Anxiety
This is an overview of CAM treatments that have been evaluated by CAM Cancer for cancer-related anxiety. Please click on a CAM treatment below to view an assessment of its safety and efficacy based on the current research status. Please note that this is not a list of recommended treatments and does not suggest that the treatments are safe and effective.
- Safety: Mild adverse effects, such as pain or bleeding at the site of acupuncture can be expected in about 10% of all cases; serious complications seem to be very rare.
- One RCT (n=173) suggested possible beneficial effects of acupuncture in reducing anxiety related to breathlessness. These preliminary findings require further confirmation.
- Read full version of Acupuncture summary.
- Safety: Although essential oils have generally shown minimal adverse effects, when used in appropriate dilutions, allergic reactions can occur with all oils.
Repeated topical administration of lavender and tea tree oil has been associated with reversible prepubertal gynecomastia, consequently there may be issues for cancer patients with oestrogen-dependant tumours. - Evidence is available from 2 SRs and 3 RCTs.
- Aromatherapy massage: There is evidence of beneficial but small effects of aromatherapy massage.
- Aromatherapy inhalation: there is insufficient evidence of consistent effects of inhalation aromatherapy on reducing anxiety.
- Read full version of Aromatherapy summary.
- Safety: Autogenic therapy has a good safety record.
- A pilot RCT (n=31) reported significant improvements in anxiety and depression (HADS) with autogenic therapy added to standard care and an uncontrolled pilot study (n=30) reported improvements in anxiety; however both studies have significant methodological limitations.
- Read full version of Autogenic therapy summary.
- Safety: Biofeedback is considered to have few adverse effects.
- One RCT (n=81, 6 groups) reported improvements in anxiety for electromyography biofeedback and skin-temperature biofeedback in combination with relaxation therapies but not for biofeedback alone.
- Read full version of Biofeedback summary.
- Safety: Hypnotherapy is considered a safe treatment modality when administered by trained professionals. Acute psychoses, severe personality disorders and an inability to be hypnotized are considered contraindications.
- Several recent SRs of randomized and non-randomized controlled trials found positive effects of hypnotherapy on anxiety in cancer patients, including paediatric populations.
- Read full version of Hypnotherapy summary.
- Safety: Classical/Swedish massage is generally considered safe. Contraindications include strong forceful massage in patients suffering from haemorrhagic disorders, low platelet counts, and blood thinning medication.
- A Cochrane review of 3 RCTs found no significant improvements of anxiety with massage compared with no massage. Trials that have reported positive results are in small numbers and at high risk of bias.
- Children: One RCT (n=30) reported that anxiety relief for children was greater for the massage group compared with the no-massage group but the size of this effect was not considered clinically significant.
- Read full version of Massage (Classical/ Swedish) summary.
- Safety: Mindfulness-based stress reduction and mindfulness based cognitive therapy are generally considered to be safe in supportive cancer care.
- Several recent SRs including a Cochrane review have assessed mindfulness for anxiety.
- Mindfulness-based stress reduction: positive short-, medium-, and potentially long-term effects on anxiety in women with breast cancer have been reported. Positive short-, medium-, and long-term effects were also found in mixed cancer types but cannot be applied to specific types of cancer other than breast cancer.
- Mindfulness-based cognitive therapy: might also improve anxiety in women with breast cancer.
- Children: Positive effects in children and adolescents with mixed types of cancer are limited by methodological flaws of the included studies.
- Read full version of Mindfulness summary.
- Safety: No safety issues are on record although caution is advised for acutely distressed and/or emotionally fragile patients, particularly in patients with serious and life-threatening cancers.
- Several SRs including a Cochrane review conclude that music therapy and music medicine both have a moderate to large effect on anxiety compared to usual care, including during active cancer treatment, although not during surgery.
- Read full version of Music therapy summary.
- Safety: PMR is considered to have few adverse effects, although some concern has been raised about the use of relaxation therapy interventions among individuals who have a history of psychiatric disorders.
- PMR has shown positive effects on anxiety compared with no standard care (n=1) but not when compared to other active control interventions (n=4). All trials had methodological limitations.
- Read full version of Progressive Muscle Relaxation summary.
- Safety: As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis or musculoskeletal difficulties.
- Findings are inconclusive: recent SRs either found conflicting data or the review and included studies have methodological limitations that do not allow any firm conclusions.
- Read full version of Qigong summary.
- Safety: Reflexology has a good safety record.
- A 2011 systematic review found that two trials suggested positive results for anxiety while two failed to show convincingly that reflexology is an effective treatment for mood and other cancer-related symptoms.
- Four studies also demonstrated reductions in anxiety/salivary cortisol, but conclusions are limited by their considerable methodological limitations.
- A large (n=385) RCT of women with advanced stage breast cancer did not find any significant changes in anxiety or depression.
- Read full version of Reflexology summary.
- Safety: Reiki has not been associated with any direct safety issues.
- Although there is some evidence that Reiki may reduce anxiety, this is not specific to cancer. Studies in cancer are too poor quality for any conclusions to be made.
- Read full version of Reiki summary.
- Safety: Tai chi appears to be safe. As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis or musculoskeletal difficulties.
- One SR concluded that tai chi may slightly reduce anxiety levels based on a pooled analyses of two low-quality trials.
- Read full version of Tai chi summary.
- Safety: Few adverse events are reported in clinical trials and serious adverse effects appear to be rare. Overall injury rates are comparable to other exercise types.
- Breast cancer: The effects of yoga on psychological health appear to be complex: yoga appears better for anxiety (5 SRs) than psychosocial/educational interventions but no better than no treatment. More recent trials suggest a difference between yoga and no treatment.
- Other cancers: Effects appear positive in the short term based on several small RCTs (n=5).
- Read full version of Yoga summary.