Advances in breast cancer treatment in recent years have saved and extended the lives of tens of thousands of women.

But breast cancer and its treatments can increase the likelihood of anxiety, depression, fatigue, insomnia, pain, stress, and other negative effects.

To ease these side effects, many people with breast cancer—up to 86 percent, according to a study published in Breast Cancer Research and Treatment—turn to complementary therapies, such as acupuncture, dietary supplements, meditation, and yoga.

Can such therapies help? The Society for Integrative Oncology's newly updated guidelines on complementary therapies for use during and after breast cancer treatment looks to answer that question.

In developing the guidelines, 12 researchers from health organizations around the world reviewed studies on more than 80 complementary therapies. They then graded the effectiveness of each at relieving the side effects above. (An A or B grade is a positive recommendation.)

Be aware that these therapies don’t treat breast cancer itself, notes Heather Greenlee, Ph.D., an assistant professor of epidemiology at the Mailman School of Public Health at Columbia University and the lead author of the guidelines. 

And if you have breast cancer, no practitioner you see for complementary therapies should promise a cure. “If it sounds too good to be true, it probably is,” says Linda Carlson, Ph.D., professor in the department of oncology at University of Calgary, one of the authors of the guidelines. She also recommends seeing a credentialed practitioner for any complementary therapy you’re considering.

Here’s what you need to know about the complementary therapies that were found to be most valuable for alleviating the side effects of breast cancer and breast cancer treatment (and one therapy to skip):

Acupressure and Electroacupuncture

Acupressure is a traditional Asian medicine that's similar to acupuncture but involves placing pressure on specific parts of the body, rather than inserting needles. In electroacupuncture, needles are placed in the body—as they are with traditional acupuncture— but a small electric pulse is also passed through the needle.

The researchers found that this helped ease nausea and vomiting in breast cancer patients when used alongside conventional anti-nausea drugs during chemo—and gave these therapies a grade B recommendation.

Finding a practitioner: The National Certification Commission for Acupuncture and Oriental Medicine licenses practitioners in many states.

Massage

Massage generally involves techniques for rubbing the body to promote relaxation and alleviate muscle tension.

Greenlee’s team reviewed several studies—most of them on multi-week massage programs—and found that it was most useful for improving low mood in the aftermath of breast cancer surgery, chemotherapy, or radiation. They gave it a grade B recommendation.

Finding a practitioner: A number of states require massage therapists to be licensed. (You can check your state's requirements here.) You can also find qualified massage therapists through several professional societies, including the American Massage Therapy Association and the Society for Oncology Massage.

If you have cancer, your massage therapist may need to take extra caution with any surgical wounds, medical devices, sensitive skin, or fragile bones.

Meditation

Meditation is meant to foster calmness, focus, and a sense of well-being—achieved by sitting or lying quietly and concentrating on your breath, body, or a specific thought or mantra.

In cancer care, meditation is often taught in multiweek structured courses known as mindfulness-based stress reduction programs.

After looking at studies on meditation—including MSBR programs— Greenlee's researchers gave it an A grade for its ability to improve the general quality of life for people with breast cancer.

They also noted two specific areas where it was deemed worthy of an A grade recommendation: in improving depressive symptoms and lifting the mood of people at different stages of breast cancer treatment (including survivors), and reducing anxiety among breast cancer survivors and people going through radiation treatment.

Finding a practitioner: Some meditation specialists are board certified by the National Meditation Specialist Certification Board. You can also find mindfulness programs through the American Mindfulness Research Association. Your doctor may be able to recommend a meditation program specifically for people who’ve had breast cancer as well.

Music Therapy

Music therapy involves more than simply listening to tunes; it may also incorporate creating or playing, and discussing music in sessions led by professional music therapists.

Greenlee’s team reviewed studies on both passive (mostly listening and relaxing) and active (involving creating music) music therapy. The studies tested whether music therapy could reduce anxiety for people undergoing breast cancer surgery, radiation, or chemotherapy.

They found that passive music therapy was fairly effective (a B grade) at easing anxiety while people were going through breast cancer treatments. In some cases, listening to music even allowed some people to decrease the amount of sedative medications they used during radiation.

Active music therapy wasn’t helpful, however, possibly because it’s simply not as relaxing, the research team suggests.

Finding a practitioner: Music therapists earn college degrees (undergraduate or above) in music therapy and are credentialed by the Certification Board for Music Therapists.

Relaxation Techniques and Stress Management

In these kinds of programs, participants learn to dial down tension.

Stress-management group programs typically offer a variety of stress-reducing strategies, including deep relaxation and meditation, over the course of several weeks. These also sometimes offer one-on-one counseling.

Relaxation programs teach techniques to temporarily reduce your heart rate, blood pressure, and muscle tension, all of which may be elevated because of the stress of cancer treatment, according to Carlson.

When the researchers reviewed the research, they found that stress-management programs were most useful for breast-cancer-related anxiety (B grade). Relaxation therapy was best suited for easing depression and improving mood (A grade).

Finding a practitioner: Relaxation and stress-management programs are usually provided by mental health professionals. Ask your primary doctor or oncologist to help you find a program that’s right for you.  

Yoga

A mind-body practice, yoga may include postures with the body, breathing exercises, meditation, and more.

For the guidelines, Greenlee’s team reviewed several studies. Some looked at types of yoga that include both postures and breathing exercises—such as Hatha—while others emphasized mostly yoga breathing.

The researchers consistently found that no matter which type, yoga was effective enough to receive a B grade for reducing anxiety and depression in people recently diagnosed or going through treatment for breast cancer. Yoga also got a B grade for improving the overall quality of life for those with breast cancer.

Finding a practitioner: The Yoga Alliance is the largest group in the U.S. that issues certification for yoga instructors.

Skip This Therapy: Dietary Supplements

Dietary supplements are some of the most popular complementary therapies used by breast cancer patients and survivors, according to Carlson.

Supplements that have been investigated for their ability to soothe symptoms—such as the nausea and vomiting common after chemotherapy, depression, and fatigue—include acetyl-L-carnitine, ginger, ginseng, glutamine, and guarana.

The problem, she says, is that there’s no evidence that they have any benefit. So the guidelines don’t recommend them.

And these products can have risks—some can interfere with medications you may be taking, for example. In addition, they’re not strongly regulated by the Food and Drug Administration, so you can’t be certain that supplements contain the ingredients on the label.