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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer</title>
<author><name sortKey="Greenlee, Heather" sort="Greenlee, Heather" uniqKey="Greenlee H" first="Heather" last="Greenlee">Heather Greenlee</name>
</author>
<author><name sortKey="Balneaves, Lynda G" sort="Balneaves, Lynda G" uniqKey="Balneaves L" first="Lynda G." last="Balneaves">Lynda G. Balneaves</name>
</author>
<author><name sortKey="Carlson, Linda E" sort="Carlson, Linda E" uniqKey="Carlson L" first="Linda E." last="Carlson">Linda E. Carlson</name>
</author>
<author><name sortKey="Cohen, Misha" sort="Cohen, Misha" uniqKey="Cohen M" first="Misha" last="Cohen">Misha Cohen</name>
</author>
<author><name sortKey="Deng, Gary" sort="Deng, Gary" uniqKey="Deng G" first="Gary" last="Deng">Gary Deng</name>
</author>
<author><name sortKey="Hershman, Dawn" sort="Hershman, Dawn" uniqKey="Hershman D" first="Dawn" last="Hershman">Dawn Hershman</name>
</author>
<author><name sortKey="Mumber, Matthew" sort="Mumber, Matthew" uniqKey="Mumber M" first="Matthew" last="Mumber">Matthew Mumber</name>
</author>
<author><name sortKey="Perlmutter, Jane" sort="Perlmutter, Jane" uniqKey="Perlmutter J" first="Jane" last="Perlmutter">Jane Perlmutter</name>
</author>
<author><name sortKey="Seely, Dugald" sort="Seely, Dugald" uniqKey="Seely D" first="Dugald" last="Seely">Dugald Seely</name>
</author>
<author><name sortKey="Sen, Ananda" sort="Sen, Ananda" uniqKey="Sen A" first="Ananda" last="Sen">Ananda Sen</name>
</author>
<author><name sortKey="Zick, Suzanna M" sort="Zick, Suzanna M" uniqKey="Zick S" first="Suzanna M." last="Zick">Suzanna M. Zick</name>
</author>
<author><name sortKey="Tripathy, Debu" sort="Tripathy, Debu" uniqKey="Tripathy D" first="Debu" last="Tripathy">Debu Tripathy</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25749602</idno>
<idno type="pmc">4411539</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411539</idno>
<idno type="RBID">PMC:4411539</idno>
<idno type="doi">10.1093/jncimonographs/lgu041</idno>
<date when="2014">2014</date>
<idno type="wicri:Area/Pmc/Corpus">000683</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000683</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer</title>
<author><name sortKey="Greenlee, Heather" sort="Greenlee, Heather" uniqKey="Greenlee H" first="Heather" last="Greenlee">Heather Greenlee</name>
</author>
<author><name sortKey="Balneaves, Lynda G" sort="Balneaves, Lynda G" uniqKey="Balneaves L" first="Lynda G." last="Balneaves">Lynda G. Balneaves</name>
</author>
<author><name sortKey="Carlson, Linda E" sort="Carlson, Linda E" uniqKey="Carlson L" first="Linda E." last="Carlson">Linda E. Carlson</name>
</author>
<author><name sortKey="Cohen, Misha" sort="Cohen, Misha" uniqKey="Cohen M" first="Misha" last="Cohen">Misha Cohen</name>
</author>
<author><name sortKey="Deng, Gary" sort="Deng, Gary" uniqKey="Deng G" first="Gary" last="Deng">Gary Deng</name>
</author>
<author><name sortKey="Hershman, Dawn" sort="Hershman, Dawn" uniqKey="Hershman D" first="Dawn" last="Hershman">Dawn Hershman</name>
</author>
<author><name sortKey="Mumber, Matthew" sort="Mumber, Matthew" uniqKey="Mumber M" first="Matthew" last="Mumber">Matthew Mumber</name>
</author>
<author><name sortKey="Perlmutter, Jane" sort="Perlmutter, Jane" uniqKey="Perlmutter J" first="Jane" last="Perlmutter">Jane Perlmutter</name>
</author>
<author><name sortKey="Seely, Dugald" sort="Seely, Dugald" uniqKey="Seely D" first="Dugald" last="Seely">Dugald Seely</name>
</author>
<author><name sortKey="Sen, Ananda" sort="Sen, Ananda" uniqKey="Sen A" first="Ananda" last="Sen">Ananda Sen</name>
</author>
<author><name sortKey="Zick, Suzanna M" sort="Zick, Suzanna M" uniqKey="Zick S" first="Suzanna M." last="Zick">Suzanna M. Zick</name>
</author>
<author><name sortKey="Tripathy, Debu" sort="Tripathy, Debu" uniqKey="Tripathy D" first="Debu" last="Tripathy">Debu Tripathy</name>
</author>
</analytic>
<series><title level="j">Journal of the National Cancer Institute. Monographs</title>
<idno type="ISSN">1052-6773</idno>
<idno type="eISSN">1745-6614</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies.</p>
</sec>
<sec sec-type="methods"><title>Methods</title>
<p>Following the Institute of Medicine’s guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system.</p>
</sec>
<sec><title>Results</title>
<p>The search (January 1, 1990–December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (<italic>n</italic>
= 32) had weaker evidence of benefit (Grade C). Some interventions (<italic>n</italic>
= 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-<sc>l</sc>
-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (<italic>n</italic>
= 138) did not have sufficient evidence to form specific recommendations (Grade I).</p>
</sec>
<sec><title>Conclusions</title>
<p>Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Natl Cancer Inst Monogr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Natl. Cancer Inst. Monographs</journal-id>
<journal-id journal-id-type="hwp">jncimono</journal-id>
<journal-id journal-id-type="publisher-id">jncmon</journal-id>
<journal-title-group><journal-title>Journal of the National Cancer Institute. Monographs</journal-title>
</journal-title-group>
<issn pub-type="ppub">1052-6773</issn>
<issn pub-type="epub">1745-6614</issn>
<publisher><publisher-name>Oxford University Press</publisher-name>
<publisher-loc>US</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25749602</article-id>
<article-id pub-id-type="pmc">4411539</article-id>
<article-id pub-id-type="doi">10.1093/jncimonographs/lgu041</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Greenlee</surname>
