CANCER significantly affects patients’ mental health, increasing their risk for anxiety and depression, which are often underdiagnosed and go untreated. Addressing these mental health needs with integrative and conventional interventions is essential for improving quality of life and outcomes, according to a presentation from the Best of ASCO 2024 Miami Symposium on Friday, July 12.
Dr. Ashwin Mehta, Medical Director, Integrative Medicine at Memorial Healthcare System, Florida, USA, delivered the session ‘Breast Cancer and Survivorship’ covering the American Society of Clinical Oncology-Society for Integrative Oncology (ASCO-SIO) clinical practice guidelines update regarding the use of integrative therapies to treat anxiety and depression in patients living beyond breast cancer and key recommendations for clinicians to guide patients with.
Mindfulness-based interventions are recommended during and after cancer treatment and have been proven effective through multiple studies and meta-analyses. Yoga was suggested for reducing anxiety and depression, a claim supported by systematic reviews of randomized controlled trials. Additional therapies during treatment may include music therapy, relaxation, reflexology for anxiety and depression; and, hypnosis and lavender essential oil for anxiety. Post-treatment, tai chi, qigong, and reflexology are recommended for anxiety and depression; and, acupuncture for anxiety in breast cancer survivors.
Access to complementary and integrative health providers varies by location and socioeconomic status. Major oncology centers often offer these services, but community-based centers may not, Mehta shared. Telehealth options and cancer support organizations can provide access to low-cost or free complementary and integrative health services. Additionally, health disparities exist based on education and socioeconomic status, affecting access to integrative therapies. Utilization of these therapies may also be influenced by cultural and religious biases.
Cancer centers should screen for emotional well-being and refer patients to evidence-based integrative therapies. Providing these services on-site or through allied practitioners is crucial, but funding and insurance coverage remain challenges. Evidence for the safety and effectiveness of dietary supplements in cancer care is inconclusive and some supplements pose risks of interactions with cancer treatments. Cognitive behavioral therapy or mindfulness-based therapies are recommended before considering supplements.
While many integrative therapies are still being researched, cancer centers should provide access to evidence-based treatments through insurance or public funding. Clinicians should stay informed and advocate for integrating these therapies into patient care.
Ashwin Mehta, Memorial Healthcare System (presentation on file)
Reference
Memorial Healthcare System. Best of ASCO® 2024 Miami Symposium. 2022. Available at: https://mhs.cloud-cme.com/course/courseoverview?P=0&EID=19848. Last accessed: July 19, 2024.
