Complementary therapies (CTs) are widely used alongside standard treatments for blood cancer.

• Complementary therapies are forms of practice and products used alongside conventional medicine.
• Complementary medicines are non-prescription medicines.
• Integrative medicine (IM) combines conventional care and complementary therapies.
• Alternative therapies are used in place of conventional medicine.

It is important to use complementary therapies safely. Complementary therapies may be perceived as safe. But some cause harm by interacting with conventional and prescribed medicine. Others provide no benefit. Some potential interactions with treatment can:

• Make treatment side effects worse
• Reduce the anti-cancer effect of the treatment

Determine the benefits and risks, and ensure the information is reputable. Discuss any complementary therapies you plan to use with your treatment team. Developing a comprehensive plan with your treatment team can ensure the complementary therapies are effective and safe for you.

The Understanding complementary therapies booklet from the Cancer Council has a question checklist on page 70-72 of things to consider and questions to ask.

Some types of complementary therapies

Acupuncture

Acupuncture is a procedure involving stimulation of anatomical locations on the skin by a variety of techniques. Generally, this is through using fine needles. It is important to talk to your treatment team before undergoing acupuncture. Studies suggest that acupuncture can:

• Reduce cancer pain
• Improve chemotherapy induced nausea

Aromatherapy

Aromatherapy is the therapeutic use of essential oils to improve emotional, physical and spiritual wellbeing. It is generally applied topically or inhaled; some studies suggest it is effective in:

• Reducing anxiety and depression
• Improving sleep
• Improving memory
• Increasing appetite

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is used to modify cognition with rational thinking. It helps people gain a sense of control and increase their confidence. Studies on cancer patients showed that CBT:

• Significantly reduced depression and anxiety
• Improved quality of life
• Reduced pain
• Reduced cancer related fatigue

Exercise

There is a large amount of research on cancer and exercise. Data shows that people who exercise before, during and following cancer treatment experience improvements in:

• Cancer related fatigue
• Pain
• Anxiety
• Depression
• Bone health
• Brain function
• Physical fitness
• Quality of life

Light therapy (for sleep)

There is some data suggesting that light therapy may benefit cancer patients. It is thought light therapy may:

• Help regulate circadian rhythm to improve sleep quality
• Suppress the release of the sleep hormone melatonin during the day, to help increase activity

Massage

Light and relaxing massage is generally safe for people at all stages of cancer. Studies have shown that massage can:

• Decrease pain
• Improve fatigue
• Reduce nausea
• Improve quality of life
• Reduce anxiety

Medicinal cannabis

Medicinal cannabis approved for medical use has the active ingredients delta‐9‐tetrahydrocannabinol (THC) and cannabidiol (CBD). They are generally oral preparations, like oil, spray or capsules. Most products are unregistered and require approval to be prescribed through a special access scheme.

Data suggests medicinal cannabis may have some effect in:

• Treatment of chemotherapy induced nausea and vomiting
• Appetite stimulation
• Pain relief in combination with other pain medications

Meditation

Meditation is a mind-body relaxation technique. It can help train the mind to stay focused and peaceful. There some types of meditation involve movement whilst others involve being still and quiet.

Meditation is known to help cancer patients by:

• Improving sleep
• Reducing pain
• Improving fatigue
• Reducing nausea
• Lowering blood pressure

Mindfulness

Mindfulness is being present in the moment without judgement. It can take practice to notice thoughts, feelings or experiences, then accept them and focus on the present moment.

The use of mindfulness in cancer has shown:

• Reduction in stress, anxiety and depression
• Increased belief in self
• Improved sleep
• Reduced fatigue
• Improvement in pain
• Increased food intake for those underweight

Music therapy

Music therapy can involve listening to or creating music. It can be singing in a choir, playing an instrument.

Music therapy in cancer care can have beneficial effects on:

• Depression
• Anxiety
• Hope
• Pain
• Fatigue
• Heart rate
• Blood pressure
• Quality of life
• Resilience

Nature prescription

Evidence shows that being in nature can make us healthier.

It can improve health in several ways:

• Walking in green spaces can improve physical well being
• Breath work or meditation in nature can improve psychological well being

Nutrition supplements and herbal medicines

Nutrition supplements include herbs, vitamins, minerals and/or probiotics. Very few herbal products have been tested for quality and side effects. Some herbal products can increase the risk of bleeding. There have been rare cases of infection from probiotics.

Check with your treatment team before starting any of these as many can interact with other medications. It may be recommended for you to delay their use until post treatment.

Vitamin C given intravenously (IV) in high doses is widely used by cancer patients. There is no evidence that it treats cancer or helps other cancer treatments. There are ongoing studies on its effectiveness to reduce cancer treatment side effects. There is some evidence that it may help improve:

• Cancer related fatigue

Nutrients | Free Full-Text | High-Dose Vitamin C in Advanced-Stage Cancer Patients (mdpi.com)

There is limited data on benefits but tailored nutritional supplements may be prescribed by your treatment team.

There is currently no evidence that it treats cancer, it has side effects and has the potential to interfere with some cancer treatments.

Qigong

Qigong is mind-body exercise, it uses a combination of meditation, breathing, and movement. Practicing qigong is known to:

• Improve fatigue
• Improve mood
• Help regulate emotion and stress
• Improve sleep

Writing therapy

Writing in a journal about experiences when you have blood cancer may:

• Give permission to express emotions
• Provide a means to reflect on fear and uncertainty

Yoga

Yoga combines poses, breathing techniques, meditation and mindfulness. It can be beneficial in improving adverse symptoms from cancer and its treatment.

There is data to suggest it improves:

• Psychological well being
• Physical health
• Emotional regulation
• Quality of life

Advice Professor David Joske provides to his patients during treatment

1. You need to understand and be committed to your medical plan.
2. You need to make your own plan to manage the situation.
3. Being calm is more important than being positive.
4. Lifestyle management: diet, stress, antioxidants (no evidence of benefit for supplements), exercise, complementary therapies.
5. Leave supplements until after treatment.
6. Exercise is the single best thing you can do to help yourself.
7. Resolve stress – get your life how you want it to be.
8. Trust your instincts.

Watch Complementary Therapies for more information from Professor David Joske.