Integrative Ways to Reduce Side Effects During Breast Cancer Treatment

Printable Version 

What is an integrative approach to cancer care?

Integrative oncology is a patient-centered, evidence-informed field of cancer care that uses mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. - Society for Integrative Oncology

Integrative medicine encourages you to focus on what is important to you in your particular situation. With integrative approaches we aim to help you optimize health, quality of life and become an active partner in your cancer treatment. The suggestions do not interfere with the treatment you are getting from your cancer team, they support it.

Foundational ways to support yourself during cancer treatment

How we eat, move and recharge are key to feeling your best under any situation.

Focus on nourishing foods that are plant based and minimally processed as much as possible. Acknowledge that what you eat will be influenced by tastes change, stomach upset and fatigue. Have easy to prepare foods available. Frozen and many canned vegetables and fruit provide nutrients and phytonutrients that promote health. Eating smaller meals more frequently and avoiding “heavy” meals and foods that have a high fat content can help with GI upset. Sometimes cooked vegetables feel better on your stomach. During chemotherapy taste changes may occur. Choose appealing foods. Cold or room temperature foods may be better tolerated.

The data to support exercise during cancer treatment is very strong.^1,2 The benefit is independent of your choice of movement. Fatigue and other side effects, during cancer therapy may make it harder to be active. Even if you are unable to do as much as before it is important to keep moving. Continuing to move helps with side effects³, improves sleep⁴ and helps you have some control of what is happening. Even if you didn’t exercise before cancer treatment you can safely exercise and gain benefit. Start slow and be consistent. Exercise during a part of the day when you have the most energy. Get friends and family to do it with you.

Recharging through adequate sleep and energy management will help deal with the fatigue that often comes with cancer treatment.⁵ Try to go to bed and get up at the same time every day, even on days when sleep is challenging. On those days, short naps before 2pm can help you feel less fatigued. Get morning sunlight if you can. Avoid caffeine too late in the day. Develop a routine to wind down that might include relaxation techniques, gentile yoga or meditation.

For more detailed information about food choice, movement, and sleep during cancer therapy, please see the “For more information” section at the bottom of this document.

Integrative ways to reduce specific side effects from treatment

• Fatigue is the most common symptom of cancer and its treatment. Daily exercise is a very effective way to improve fatigue.⁶ Almost all forms of exercise studied help. Seek out movement you enjoy. Acupuncture may provide some relief.⁷ Accept help from others for activities like shopping, cooking, cleaning. If there is work that needs to be done including meal preparation, do it during times of the day you have the most energy. Work on improving sleep if sleep is challenging. If you take naps try to have your nap done before 2pm.
  
  
• Anxiety/Stress/Depression. A cancer diagnosis is often a life changing event. Feeling anxious or down is common. There is often added stress related to family, job and finances. Mindfulness based interventions such as mindfulness-based stress reduction or meditation are effective ways to help control anxiety, stress and depression during therapy.⁸ Other helpful interventions include yoga and music therapy.^9,10 Relaxation techniques such as progressive muscle relaxation, guided imagery and breathing interventions can help decrease anxiety during treatment.

Several handouts on Progressive Muscle Relaxation, Guided Imagery, and Breathing practices can be found on the Osher Center for Integrative Health Clinician and Patient Education webpage and in the Mind & Emotions module.

• Nausea and Vomiting. Several chemotherapies cause nausea and vomiting. Your care team will provide you with medications to help. If you have nausea eating smaller meals more frequently can help. Avoid food with strong odors or strong cooking odors. For some people cool or bland foods are better tolerated. If you have a bad taste in your mouth, try hard candy such as peppermint or lemon. Lemon also helps if you have a dry mouth. Ginger can be helpful for nausea and vomiting related to chemotherapy.¹¹ The amount of ginger that is helpful is 500 to 1000mg up to every 8 hours. You can get that in capsules, liquid forms, crystallized ginger. Too much ginger can cause heartburn. If you are taking ginger for nausea, discontinue it before any surgical procedures. Aroma therapy with peppermint and ginger essential oils may also help with nausea.¹² Acupuncture including acupressure may help with nausea and vomiting.¹³ If you are experiencing nausea and vomiting, please talk to your care team. There are effective medicines that can help.
  
