5.1 Complementary & Alternative Medicine

5.1.1 What is Complementary & Alternative Medicine?

Complementary and alternative medicine (CAM) includes health and wellness practices not necessarily included in standardized medical care (National Cancer Institute, 2023b). You might already be doing CAM in your daily life but might not know it. When talking about breast cancer and CAM, there are different reasons to use these practices. Some have used CAM to help with side effects of treatments, create more balance and peace of mind while living with cancer, as a treatment option, or for other reasons (National Cancer Institute, 2023b).

To learn more about complementary and alternative medicine, check out Video 17 (National Cancer Institute, 2010).

5.1.2 Diet

Simple changes to your diet can help improve your health (Lymphedema Working Group, 2012). Furthermore, specific foods have been classified as anti-cancer or used to treat specific aspects of cancer.

Helpful vitamins and minerals can include:

• vitamin C,
• vitamin D,
• vitamin E,
• anti-oxidants,
• and lycopene (Lymphedema Working Group, 2012).

Meanwhile, foods that can help lower your risk for cancer can include:

• blueberries,
• carrots,
• cherries,
• cranberries,
• kale,
• legumes,
• spinach,
• and grapefruit (Lymphedema Working Group, 2012).

At the same time, there are certain foods that should be eaten in moderation when thinking about anti-cancer foods, including:

• red meat,
• processed meat,
• alcohol,
• and sugary beverages (American Institute for Cancer Research, n.d.).

Here are some more general healthy eating tips:

• eat with those whom you enjoy spending time with.
• eat foods you enjoy,
• drink water throughout the day,
• and eat smaller snacks periodically to keep your body as energized as possible (Canadian Cancer Society, 2018b).

5.1.3 Traditional Chinese Medicine & Ayurveda

Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) encompasses a wide variety of practices, such as acupuncture and herbal therapy, that work to balance your emotional, physical, spiritual, and mental health (Lymphedema Working Group, 2012). In TCM, your overall health is composed of functions, such as breathing and digestion, that work together in harmony with each other and the outside world. A disease disrupts this harmony and needs treatment to restore balance.

Ayurveda

Ayurveda is a spiritual practice from India that focuses on cleansing the body and bringing balance to your body, spirit, and mind (Lymphedema Working Group, 2012). Various other practices to improve overall health make up ayurveda, including meditation, exercise, diet, herbal medicine, massage, and cleansing.

For cancer, ayurveda views cancer cells as pieces of the mind-body system that are no longer whole and have forgotten their role; this disconnect results in disjointed physiology in your body (Lymphedema Working Group, 2012). As such, ayurveda focuses on placing you in an environment that supports inner healing and encourages wholeness.

As mentioned above, ayurveda looks at how diet and nutrition can help deal with the root of your stress (Lymphedema Working Group, 2012). Additionally, herbal medicine is used for detoxification and treating side effects (e.g., nausea). Using this practice along with standardized medical care may be beneficial to you. You can find healthcare practitioners who have become certified to teach and guide you through the principles of ayurveda.

5.1.4 Therapies

Acupuncture

Acupuncture is a common TCM practice that involves stimulating certain body parts to improve the flow of qi (vital energy) through your body and, therefore, improve your overall mental, physical, and spiritual health (Lymphedema Working Group, 2012). During acupuncture, stainless-steel needles are inserted into your skin and left there for under an hour.

Certain studies have found that acupuncture can help with nausea and vomiting caused by chemotherapy, along with general symptoms of fatigue and anxiety (Lymphedema Working Group, 2012). However, acupuncture is usually not recommended if you have a low white blood cell, low platelet count, or lymphedema.

Aromatherapy

Aromatherapy uses the scents from essential oils to improve your health (Lymphedema Working Group, 2012). The belief is that these scents affect your blood pressure, heart rate, and breathing. You can add essential oils to a diffuser or humidifier or apply them to your skin.

Aromatherapy may help with nausea, stress, pain, sleep, and calmness (Lymphedema Working Group, 2012). Although essential oils can cause skin reactions and trouble breathing, they are considered fairly safe.