<given-names>Heather</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Balneaves</surname>
<given-names>Lynda G.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Carlson</surname>
<given-names>Linda E.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Cohen</surname>
<given-names>Misha</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Deng</surname>
<given-names>Gary</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Hershman</surname>
<given-names>Dawn</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Mumber</surname>
<given-names>Matthew</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Perlmutter</surname>
<given-names>Jane</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Seely</surname>
<given-names>Dugald</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Sen</surname>
<given-names>Ananda</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Zick</surname>
<given-names>Suzanna M.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Tripathy</surname>
<given-names>Debu</given-names>
</name>
</contrib>
<contrib contrib-type="author"><collab>for the Society for Integrative Oncology Guidelines Working Group</collab>
</contrib>
<aff id="AF0001"><bold>Affiliations of authors:</bold>
<institution>Department of Epidemiology, Mailman School of Public Health</institution>
(HG, DH),<institution>Herbert Irving Comprehensive Cancer Center, (HG, DH), and Department of Medicine, College of Physicians and Surgeons (DH), Columbia University</institution>
,<addr-line>New York, NY</addr-line>
(HG, DH);<institution>School of Nursing, University of British Columbia</institution>
,<addr-line>Vancouver, BC</addr-line>
, Canada (LGB);<institution>Department of Oncology, University of Calgary</institution>
,<addr-line>Calgary, AB, Canada</addr-line>
(LEC); Institute for Health and Aging,<institution>University of California</institution>
San Francisco, CA (MC);<institution>Chicken Soup Chinese Medicine</institution>
,<addr-line>San Francisco, CA</addr-line>
(MC);<institution>Department of Medicine, Memorial Sloan Kettering Cancer Center</institution>
,<addr-line>New York, NY</addr-line>
(GD);<institution>Harbin Clinic</institution>
,<addr-line>Rome, GA</addr-line>
(MM);<institution>Gemini Group</institution>
,<addr-line>Ann Arbor, MI</addr-line>
(JP);<institution>Ottawa Integrative Cancer Center</institution>
,<addr-line>Ottawa, ON</addr-line>
, Canada (DS);<institution>Canadian College of Naturopathic Medicine</institution>
,<addr-line>Toronto, ON</addr-line>
, Canada (DS);<institution>Department of Family Medicine, University of Michigan Health System</institution>
(AS, SMZ)<institution>, Department of Environmental Health Sciences, School of Public Health</institution>
(SMZ), and<institution>Department of Biostatistics (AS), University of Michigan</institution>
,<addr-line>Ann Arbor, MI (AS, SMZ)</addr-line>
;<institution>Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center</institution>
,<addr-line>Houston, TX</addr-line>
(DT).</aff>
</contrib-group>
<author-notes><corresp id="c1"><bold>Correspondence to:</bold>
Heather Greenlee, ND, PhD, MPH, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722W. 168th Street, 7th Floor, New York, NY 10032 (e-mail: <email>hg2120@columbia.edu</email>
).</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>4</day>
<month>11</month>
<year>2014</year>
</pub-date>
<volume>2014</volume>
<issue>50</issue>
<fpage>346</fpage>
<lpage>358</lpage>
<permissions><copyright-statement>© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><sec><title>Background</title>
<p>The majority of breast cancer patients use complementary and/or integrative therapies during and beyond cancer treatment to manage symptoms, prevent toxicities, and improve quality of life. Practice guidelines are needed to inform clinicians and patients about safe and effective therapies.</p>
</sec>
<sec sec-type="methods"><title>Methods</title>
<p>Following the Institute of Medicine’s guideline development process, a systematic review identified randomized controlled trials testing the use of integrative therapies for supportive care in patients receiving breast cancer treatment. Trials were included if the majority of participants had breast cancer and/or breast cancer patient results were reported separately, and outcomes were clinically relevant. Recommendations were organized by outcome and graded based upon a modified version of the US Preventive Services Task Force grading system.</p>
</sec>
<sec><title>Results</title>
<p>The search (January 1, 1990–December 31, 2013) identified 4900 articles, of which 203 were eligible for analysis. Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B). Many interventions (<italic>n</italic>
= 32) had weaker evidence of benefit (Grade C). Some interventions (<italic>n</italic>
= 7) were deemed unlikely to provide any benefit (Grade D). Notably, only one intervention, acetyl-<sc>l</sc>
-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. The majority of intervention/modality combinations (<italic>n</italic>
= 138) did not have sufficient evidence to form specific recommendations (Grade I).</p>
</sec>
<sec><title>Conclusions</title>
<p>Specific integrative therapies can be recommended as evidence-based supportive care options during breast cancer treatment. Most integrative therapies require further investigation via well-designed controlled trials with meaningful outcomes.</p>
</sec>
</abstract>
<counts><page-count count="13"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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