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Cancer and its treatments can cause a range of symptoms and side effects. Whereas fatigue, nausea, nerve damage and other physical symptoms are widely acknowledged, and therapies are often available to counter them, the same can’t be said for the psychological effects.

Recognizing this gap in care, the Society for Integrative Oncology and the American Society of Clinical Oncology have published an evidence-based guideline that recommends several therapeutic approaches, and specifically mindfulness-based interventions, for adults with cancer who are experiencing symptoms of anxiety and depression. The guideline and an accompanying editorial are published in the Journal of Clinical Oncology.

Headshot of Gary Asher
UNC Lineberger’s Gary Asher, MD, MPH.

Gary N. Asher, MD, MPH, director of Integrative Medicine Services at the UNC Lineberger Comprehensive Cancer Center and guideline and the study co-author, said the development of the guideline is a critical step in making integrative therapies more broadly available — and accepted. 

“Lack of knowledge about the effectiveness or availability of integrative oncology services often prevent patients from asking about and providers from recommending evidence-based integrative oncology treatments and interventions,” said Asher, who is a professor of family medicine at the UNC School of Medicine. “The publication of the guideline can help patients and providers make evidence-based decisions and hopefully pave the way for more insurance companies to cover these services.”

Previous studies estimate that upwards of one in four adults being treated for cancer, or who have been treated for cancer, experience anxiety and depression. With the overall incidence of cancer in adults and the number of cancer survivors  expected to increase the next few decades, the need for better, more effective care for psychological symptoms will also grow.

Mindfulness-based interventions, which include mindfulness-based stress reduction, meditation, and mindful movement such as tai chi and qigong, were found to be the most effective in treating anxiety and depression symptoms in patients during active treatment and those post-treatment. The guideline also recommended yoga to reduce anxiety symptoms in people currently undergoing treatment. Music therapy, relaxation therapies and reflexology may be offered to reduce both anxiety and depression symptoms in people undergoing active treatment. Hypnosis was found to help specifically with anxiety symptoms during diagnostic and treatment procedures.

“Many patients with cancer experience challenges with coping that can manifest as symptoms of anxiety and depression, and there are a variety of evidence-based integrative medicine approaches to help manage these symptoms,” Asher said. “The guideline should help patients and providers make more confident decisions about how and when to incorporate integrative therapies into conventional treatment plans, both during and after cancer treatment.”

A group of adults doing a yoga pose


UNC Lineberger and UNC Health offer adults with cancer in active and post-treatment a wide range of integrative therapies and comprehensive care support services, including massage, yoga, acupuncture, biofeedback, nutrition, health coaching and exercise, mental health and emotional support, and integrative and lifestyle medicine consultations.