Art Therapy

Art therapy is a way of healing involving expressing your emotions, such as fear, anger, and sadness, through creativity (Lymphedema Working Group, 2012). An art therapist will help you navigate these emotions using an art form you choose (e.g., drawing or sculpture).

Overall, art therapy can help you uncover and deal with your feelings surrounding breast cancer (Lymphedema Working Group, 2012).

Biofeedback

Biofeedback is a mind-body therapy that utilizes special machines to control bodily functions that you usually cannot control easily, such as blood pressure, heart rate, sweating, and muscle tension (Lymphedema Working Group, 2012).

This therapy can be beneficial if you have lost control of certain bodily functions during treatment (Lymphedema Working Group, 2012). Although there are minimal risks associated with biofeedback, ensure you have a trained professional to guide you through it.

Guided Imagery

Guided imagery is a mind-body therapy that involves visualizing different things that improve your health (Lymphedema Working Group, 2012). Sometimes, you can combine senses (e.g., sound and smell) with mind visualization to create scenes. For example, you might visualize your body destroying cancer cells or see yourself without breast cancer.

Guided imagery may help with cancer treatment side effects, such as nausea, vomiting, pain, and anxiety (Lymphedema Working Group, 2012). Ensure you have a trained mental health professional walk you through guided imagery.

Heat & Cold Therapy

Heat therapy involves using a hot water bottle or heating pad to help with sore muscles (Healthwise Staff, 2023c). Meanwhile, cold therapy uses an ice pack (or even a bag of frozen peas) to help numb pain in a specific area. For both therapies, only do them for 10 minutes or less to avoid burning and skin irritation. Avoid direct contact between your skin and the heat/cold by putting a barrier, such as a towel, in between.

You should not use heat and cold therapies if your skin is damaged or you have poor blood circulation in that part of your body (Healthwise Staff, 2023c).

Hypnotherapy

Hypnotherapy, also known as hypnosis, is a mind-body therapy that involves putting you in a trance-like state that helps you to navigate your feelings, behaviours, and thoughts (Lymphedema Working Group, 2012). A hypnotherapist will use suggestions to help you manage these aspects of yourself.

Hypnosis can help manage anxiety, depression, nausea, vomiting, and pain relief (Lymphedema Working Group, 2012). Potential side effects include anxiety, confusion, fatigue, dizziness, and even more serious health concerns such as seizures. Furthermore, hypnotherapy may uncover other psychological traumas that you do not want to explore right now.

Massage Therapy

Massage therapy involves kneading and rubbing your soft tissues and muscles to help alleviate the physical symptoms of cancer (Lymphedema Working Group, 2012; National Cancer Institute, 2023b). There are various types of massages, including relaxation, Thai, lymphatic, and deep tissue. Consult your doctor about what type of massage would be most beneficial for you.

Massage therapy can help with pain, stiffness, stress, anxiety, and tension (Lymphedema Working Group, 2012). It can also help promote circulation and relaxation. Note that you should not have deep tissue massage in the area where your cancer is situated; however, this massage is ideal for the rest of your body for relaxation and de-stressing. The healthcare practitioner should be aware that you have cancer and what stage of treatment you are in.

Music Therapy

Music therapy involves listening to music or playing musical instruments to express emotions, improve mood, and encourage socialization (Lymphedema Working Group, 2012). A music therapist can help guide you through this process.

Music therapy can help alleviate pain, nausea, and vomiting from chemotherapy (Lymphedema Working Group, 2012). It can also help manage your heart rate, breathing rate, blood pressure, and overall stress levels.

5.1.5 Spiritual Practices

Energy Medicine

Energy medicine (biofield therapy) is a spiritual therapy that focuses on changing how vital energy flows through your body to improve your health and wellbeing (Lymphedema Working Group, 2012).

There are various types of energy medicine, including reiki and therapeutic touch (National Cancer Institute, 2022). Reiki involves a trained professional lightly touching or hovering their hands over your body. Meanwhile, therapeutic touch involves them moving their hands over your body’s energy fields. Both guide energy to promote healing.

