Quality of life

This is an overview of CAM treatments that have been evaluated by CAM Cancer for Quality of life (QoL). The CAM treatments have been categorized according to the currently available level of evidence. Please click on the different categories to view the assessment efficacy and safety of the outcomes. Please note that this is not a list of recommended treatments.

Please also see our summaries on  Wellbeing

Ginseng (Panax ginseng)

Efficacy
Asian ginseng (Panax ginseng): The available evidence suggests P.  ginseng to be effective for QoL. Out of four RCTs (ranging from 30 – 112 participants), three found it significantly improved QoL (low-moderate quality evidence), and the remaining one found a trend that was, however, not significant (high-quality evidence). 

Safety
Generally considered safe, with only minor adverse drug reactions reported. Mainly gastrointestinal intolerances, headaches, and sleep disorders have been reported. These are dose-dependent, infrequent, and transient. 

Read the full version of the Ginseng summary.

Green tea

Efficacy
The available evidence suggests green tea to be effective on QoL. A SR (n=4 RCTs) found a slight improvement in QoL in three RCTs and no effect in the fourth RCT.  

Safety
Green tea prevention is generally safe with moderate, regular, and habitual use, with only transient and mild adverse events. Adverse effects reported included various gastrointestinal problems, effects on liver enzymes, and allergic reactions. Liver-related adverse effects have been reported, particularly with high intakes or in those with existing liver disease. 

Read the full version of the Green tea summary.

Mindfulness

Efficacy
Mindfulness-based stress reduction (MBSR): The available evidence suggests that MBSR has short and medium effects on QoL among women with breast cancer. Three out of four SRs (n=7, n=10, n=14 RCTs) found that MBSR improves QoL. One SR (n=4 mixed study designs) evaluated the effect of MBSR on QoL among children and found a positive effect. Results must be interpreted with caution due to the low methodological quality of the included trials. 

Mindfulness-based cognitive therapy (MBCT):  available evidence suggests MBCT to be effective for QoL. Three RCTs (n=100, n=129, n=137) evaluated the effect of MBCT on QoL; two found MBCT improved QoL, and the third one found no effect. 

Safety
Mindfulness-based approaches are generally considered safe in supportive cancer care. However, no rigorous assessment of their safety in cancer patients is available.

Read the full version of the Mindfulness summary.

Mistletoe

Efficacy
The available evidence suggests mistletoe to be effective for QoL. The evidence is based on six SRs (ranging from 12 to 46 mixed study designs). All the systematic reviews found mistletoe to have a beneficial effect on QoL. 
 
Safety

Mistletoe is generally considered safe, with only transient and mild adverse effects. 
Common adverse events include soreness and inflammation at injection sites, headache, fever and chills.

Read the full version of the Mistletoe summary. 

Music interventions

Efficacy
The evidence suggests music interventions to be effective on QoL. An overview of thirteen SRs found improvements on QoL. Five SRs (ranging from 11 to 81 mixed study designs) not included in the overview also found that music interventions improved QoL. One of the latter SRs evaluated paediatric populations. 

Safety
Generally considered safe with no safety issues on record. Caution is advised for acutely distressed and/or emotionally fragile patients, particularly in patients with serious and life-threatening cancers.

Read the full version of the Music intervention summary.

Progressive Muscle Relaxation

Efficacy
The evidence suggests progressive muscle relaxation to be effective on QoL. One SR (n=12 RCTs) and one CCT (n=138) found significant improvement in QoL. One RCT (n=63) found no effect on QoL among women with breast cancer. 

Safety
Generally considered safe when administered by a qualified practitioner. Some concerns have been raised about the use of relaxation therapy interventions among individuals who have a history of psychiatric disorders.

Read the full version of the Progressive Muscle Relaxation summary.

Qigong

Efficacy
The evidence suggests qigong to be effective on QoL. Seven SRs (including 11- 17 mixed study designs) and one RCT (n=80) suggest qigong improves QoL; however, three of the SRs made no distinction between qigong and tai chi. Some of the SR and RCT evaluated specific cancer types such as breast, lung, and gastrointestinal.

Safety
Generally considered safe when administered by a qualified practitioner. 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.

Read the full version of the Qigong summary.

Yoga

Efficacy
Breast cancer: The available evidence suggests yoga to be effective on QoL.  The conclusion is reached from the results of six SRs (including 7 to 24 RCTs).
Other cancers: The available evidence on yoga for QoL is inconclusive. The conclusion is reached from the results of three RCTs (n=54, n=62, n=68). Two RCTs found no effect, and one found a small effect. 

Safety
Generally considered safe when administered by a qualified practitioner. 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.

Read the full version of the Yoga summary.

Aromatherapy

Efficacy
The available evidence is contradictory on the effect of aromatherapy on quality of life. The results are based on two SRs (n=4 RCTs, n=9 RCTs). Both SRs found conflicting results in the studies included, and one SR found that the studies were of low methodological quality. 

Safety
Generally safe and only associated with minimal adverse effects when used in appropriate dilutions. Allergic reactions can occur with all oils. Should not be used undiluted.

Read the full version of the Aromatherapy summary. 

Astragalus spp

Efficacy
The available data on the effect of astragalus on QoL is inconclusive. One RCT (n= 136) found significant improvements in QoL while one small RCT (n=17) found no significant results. 

