Mind-body therapies as supportive treatments for cancer? The “CAM-cancer” initiative

CAM-Cancer is short for a project entitled “Concerted Action for Complementary and Alternative Medicine Assessment in the Cancer Field”. Originally funded by the European Commission, it is now hosted by the National Information Center for Complementary and Alternative Medicine (NIFAB) at the University of Tromsø, Norway.

Our executive Committee is very international and, in my view, fairly balanced; it consists of the following experts:

• Prof Vinjar Fønnebø, The Norwegian National Research Center in CAM
• Prof Thomas Cerny, Kantonsspital St Gallen, Switzerland
• Prof Edzard Ernst, University of Exeter, UK
• Dr Markus Horneber, Department of Oncology/Hematology, Klinikum Nuernberg, Germany
• Dr Christine Paludan-Müller, Danish Cancer Society

Our work consists mainly of conducting and updating systematic reviews of treatments often used by cancer patients and providing them for free via the Internet. To date, we have concluded more than 60 such projects and they are all available for anyone to study. I have previously reported about our results in the area of herbal medicine. Today, I will briefly mention those on mind-body interventions.

The Internet is awash with information on the effectiveness of such treatments which is not always accurate, and even top-journals publish reviews which paint a rather optimistic picture: Mind-body therapies categorized as CAM could potentially serve as a positive platform from which providers could discuss CAM and even link survivor subgroups to services that may, at least, partly address unmet psychosocial needs. This would be especially relevant for survivor subgroups that have a cultural bias toward CAM. The mind-body therapies reviewed in this article have some supportive evidence and a rationale for use in cancer survivors. Although data on efficacy and mechanisms of action of mind-body therapies are incomplete and inconclusive, the potential benefits of using these therapies in survivor care plans warrant consideration.

By contrast, our reviews seem far less positive. Here are the key sentences describing the evidence of the four mind-body therapies that we at ‘CAM cancer’ have so far tackled.

• Based on one clinical trial and two pilot studies, it is not possible to draw conclusions about the effectiveness of autogenic therapy for people with cancer
• There is presently a lack of good quality, single-intervention trials, so it is not possible to draw clear conclusions about the efficacy of biofeedback for people with cancer
• Existing evidence suggests that hypnotherapy may reduce cancer therapy related pain, anticipatory nausea and vomiting, and anxiety
• There is insufficient evidence for the effectiveness of PMR for cancer patients suffering from pain, anxiety, depression, sleep disorders and chemotherapy-induced nausea

The question is, what precisely does that mean? I think this evidence is compatible with several interpretations:

1. Mind-body therapies are generally over-rated but not really that helpful.
2. They are effective, but the research is in its infancy and currently fails to document their value adequately.
3. Some mind-body therapies are effective, while others are not.

At present, it is impossible to tell which interpretation is correct. What is clear, however, is the fact that ‘CAM-Cancer’ is a source that tries its utmost to inform people accurately while doing everything possible to minimise bias.