Although there is little evidence and concrete research supporting this practice, using energy medicine is safe (National Cancer Institute, 2022). Energy medicine may help alleviate symptoms such as anxiety, pain, fatigue, nausea, and vomiting (Lymphedema Working Group, 2012).

Meditation

Meditation is the spiritual practice of focusing on breathing and specific words to help deal with stressful situations and feelings (Lymphedema Working Group, 2012; National Cancer Institute, 2022). Specifically, this practice uses breathing patterns and phrases to help ground yourself in your thoughts. You can meditate alone (self-managed) or with someone trained to teach meditation.

Meditation can help lower stress and blood pressure, manage chronic pain, and promote feelings of control over yourself (Lymphedema Working Group, 2012).

5.1.6 Physical Activities

Tai Chi

Tai Chi is a Chinese martial arts practice that involves moving your body slowly, meditating, and controlling your breathing (Lymphedema Working Group, 2012). The belief is that Tai Chi moves vital energy throughout your body to improve your health.

Tai Chi can improve agility, flexibility, and muscle tone (Lymphedema Working Group, 2012). As well, mindful breathing can help with stress anxiety. Check with your healthcare provider before beginning Tai Chi, as this practice requires strong muscles and bones.

Yoga

Yoga is another practice that involves practicing mindfulness, stretching your body, and controlling your breathing (Lymphedema Working Group, 2012). Yoga comes in many forms, so do not be afraid to try different types to find one you like.

Furthermore, yoga is not just a physical activity, it is also a philosophy. This philosophy is illustrated through the eight limbs of yoga:

• Samadhi — union and integration.
• Yamas — external disciplines.
• Niyama — internal disciplines.
• Asana — posture (meditation seat).
• Pranayama — breath control.
• Pratyahara — withdrawal of senses.
• Dharana — concentration.
• Dhyana — meditative absorption. (Alexander, 2019)

See Image 23 for an illustration of the eight limbs of yoga (Alexander, 2019).

Yoga can decrease stress and manage blood pressure, breathing, and metabolism (Lymphedema Working Group, 2012). Since yoga involves stretching, sometimes it can cause injuries to certain parts of your body (e.g., muscles and ligaments). Before beginning yoga, talk to your healthcare team to ensure it is appropriate.

5.1.7 Medicinal Plants

Herbs

Certain herbs can help prevent or slow the development of breast cancer (McGrowder et al., 2020). These herbs include:

• ginseng,
• green tea (camellia sinensis),
• black cohosh,
• turmeric,
• and black cumin (McGrowder et al., 2020).

However, some of these herbs can interact negatively with chemotherapy treatments, resulting in toxicity (McGrowder et al., 2020). As such, it is crucial that you talk to your healthcare team first before taking herbal supplements to ensure they are safe for you to consume.

Medical Cannabis & Cannabinoids

Medical cannabis (marijuana), which comes from the cannabis plant, and cannabinoids, which are the chemicals of the plant, can be used to manage side effects that occur during breast cancer treatment (BC Cancer, n.d.5). Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most commonly available cannabinoids.

There are various ways you can use medical cannabis, including edibles you can add to tea, cookies, and other food items (BC Cancer, n.d.5). You can also get it in extract form. Although you can smoke medical cannabis, you should avoid this method due to the potential for lung damage.

Medical cannabis can help manage nausea, pain, and insomnia (BC Cancer, n.d.5). However, it can also result in side effects, such as hunger, drowsiness, dry mouth, and decreased reaction time. Because of this, you should not drive for up to 8 hours after you take medical cannabis.

If you would like more information on where to get medical cannabis, check out Video 18 (BC Cancer, 2020).

5.1.8 Questions to Ask About Complementary & Alternative Therapy

1. How well-researched are CAM therapies?
2. How do I know what complementary and alternative therapies are available to me?
3. Will I know if the complementary and alternative therapy is working?
4. How do I find resources for this CAM?
5. How do I know what CAM therapies are safe for me?
6. How long after my treatment can I do CAM therapies? (Lymphedema Working Group, 2012)

Chapter 5: Learning Activity

Chapter 5: Assessment