-term and include fatigue, anxiety, confusion, fainting and dizziness. However, some serious reactions have been reported such as chronic psychological problems, bringing back memories of previous trauma or seizures.
Imagery techniques are generally considered to be safe.
Problems rarely occur with meditation, but some people have become disoriented or anxious and experienced some negative feelings. People with certain types of mental illness may be more likely to have these responses to meditation. People with cancer should talk to their doctor before starting any type of meditation that involves movement of joints and muscles, such as qigong or martial arts.
Music therapy done by a professionally trained therapist is considered safe.
Relaxation techniques are generally considered to be safe.
Side effects from yoga are rare. However, people with cancer should talk to their doctor before starting any type of therapy that involves movement of joints and muscles. Some yoga postures are hard to achieve, and overstretching joints and ligaments can cause injuries. Yoga may not be advised for people with bone metastases who are at risk of fractures.