  
• Constipation/Diarrhea. Both can occur during cancer therapy. If you have either one, try to drink plenty of fluids. For constipation warm fluids such as coffee can be helpful.¹⁴ So can prune juice.¹⁴ Try to include high fiber foods for meals and snacks. Exercise also helps constipation.¹⁵ For diarrhea eating small amounts more frequently may help. Cooked foods may be better tolerated. Make sure to call your care team if you are having frequent bouts of diarrhea. There are medications they can provide to help.
  
  
• Hot Flashes. Frequently premenopausal women who receive chemotherapy are quickly pushed in to menopause resulting in menopausal symptoms including hot flashes. Some of the medications given with chemotherapy such as steroids can increase hot flashes. Cognitive behavioral therapy and mindfulness may reduce severity of hot flashes.¹⁶ Acupuncture may lessen hot flashes.^17,18 Dressing in layers and sleeping in a cool room are practical suggestions. Some supplements may be helpful. Please select a supplement under the guidance of your care team since some may interfere with your treatment.

NOTE: Dietary supplements are intended to supplement the diet. They are not medicines and are not intended to treat, diagnose, mitigate, prevent, or cure disease. In some cases, dietary supplements may have unwanted effects, especially if taken before surgery or with other dietary supplements or medicines, or if you have certain health conditions. Also, supplements are not regulated with the same degree of oversight as medications. Products vary greatly in terms of accuracy of labels, presence of contaminants, and the validity of claims on the label. Work with your health care provider to determine how best to achieve optimal health.

• Pain. Several cancer treatments may be associated with pain. Acupuncture can help with aromatase inhibitor-related pain and general cancer pain.^19,18,20 It may also help with chemotherapy induced peripheral neuropathy.^21,22 If you want to try acupuncture, ask someone from your care team to place an order for it. Yoga may help with aromatase inhibitor related pain and general pain.²³ Reflexology and acupressure may help with general cancer pain.²¹ Some people find that massage also helps.
  
  
• Range of Motion and Lymphedema. If you had surgery to treat cancer you may have challenges moving your body the way you used to. Your range of motion may be diminished. Lymphedema occurs when lymph nodes are removed. Extra lymph fluid may build up in body tissues and causes swelling. It can occur in your arm or leg on the side of surgery. Risk factors include the extent of surgery, number of lymph nodes removed and radiation. This can happen shortly after surgery or later. If range of motion challenges or lymphedema occurs occupational therapists can help. A specially trained massage therapist can also help.

What we know about integrative health care has come to us thanks to the efforts, experiences, and collective wisdom of people from many cultures and backgrounds. We wish to acknowledge all the healers, researchers, patients, and peoples who have informed the content of this tool.

Author(s)

This handout was adapted for the Osher Center for Integrative Health at the University of Wisconsin-Madison by Kim Dittus MD, PhD.

