Breast Cancer

Key Points

Including quick links to sections of this page

Integrative breast cancer care has a remarkable amount to offer you. It can add to your treatment, help with with side effects, benefit your quality of life, help you get well again, and reduce your risk of recurrence. Psychologically and spiritually, it can have transformative effects.

Let’s be clear: integrative cancer care means skillful choices in both conventional and complementary cancer therapies.

The very first step is deciding what your goals are. Your goals will guide you in choosing conventional therapies. No matter what conventional therapies you choose, our 7 Healing Practices can be beneficial in many ways—physical, emotional, mental and spiritual. They are the foundation to strengthen you for rigorous conventional therapies, reduce side effects, build health and help reduce the risk of recurrence.

Beyond the 7 Healing Practices you will find many specific integrative therapies to explore. Don’t let the number of choices deter you. We’ve arranged them in an easy order to consider, starting with those with the greatest safety, efficacy, and ease of access. Also, don’t overlook our special category of overlooked and neglected cancer approaches (we call them ONCAs). They have a lot to offer even if lifestyle changes seem too hard at this point.

I’ve known quite a few 20-year survivors of metastatic breast cancer—and I have known hundreds of women who have far outlived a metastatic prognosis.

Don’t try to take all this in one bite. Take small bites, and come back as you are ready for more.

We do this for you. We hold you in our thoughts and prayers,

Michael Lerner

Not only will conventional treatment vary from one person to the next, but integrative breast cancer care will vary and should be individualized.

Diagnostic Testing

Advanced and non-standard diagnostic tests, some specific for breast cancer, are available. These tests can often identify specific therapies that will be most effective. Some require pre-planning for collection and shipping of live tissue samples. See Diagnostic Approaches and De-escalation of DCIS Treatment (below).

Integrative Care in Breast Cancer

Before investigating integrative care in breast cancer, we recommend reviewing integrative cancer care in general.

Breast cancer is many different diseases. Not only will conventional treatment vary from one person to the next, but integrative breast cancer care will vary and should be individualized. For instance, some therapies that enhance specific immune functions may actually heighten cancer growth and progression in some types of breast cancer while inhibiting growth and progression in other types.1

Read more

Clinical Practice Guidelines

Further Clinical Practice Guidelines

The Society for Integrative Oncology (SIO), the leading organization of its kind, has conducted a monumental review of randomized control trials of complementary therapies in breast cancer care.4 From this review, SIO created integrative care guidelines.

Read more

Integrative Plans, Protocols and Medical Systems

Read more

Three Examples of Integrative Approaches

Read more

Block Center Program Supplements

Supplements used in the 2009 study of advanced metastatic breast cancer patients:18

Read more

The Block Center for Integrative Cancer Treatment (BCICT)

Read more

Bastyr Integrative Oncology Care: A Naturopathic Oncology Approach

Bastyr Breast Cancer Study Supplements

No one "Bastyr protocol" exists, as researchers continue to investigate and refine approaches. Supplements used in one Bastyr protocol for breast cancer:21

Expand list

Read more

Dr. Kleef: Hyperthermia, Immunology and Integrative Oncology Program

Read more

The Ecology of Breast Cancer

The Ecology of Breast Cancer: The Promise of Prevention and the Hope for Healing by BCCT advisor Ted Schettler, MD, MPH, is one of the best sources of information on lifestyle and environment in relation to breast cancer risk and outcomes.

Dr. Schettler proposes that individual body terrain is shaped across the lifespan by all levels, from individual to societal. “Efforts to change the design of that terrain can continue throughout life, so that breast cancer or its recurrence after initial treatment is less likely."

The Ecology of Breast Cancer

Integrative Therapies in Breast Cancer

7 Healing Practices: The Foundation

Adding Up Benefits

Studies show that while a single lifestyle practice—such as a healthy diet or exercise—show benefit, combining practices is even more powerful.25

Breast cancer patients who adopted a healthier diet and regular exercise lowered their risk of relapse by nearly half, an effect seen in both obese and nonobese women.26

Read more

The 7 Healing Practices listed here all promote wellness and tend to make your body terrain less hospitable to the development and progression of cancer. Some practices address cancer symptoms and side effects.

Eating Well

Read more

Moving More

Read more

Managing Stress

Read more

Sleeping Well

Read more

Creating a Healing Environment

Read more

Sharing Love and Support

Read more

Exploring What Matters Now

Read more

Beyond the 7 Healing Practices: Further Integrative Therapies

Complementary therapies and lifestyle practices can be useful to enhance treatment effects, improve quality of life and possibly even extend life for those with breast cancer.

Read more

We present natural products and off-label, overlooked and novel cancer approaches (ONCAs) in five categories:

  1. Good evidence of efficacy and safety, with easy acces
  2. Good evidence of efficacy and safety but limited access
  3. Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols
  4. Limited evidence of efficacy, or significant cautions, or may interfere with treatments (any combination of these three criteria)
  5. Evidence of no efficacy or may be dangerous

Other integrative therapies and approaches are described but not categorized. See the full summaries as linked for more information on each of these therapies.

Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

The role of each of the 7 Healing Practices in arresting or reducing breast cancer growth and spread is described above. 

Natural Products

Debu Tripathy, MD, writes that “herbal and botanical agents have significant potential as bioactive agents that can affect cellular pathways involved in breast cancer, but may also cause side effects and drug interactions. . . Caution should be exercised when used with other treatments.”69

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Therapy Notes
Flaxseed lignans
  • Clinical evidence of anticancer effects among newly diagnosed breast cancer patients
  • Observational evidence of lower mortality among breast cancer patients
  • Limited evidence it reduces radiation therapy-induced lung damage
Ginseng (About Herbs)
  • Epidemiological data show improved survival in breast cancer patients with ginseng use
Melatonin
  • Protects normal reproductive cells during chemotherapy
  • Increases survival time
Omega-3 fatty acids
  • Evidence from laboratory and clinical studies that eicosapentaenoic acid (EPA) has antitumor effects and is associated with improved clinical and biologic parameters
Turkey tail mushroom
  • Direct anticancer effects resulting in reduced tumor growth and metastasis
  • Enhances the effectiveness of chemotherapy and radiation therapy against cancer cells while protecting normal cells
  • Extends survival in patients with certain types of breast cancer
  • Improves the survival curve of people with operable breast cancer with vascular invasion
Vitamin D (in doses up to 4000 IU per day for adults)
  • Deficiency is associated with these outcomes
    • Lower odds of receiving a pathologic complete response to breast cancer treatment
    • Breast cancer metastasis
  • Higher vitamin D status is strongly associated with better breast cancer survival
  • Vitamin D supplementation plays an important role in disease-free survival in a number of cancers, particularly breast

Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

(None)

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

Read more

Category 4: Limited evidence of efficacy, or significant cautions, or may interfere with treatments

May involve any combination of these three criteria. May be used in leading integrative oncology plans and protocols.

Read more

Category 5: Evidence of no efficacy or may be dangerous

Read more

Off-label, Overlooked or Novel Cancer Approaches (ONCAs)

Off-label drug use involves a physician prescribing a drug for a disease or condition not approved by the FDA. Prescribing drugs off-label is legal if sufficient evidence indicates its usefulness for the condition or disease prescribed. However, different state medical boards have varying standards regarding off-label use of specific drugs.

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Therapy Notes
Chronomodulated therapies
  • Good evidence of reducing toxicity and improving response to chemotherapy

Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

Read more

Category 4: Limited evidence of efficacy, or significant cautions, or may interfere with treatments

May involve any combination of these three criteria. May be used in leading integrative oncology plans and protocols.

Read more

Diets and Metabolic Therapies

Read more

Read more

Managing Side Effects and Promoting Wellness

Compelling evidence shows that stress reduction significantly improves quality of life after initial treatment of breast cancer and beyond.

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

The role of each of the 7 Healing Practices in managing symptoms, improving quality of life and  promoting wellness is described above.

Natural Products

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Therapy Notes
Ginger
  • Evidence for adding to antiemetic drugs to control nausea and vomiting during chemotherapy
Ginseng (About Herbs)
  • Evidence for improving fatigue during treatment
  • Epidemiological data show improved quality of life in breast cancer patients with ginseng use
Omega-3 fatty acids
  • Evidence from laboratory and clinical studies that eicosapentaenoic acid (EPA) has anticachectic (muscle wasting) effects and is associated with improved quality of life 
Probiotics
  • Evidence that probiotics are useful in reducing enteritis related to radiation therapy and Fluorouracil (5-FU), as well as reducing diarrhea induced by 5-FU and Irinotecan
Vitamin D (in doses up to 4000 IU per day for adults)
  • Improved bone health when used with calcium in breast cancer patients
  • Increased doses are needed with concomitant steroid uptake

Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

Read more

Category 4: Limited evidence of efficacy, or significant cautions, or may interfere with treatments

May involve any combination of these three criteria. May be used in leading integrative oncology plans and protocols.

Read more

Category 5: Evidence of no efficacy or may be dangerous

Read more

ONCAs

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

(None)

Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

Read more

Diets and Metabolic Therapies

Periodic fasting shows benefits on side effects during chemotherapy treatment:

Read more

Mind-Body Approaches

Energy Therapies

Manipulative and Body-based Methods

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Risk Factors

Generally accepted individual risk factors for breast cancer include these, with varying levels of association:

Expand list

Although these are important, they do not fully explain why many people develop breast cancer. Lifestyle and environment influence both the risk of developing breast cancer and recurrence after treatment.

It Takes a Village (or a Whole Country) to Reduce the Risk of Breast Cancer

Reducing these risk factors “cannot be accomplished by individuals alone. Public health strategies to re-shape the terrain are essential.” Many of these can only partially be addressed by changes in individual behavior. Multi-level public-health and policy interventions at the population level are also necessary in order to re-design system conditions in more favorable ways.