Safety
Generally, it is well tolerated and considered safe when good-quality products are used.  
Safety research is needed, particularly for possible herb-drug interactions. 

Read the full version of the Astragalus spp summary.

Curcumin

Efficacy
The evidence for the effect of curcumin on QoL is of low methodological quality. A RCT (n=80) and a CCT (n=160) found QoL significantly improved among those treated with curcumin but the methodological limitations prevent any firm conclusions. 

Safety
Curcumin is generally considered safe at doses up to 12g daily for several months. 
It has been recognized as safe (GRAS) by the US FDA.   

Read the full version of the curcumin summary.

Fermented wheat germ extract

Efficacy
Few trial data are available for the effect of FWGE on QoL. Although two non-randomized trials (n=16, n=60) found that FWGE improved QoL, the results need to be interpreted with caution, as the trials were not randomized, and the sample sizes were small. 
 
Safety
Fermented wheat germ extract is generally considered safe with only transient and mild adverse events.  Adverse effects include diarrhoea, nausea and vomiting, flatulence and constipation.

Read the full version of the Fermented wheat germ extract summary.

Ginseng

Efficacy
American ginseng (Panax quinquefolius): The available evidence on the effect of American ginseng on QoL is inconclusive. One RCT (n=282) found a positive but not significant trend for positive effects; the study was of as a high-quality evidence. 

Safety
Generally considered safe, with only minor adverse drug reactions reported. Mainly gastrointestinal intolerances, headaches, and sleep disorders have been reported. These are dose-dependent, infrequent, and transient. 

Read the full version of the Ginseng summary.

Homeopathy

Efficacy
The evidence on the effect of homeopathy on QoL is inconclusive. One SR (n=7 RCTs) found three RCTs that reported positive effect of homeopathy on QoL and the remaining four found no significant effects.

Safety
Generally safe, and there are no serious direct risks associated with homeopathy. There are indirect risks if homeopathic preparations are used in place of conventional cancer treatment. 

Read the full version of the Homeopathy summary.

Mindfulness

Efficacy
Mindfulness-based stress reduction: The evidence on the effect of mindfulness on QoL is inconclusive due to low methodological quality. One SR (n=4 mixed study design) evaluated the effect of MBSR on QoL among children and found a positive effect, but the studies included had low methodological quality.  

Safety
Mindfulness-based approaches are generally considered safe in supportive cancer care. However, no rigorous assessment of their safety in cancer patients is available.

Read the full version of the Mindfulness summary.

Ornish diet

Efficacy
Few trial data are available on the effect of the Ornish diet on QoL. One RCT (n=93) found overall QoL improved with the Ornish diet.

Safety
The safety of the Ornish diet has not been systematically assessed.  Trial results to date indicate the absence of adverse effects.
 
Read the full version of the Ornish diet summary. 

Reiki

Efficacy
The available evidence on reiki for QoL is inconclusive and of low methodological quality. Three RCTs (n=26, n=36, n=58) evaluated the effect of reiki. Two RCTs found a significant improvement in QoL but had low methodological quality. The last trial found no significant difference. 

Safety
Generally considered safe when administered by a qualified practitioner.  

Read the full version of the Reiki summary.

Tai chi

Efficacy
The available evidence of tai chi on QoL is inconclusive due to conflicting results and low methodological quality. Five SRs (including 9-26 mixed study designs) evaluated the effectiveness of tai chi for QoL. Three of the five SRs (n=15, n=16, n=22) found positive effects of tai chi; the remaining two SRs found no significant difference. Four of the five SRs had low methodological quality. 

Safety
Generally considered safe when administered by a qualified practitioner. 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.

Read the full version of the Tai chi summary.

Therapeutic touch

Efficacy 
Few data are available on therapeutic touch for QoL. One RCT (n=20) found significant effects but is very small and has methodological limitations. 

Safety
Generally considered safe when administered by a qualified practitioner, no serious safety concerns are known.

Read the full version of the Therapeutic touch summary.

Yoga

Efficacy
Mixed cancers: The available evidence on yoga for QoL is contradictory. The conclusion is reached from the results of three RCTs (n=54, n=62, n=68). Two RCTs found no effect, and one found a small effect. 

Safety
Generally considered safe when administered by a qualified practitioner. 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.

Read the full version of the Yoga summary.

Cannabis and cannabinoids

Efficacy
Few trial data are available on the effect of cannabis and cannabinoids on QoL. One RCT (n=56) found no effect of cannabinoids on QoL. 

Safety
Cannabis and cannabinoids are generally considered safe.  Adverse effects on the central nervous system are common (e.g., mood changes, memory disorders, blurred vision, and dizziness); these are dose dependent. Caution is advised during pregnancy and lactation.  The risk of drug interactions is low.

Read the full version of the Cannabis and cannabinoids summary. 

Massage (Classical/Swedish)

Efficacy
The evidence suggests massage not to be effective on QoL. Five SRs have been conducted, ranging from seven to 19 RCTs and CCTs. Four SRs found that massage had no significant effect on QoL.

Safety
Generally considered safe when administered by a qualified professional. Contraindications include strong, forceful massage in patients suffering from haemorrhagic disorders, low platelet counts, and blood thinning medication.

Read the full version of the Massage summary.

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