Date Created: May, 2025

References

1. Ficarra S, Thomas E, Bianco A, et al. Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review. Breast Cancer. May 2022;29(3):402-418. doi:10.1007/s12282-022-01347-z
2. Rodríguez-Cañamero S, Cobo-Cuenca AI, Carmona-Torres JM, et al. Impact of physical exercise in advanced-stage cancer patients: Systematic review and meta-analysis. Cancer Med. Oct 2022;11(19):3714-3727. doi:10.1002/cam4.4746
3. Zheng X, Peng P, Wang Y, et al. The impact of exercise during radiotherapy on treatment-related side effects in breast cancer patients: A systematic review and meta-analysis. Int J Nurs Stud. Mar 2025;163:104990. doi:10.1016/j.ijnurstu.2024.104990
4. Hasan F, Tu YK, Lin CC, Yuliana LT, Romadlon DS, Chiu HY. Exercise regimens for improved sleep quality in adult breast cancer survivors: systematic review and network meta-analysis. BMJ Support Palliat Care. Dec 2023;13(4):393-400. doi:10.1136/spcare-2023-004363
5. Dun L, Xian-Yi W, Si-Ting H, Xin-Yuan Y. Effects of sleep interventions on cancer-related fatigue and quality of life in cancer patients: a systematic review and meta-analysis. Support Care Cancer. Apr 2022;30(4):3043-3055. doi:10.1007/s00520-021-06563-5
6. Medeiros Torres D, Jorge Koifman R, da Silva Santos S. Impact on fatigue of different types of physical exercise during adjuvant chemotherapy and radiotherapy in breast cancer: systematic review and meta-analysis. Support Care Cancer. Jun 2022;30(6):4651-4662. doi:10.1007/s00520-022-06809-w
7. Tian H, Chen Y, Sun M, et al. Acupuncture therapies for cancer-related fatigue: A Bayesian network meta-analysis and systematic review. Frontiers in oncology. 2023;13:1071326. doi:10.3389/fonc.2023.1071326
8. Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis. PloS one. 2022;17(7):e0269519. doi:10.1371/journal.pone.0269519
9. Li Y, Xing X, Shi X, et al. The effectiveness of music therapy for patients with cancer: A systematic review and meta-analysis. Journal of advanced nursing. May 2020;76(5):1111-1123. doi:10.1111/jan.14313
10. Gonzalez M, Pascoe MC, Yang G, et al. Yoga for depression and anxiety symptoms in people with cancer: A systematic review and meta-analysis. Psycho-oncology. Aug 2021;30(8):1196-1208. doi:10.1002/pon.5671
11. Lin CY, Huang SH, Tam KW, Huang TW, Gautama MSN. Efficacy and Safety of Ginger on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cancer nursing. Apr 16 2024;doi:10.1097/ncc.0000000000001355
12. Toniolo J, Delaide V, Beloni P. Effectiveness of Inhaled Aromatherapy on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Journal of alternative and complementary medicine (New York, NY). Dec 2021;27(12):1058-1069. doi:10.1089/acm.2021.0067
13. Yan Y, López-Alcalde J, Zhang L, Siebenhüner AR, Witt CM, Barth J. Acupuncture for the prevention of chemotherapy-induced nausea and vomiting in cancer patients: A systematic review and meta-analysis. Cancer Med. Jun 2023;12(11):12504-12517. doi:10.1002/cam4.5962
14. Johns Hopkins Medicine. Foods for Constipation. Accessed May 6, 2025, https://www.hopkinsmedicine.org/health/wellness-and-prevention/foods-for-constipation#:~:text=Sip%20a%20hot%20beverage,stimulates%20the%20bowels%20as%20well.
15. Johns Hopkins Medicine. Constipation: Causes and Prevention Tips. Accessed May 6, 2025, https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation-causes-and-prevention-tips
16. Carmody JF, Crawford S, Salmoirago-Blotcher E, Leung K, Churchill L, Olendzki N. Mindfulness training for coping with hot flashes: results of a randomized trial. Menopause. Jun 2011;18(6):611-20. doi:10.1097/gme.0b013e318204a05c
17. Lu W, Giobbie-Hurder A, Tanasijevic A, et al. Acupuncture for hot flashes in hormone receptor-positive breast cancer: A pooled analysis of individual patient data from parallel randomized trials. Cancer. Sep 15 2024;130(18):3219-3228. doi:10.1002/cncr.35374
18. Zhang XW, Hou WB, Pu FL, et al. Acupuncture for cancer-related conditions: An overview of systematic reviews. Phytomedicine. Nov 2022;106:154430. doi:10.1016/j.phymed.2022.154430
19. Hershman DL, Unger JM, Greenlee H, et al. Comparison of Acupuncture vs Sham Acupuncture or Waiting List Control in the Treatment of Aromatase Inhibitor-Related Joint Pain: A Randomized Clinical Trial. JAMA network open. Nov 1 2022;5(11):e2241720. doi:10.1001/jamanetworkopen.2022.41720
20. Mao JJ, Ismaila N, Bao T, et al. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. Dec 1 2022;40(34):3998-4024. doi:10.1200/jco.22.01357
21. Klafke N, Bossert J, Kröger B, et al. Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Non-Pharmacological Interventions: Clinical Recommendations from a Systematic Scoping Review and an Expert Consensus Process. Med Sci (Basel). Jan 30 2023;11(1)doi:10.3390/medsci11010015
22. de Sousa TR, Mattos S, Marcon G, Furtado T, Duarte da Silva M. Acupuncture techniques and acupoints used in individuals under chemotherapy or radiotherapy treatment of cancer: A systematic review. Journal of clinical nursing. Oct 2023;32(19-20):6917-6933. doi:10.1111/jocn.16812
23. Carvalho V, Rangrej SB, Rathore R. The Benefits of Integrative Medicine for Pain Management in Oncology: A Narrative Review of the Current Evidence. Cureus. Jun 2023;15(6):e41203. doi:10.7759/cureus.41203