Read more

From Dr. Ted Schettler's The Ecology of Breast Cancer:155

Breast cancer risk factors help shape conditions that foster vulnerability to the disease and less favorable outcomes. Risk factors for which the strength of evidence varies from strong to probable to plausible:

Expand list

The role of each of the 7 Healing Practices in reducing the risks of breast cancer development and recurrence is described above. Two further factors—alcohol use and breast feeding—are discussed here.


Alcohol Intake

Alcohol consumption is a recognized risk factor—among those with the strongest evidence—for developing breast cancer.156

Read more

Breastfeeding

Breastfeeding brings many benefits to the mother as well as the infant, including reducing the mother’s risk of breast cancer.160

Read more

Therapies to Reduce Risk

The role of each of the 7 Healing Practices in reducing risk is described above.

Natural Products

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

Therapy Notes
Green tea
  • Consuming greater than 5 cups per day is associated with lower breast cancer onset and cancer recurrence in those with early stages of breast cancer
Lycopene
  • Large, population-based studies associate lycopene with lower risk of estrogen-receptor-positive (ER+) and progesterone-receptor-positive (PR+) breast cancers
Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

(None)

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

Read more

Category 4: Limited evidence of efficacy, or significant cautions, or may interfere with treatments

May involve any combination of these three criteria. May be used in leading integrative oncology plans and protocols.

Read more

Off-label, Overlooked and Novel Cancer Approaches (ONCAs)

Category 1: Good evidence of efficacy and safety, with easy access

These therapies may be widely used in integrative cancer protocols and traditional medical systems.

(None)

Category 2: Good evidence of efficacy and safety but limited access

Some may require a prescription, for example.

Read more

Category 3: Limited evidence of efficacy but good safety, used in leading integrative oncology plans and protocols

(None)

Category 4: Limited evidence of efficacy, or significant cautions, or may interfere with treatments

May involve any combination of these three criteria. May be used in leading integrative oncology plans and protocols.

Read more

Diets and Metabolic Therapies

Read more

Advice from Medical Advocate and Breast Cancer Survivor
Gwendolyn Stritter, MD

Dr. Stritter is a BCCT advisor.

As a breast cancer medical advocate, I find there are certain areas that patients are really grateful to learn about. Here are a few:

Regional Anesthesia for Mastectomy


Dr. Stritter's "pole dance" following her double mastectomy

Performing certain nerve blocks (paravertebral or pectoral) before surgical incision allows for “light" general anesthesia. This in turn results in quickly “waking up” from anesthesia without nausea or prolonged grogginess. It also lowers the chance of post-mastectomy chronic pain that, unfortunately, is not uncommon.190 Giving opioids (like morphine) for pain control during and after surgery can be minimized or even avoided entirely. Enough evidence shows that regional anesthesia lowers the chance of subsequent relapse and metastasis.191 A formal clinical trial is looking at this very issue: Regional Anesthesia and Breast Cancer Recurrence.

Read more

Hormone Therapy before Surgery

Anti-estrogen therapy, typically started after surgery, prevents breast cancer relapse and death in ER+ cancers. However, some patients do not relapse even if they do not take anti-estrogen medication. Other patients will relapse despite taking them. This means a significant number of patients taking anti-estrogens suffer from the adverse effects of treatment without the benefit of improved outcomes. Taking anti-estrogens before surgery reveals those who would not respond to such treatment, thus saving 5 to 10 years of ineffective therapy. Another benefit of neoadjuvant hormone therapy: good outcomes despite less aggressive surgery, such as lumpectomy instead of mastectomy.  

Read more

De-escalation of DCIS Treatment

60 percent of the patients with DCIS would not progress to invasive breast cancer even without any treatment whatsoever. But not knowing which patient will progress, combined with the potential for metastasis in those who do progress, has understandably led oncologists to overtreat everyone in the hopes of improving the survival of the 40 percent who are at risk.

Read more

Taking Care of Your Heart: Cardiac Toxicity and Breast Cancer Treatment

People with breast cancer who are undergoing chemotherapy such as anthracylines (including Adriamycin/doxorubicin), targeted agents such as Herceptin/trastuzumab, and radiation therapy to the chest are at risk for heart damage. Risk is even higher for those receiving anthracyclines plus Herceptin or anthracyclines plus chest radiation.

Read more

Some complementary therapies may be helpful.

Read more

Read more

Read more

Breast Reconstruction: Now More Options


Dr. Deb's operating room flash mob before her double mastectomy

Two basic types of breast reconstruction are available after mastectomy:

  1. Breast implants
  2. Flap reconstruction using tissue from your own body to reconstruct the breast

Further options are available within those two categories. To learn more about the standard post-mastectomy breast reconstruction options, see an online decision aid called BRECONDA: Breast Reconstruction Decision Aid.

Read more

Written by Laura Pole, RN, MSN, OCNS, and Michael Lerner, PhD. Reviewed by Ted Schettler, MD, MPH, and Nancy Hepp, MS; most recent update on November 13, 2018.

View All References

More Information

Enter your comments or questions below.

Comments (0)




Allowed tags: <b><i><br>Add a new comment: