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Therapy-based complementary -- sometimes called integrative -- medicine encompasses a wide range of practices and approaches to support you physically, emotionally, and mentally, used alongside conventional medical treatments as prescribed by your healthcare team.

Complementary medicine is not an alternative or a replacement for the medical therapy your healthcare providers have designed for you. Note that naturopathic or homeopathic interventions are often placed under the umbrella of complementary medicine, but certain herbs and supplements can actually interfere with chemotherapy or radiation therapy. Similarly, some may cause or worsen adverse side effects to other types of breast cancer therapy. It is best to discuss the use of naturopathic or homeopathic interventions with your healthcare team before starting any of the approaches.

Therapy-based complementary medicine refers to practices such as acupuncture, massage therapy, yoga, meditation, and mind-body techniques such as guided imagery and hypnotherapy. These methods may help you manage your symptoms, improve your quality of life, and support your overall well-being.

Complementary medicine approaches are often promoted quite heavily, but remember that an online endorsement, or even a recommendation from a friend or relative, does not necessarily mean the approach is safe or effective for you.

Your healthcare providers are the best resource to discuss your preferences and goals and let you know about the potential risks, benefits, and limitations that will help you make informed decisions about these therapeutic approaches. Your healthcare provider also will help you determine if the complementary/integrative therapy is safe and won't interfere with your cancer treatment or any other medications you're currently taking.

Your healthcare team will also be able to assist you in selecting a therapy or therapies that have peer-reviewed, scientific evidence supporting their safety and effectiveness, particularly for managing symptoms or improving your quality of life. Complementary medicine continues to evolve, with new research and evidence emerging on an ongoing basis.

The following are some of the common types of complementary medicine that have been tied to successful management of symptoms related to breast cancer and breast cancer treatment, along with the potential to improve quality of life:

Acupuncture

Acupuncture involves the insertion of sterile, extremely thin needles into specific points of the skin. These acupuncture points are thought to connect pathways of energy through a person's body.

This method has been associated with a significant reduction in multiple treatment-related symptoms among people with breast cancer, such as pain intensity, fatigue, and depression. It is generally a safe treatment with some mild adverse events (for example, bruising, pain, and swelling at the needle insertion sites).

Aromatherapy and Music Therapy

Aromatherapy is a technique where scented oils are inhaled through the nostrils or rubbed on the body during the course of a massage. Aromatherapy with single essential oils such as lavender oil has been shown to have a positive effect on sleep quality for patients with cancer.

Music therapy, which uses live or recorded music to promote relaxation, may relieve anxiety and depression in people with breast cancer, along with mitigating pain to some degree.

A combination of music therapy and aromatherapy may help with pain improvement and anxiety reduction in patients with breast cancer.

Guided Imagery and Progressive Muscle Relaxation

Guided imagery, also known as visualization, is a practice where a person imagines being in a certain environment or situation by thinking of pictures, sounds, smells, and other sensations associated with reaching a goal.

Progressive muscle relaxation involves tensing and releasing the muscles, one body part at a time, to induce physical relaxation.

A study examining the effect of guided imagery and progressive muscle relaxation among people with breast and prostate cancers concluded that both forms of complementary therapy could be of benefit in reducing stress, anxiety, and depression.

Hypnosis

Hypnosis is a technique intended to encourage a state of calm, alert awareness. The practice is believed to help a person relax deeply and focus on a specific idea, sensation, or memory. Among people with breast cancer undergoing therapy, hypnosis has been tied to improvements in pain, distress, and fatigue.

Meditation

Meditation is a mind-focusing practice that endeavors to suspend the normal stream of thoughts occupying a person's conscious mind. Some forms of mediation take place while a person is still and quiet; others can be conducted while a person is in motion. A series of meditation-based sessions was tied to reductions in anxiety and fatigue in women with breast cancer undergoing radiation therapy.

For example, Tibetan medicine meditation involves visualizing beneficial energy in the shape of a sphere of white light, providing positive benefits to specific areas of a person's body or their entire being. This method has been linked with a decrease in anxiety-tension, depression-dejection, anger-hostility, fatigue, and confusion.

Buddhist walking meditation, which involves mindfulness walking exercises at moderate intensity for 30 minutes, has been shown to improve cardiovascular fitness among people with breast cancer receiving chemotherapy.

Movement-Based Therapies

These therapies often involve a physical practice with a spiritual component. For example:

• Tai chi, an exercise comprised of a choreographed series of slow movements in concert with meditation and breathing techniques, is conducted by a teacher and most often takes place in a group setting. It's not entirely clear if tai chi can be a meaningful supportive-care intervention in breast cancer, although it may offer some improvement in quality of life.

• Yoga, from the Sanskrit word "yuj" or union, is a more than 5,000-year-old tradition of principles and practices originating in India. Most styles of yoga practiced in the Western world focus on movement and breathing, with a multitude of variations available -- some slow, some gentle, some active, and some fast-moving. It is perhaps the most studied form of complementary therapy for cancer care, with a plethora of evidence-based material supporting its use among patients with breast cancer. A fair amount of research has tied yoga therapy to improvements in quality of life and symptom management.

Spirituality and Prayer

Spirituality, being concerned with the human spirit or soul, is most often expressed via religion and prayer, although there are many other means of expressing it. Various studies have supported the role of spirituality and prayer, when appropriate, to help patients cope with a breast cancer diagnosis, stage of illness, and treatment.

If you have a spiritual or prayer practice in your life that provides comfort, continue to embrace that tradition.

Hands-On Therapies

There is less evidence for the benefits of these treatments, which are given primarily through direct touch between the practitioner and the patient:

• Reiki, or "universal life force energy," is a Japanese form of therapy during which the practitioner attempts to balance the flow of energy believed to move through the body in order to stimulate its healing capabilities. A small study showed that the technique reduced fatigue and improved the quality of life of people with breast cancer undergoing chemotherapy.

• Massage involves manipulating the soft tissues of the body, most commonly by using the hands, fingertips, and fists. Shiatsu is a Japanese massage technique that uses acupressure through a practitioner's fingers. These body manipulation-based practices have shown positive effects on pain and fatigue in patients with cancer.

Read the rest of the installments in this series:

For Your Patients: Breast Cancer Basics

For Your Patients: The Crucial Role of the Biopsy in Breast Cancer

For Your Patients: Understanding Early-Stage Breast Cancer

For Your Patients: New Therapies, New Hope in Later-Stage Breast Cancer

For Your Patients: The Importance of Genes in Breast Cancer

For Your Patients: Understanding Palliative Care for Breast Cancer

For Your Patients: Next Steps After Breast Cancer Surgery

For Your Patients: Partner With Your Primary Care Doc for Help With Side Effects

For Your Patients: Managing the Long-Term Effects of Treatment

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.