Using Integrative Medicine Approaches for Cancer-Related Fatigue

Breast and gynecologic cancer patients undergoing chemotherapy may experience improvement in cancer-related fatigue with integrative medicine approaches, explained researchers of a recent study. The researchers’ objective was to evaluate the effect of integrative medicine on those with both early and advanced breast and gynecologic malignancies receiving chemotherapy as treatment. What they found was that the use of integrative medicine may help alleviate some of the fatigue experienced by these patients.

“Fatigue is almost always multifactorial. Chemotherapy can increase fatigue by causing anemia, poor sleep, suppression of endogenous corticosteroids, release of pro-inflammatory cytokines, and poor nutrition from reduced appetite and increased nausea,” said Gary Deng, MD, PhD, medical director of the integrative medicine service at Memorial Sloan Kettering Cancer Center in New York, who was not involved in this research.

The study, published in Supportive Care in Cancer, which was conducted between June 2013 and May 2016, included 258 patients with early- to late-stage gynecologic or breast cancers undergoing treatment with adjuvant, neoadjuvant, or palliative chemotherapy. Study participants were evaluated at baseline and then at their 6- and 12-week follow-up appointments. Assessments included evaluation of quality of life, cancer-related fatigue, and routine hemoglobin levels. In addition, the relative dose intensity was assessed during the 6- and 12-week visits.

Researchers led by Eran Ben-Arye, MD, of the integrative oncology program at Lin and Carmel Medical Centers, Clalit Health Services in Haifa, Israel, found improvement in fatigue at both the 6- and 12-week follow-up evaluations in study participants treated with integrative medicine modalities, such as acupuncture, mind-body-spirit therapies, touch/movement therapies, and herbal/nutritional interventions. The researchers noted that acupuncture was used to treat the 120 study participants who were optimally assessed during the trial, adding that most of the participants underwent simultaneous treatment with at least two integrative medicine methods.

“It is imperative to take a holistic approach in treating [fatigue],” noted Deng. “The ‘one-symptom, one-drug’ approach would miss the mark. Therefore, we have to take a multidisciplinary approach to address all contributing factors.”

Although fatigue levels improved in the treatment arm of the study, hemoglobin levels were noted to decline in those treated with integrated medicine. “The relationship between improved fatigue levels despite reduced hemoglobin levels in complementary and alternative medicine–treated patients, which was reported in the present study, needs to be better understood,” noted the researchers.

“Because of the complexity in managing fatigue, research in this area is challenging. What would constitute the combination of “secret ingredients” that produces optimal clinical benefit is very difficult to tease out. On the other hand, fatigue is so prevalent among cancer patients, and we currently have no reliable treatment that gives us satisfactory results. Any research to explore new approaches would be very much needed,” stressed Deng.